"Eticamente impossível": quando cientistas agem criminosamente em nome do Estado

sexta-feira, setembro 23, 2011

Michael Cook | Thursday, 22 September 2011
tags : bioethics, Guatemala, utilitarianism

“Ethically impossible”

Are there any lessons for the future in the scandalous story of American syphilis research in Guatemala?

For the past year, it has been bioethical bow, scrape and grovel time in Washington DC. After learning that American public health researchers had infected hundreds of Guatemalans with venereal diseases between 1946 and 1948, President Obama had to telephone his Guatemalan counterpart to apologize. He then set up a commission to investigate the appalling story of coercion and deception. A detailed historical report was published on September 13.

The tale came to light long after the doctors and participants had passed away. After World War II thousands of STD-infected servicemen were being demobbed. American public health officials needed to know more about the effectiveness of the new miracle drug penicillin to control the spread of STDs in the US. After research on volunteers in an Indiana prison, they went to Guatemala.

With the cooperation of local officials, Dr John C. Cutler, a Public Health Service physician, first selected men in the Guatemala National Penitentiary, then men in an army barracks, and then men and women in the National Mental Health Hospital.

The Commission concluded that researchers deliberately exposed about 1,300 inmates, psychiatric patients, soldiers and commercial sex workers to syphilis, gonorrhoea or chancroid. Permissions were obtained from government authorities but not from individuals.

Initially the doctors used prostitutes with the disease to infect the prisoners (since sexual visits were allowed by law in Guatemalan prisons). When “normal exposure” failed to infect, they did direct inoculations. These were made from syphilis bacteria poured onto the men’s penises, forearms or faces after lightly abrading them. In some cases they used spinal punctures. The subjects were given penicillin after they contracted the illness.

In the 1950s Dr Cutler also worked on a project which became an even bigger scandal, the Tuskegee syphilis study. But he eventually became “a much beloved professor” at the graduate school of public health at the University of Pittsburgh. He died in 2003. The findings of his research in Guatemala were never published and his notes gathered dust in university archives – until they were unearthed by a historian at Wellesley College, Susan M. Reverby. Like most of the research done by Nazi doctors, it had been a waste of time. “What stings the most in terms of bad science is that it never passed peer review and was never published,” one member of the commission said.

Even by the standards of the time, this project was regarded as unethical. After all, only a few months before, Nazi death camp doctors had been condemned to death and long prison terms for medical experiments conducted without informed consent. Principles later formalised as the Nuremberg code of medical ethics had been published in the Journal of the American Medical Association in 1947. In April 1947, New York Times science editor Waldemar Kaempffert observed, as if it were universally accepted, that deliberately injecting human subjects with syphilis microbes was “ethically impossible”.

Read more here/Leia mais aqui: Mercatornet