Violations of ethical principles that govern the conduct of science and medicine using human subjects first jolted the world in the 1940s with the revelation that Nazi physicians were performing unethical and dangerous studies on humans in concentration camps. Following their revelation, the Nuremberg Code was formulated in 1947. It emphasized that ethical guidelines for the conduct of research cannot be established by the health profession alone.  The World Medical Association Helsinki Declaration was established in 1947 and continues to function as international body building an international code of ethics.

The US was not immune to questions about unethical medical practices in research. In the 1970s it was revealed that African-American sharecroppers had been involved in a “natural history” study of untreated syphilis sponsored by the US Public health Service.   More recently, a 1940s unethical research study sponsored by the US Public Health was uncovered by Dr. Susan Reverby of Wellesley College, while researching documents on the Tuskegee experiments.   The Guatemala study paid prostitutes who were infected with syphilis to have sexual intercourse with prisoners to determine the infectivity of syphilis under “natural” conditions. Research subjects included individuals in mental hospitals, prisoners, and soldiers.

The revelation of yet another US government-sponsored unethical clinical research study had been conducted precipitated the request by President Obama in October, 2010 to direct the Presidential Commission for the Study of Bioethical Issues to review the Tuskegee and Guatemala experiments and determine whether unethical practices currently exist in clinical research studies sponsored by the US government.

This blog was initiated as a vehicle to uncover and discuss ethical concerns that perhaps might not reach the level of visibility of previous unethical studies but are nevertheless important for protecting millions of human subjects from abuse. The quest for equity and justice in healthcare and clinical research must continue with the goal of protecting all humans from potential neglect or abuse.