The news has been filled with reports of the trade imbalance with China, and recently our president encouraged India to increase trade with the US. We need to increase our exports. But, there’s one kind of export the world should reject, because we have rejected it for ourselves. It has to do with informed consent and research.
You’ve probably heard about an apology from the US government to the people of Guatemala for a syphilis trial conducted in the 1940s. Our scientists deliberately infected hundreds of Guatemalan men with syphilis and gonorrhea. Researchers wanted to study the prevention and treatment of STDs. Prisoners, solders and even patients in mental asylums were infected through prostitutes provided by the scientists. Or, some were directly inoculated with an STD. In all, 1500 Guatemalans were used as subjects for these experiments. We traded access to penicillin for the permission of the Guatemalan authorities.
Today, we are naturally revolted at the thought of our government—or any government—treating human beings as guinea pigs, to be poked, prodded, or infected with serious diseases.
Ten years before the Guatemalan study, African American men were deliberatly infected with syphilis in a study that lasted until 1972. Even after the discovery of penicillin in the 1940s, they were denied the drug. This and other unethical experiments triggered the 1978 Belmont Report. The Belmont Report established ethical principles for conducting research with human subjects.
First, the human person must be respected. How? They must voluntarily consent to be part of the study or drug trial. That means clearly informed consent (truthfully telling all the facts and risks), no lies, and no coercion. The Belmont Report came too late for the Guatemalan trial patients. They “were not informed of the purpose of the study and did not provide consent.”[1]
Second, the research must be beneficent, according to the first principle of medicine: “do no harm.” Maximize the benefits of research while minimizing the harms. Researchers in the Guatemalan trial failed on both accounts. Individual human subjects were harmed through deliberate infection, and some were denied treatment.[2]
Third, is the principle of justice. This means don’t exploit vulnerable populations like the poor, the imprisoned and the mentally ill. This study was fundamentally unjust as it specifically targeted highly vulnerable Guatemalans who were not allowed to benefit from the research.
As Christians we know that each human life has been created in the image of God and must be respected. The US government was right to apologize for such an atrocious chapter in American history. Ethical human subject research requires that we follow the three principles of respect for persons, beneficence, and justice.
This is the kind of export we want to increase.
[1] U.S. Department of Health and Human Services, “Fact Sheet on the 1946-1948 U.S. Public Health Service Sexually Transmitted Diseases (STD) Inoculation Study,” http://www.hhs.gov/1946inoculationstudy/factsheet.html (accessed October 29, 2010).
[2] Ibid.