The Syphilis Experiment
description
Transcript of The Syphilis Experiment
![Page 1: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/1.jpg)
The Syphilis Experiment
Alyssa Emanuelson, MS, MAT, ATC
![Page 2: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/2.jpg)
Tuskegee Study of Untreated Syphilis in the Negro Male
• Study started in 1932 @ Tuskegee Institute with the Public Health Service– Record the natural hx of syphilis– Hoped to justify treatment programs for
blacks• Participants– Initially black men• 399 had syphilis• 201 didn’t have syphilis
![Page 3: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/3.jpg)
Purpose of Study• Determine the natural course of untreated
latent syphilis • The study was meant to discover how
syphilis affected blacks as opposed to whites—the theory being that whites experienced more neurological complications from syphilis, whereas blacks were more susceptible to cardiovascular damage. How this knowledge would have changed clinical treatment of syphilis is uncertain.
![Page 4: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/4.jpg)
Ethical Issues of this Study1) No Informed Consent2) Not informed of all known dangers3) Participants had to agree to autopsy after
death to have burial paid for4) Scientists denied treatment to some
patients in order to observe the individual dangers and fatal progression of the disease
5) Participants not given a cure, even when widely known and easily available
6) Misleading advertisement—subjects not given treatment—they were recruited for a very risky spinal tap-diagnostic
![Page 5: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/5.jpg)
Informed Consent• Conducted without the benefit of
informed consent • Men were being treated for “bad blood”– Ailments including syphilis, anemia, and
fatigue• Didn’t receive proper care to cure illness• In exchange:– Free Medical Exams– Free Meals– Burial Insurance
• Projected to last 6 months—it lasted 40+ years
![Page 6: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/6.jpg)
Informed Consent Continued
• Not informed about the whole purpose of the research
• Not informed of dangers of study• Experiment was considered as
beneficial for humankind– Human Guinea Pigs
![Page 7: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/7.jpg)
Human Guinea Pigs• Nature of study kept quiet to ensure
compliance• Grossly disadvantaged lifestyle made
them easy to manipulate• Pleased by prospect of “free”
healthcare–Many had never seen a doctor before
• Last chance for “free medical care”– Lured men to dangerous spinal taps
![Page 8: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/8.jpg)
Syphilis• Bacterial• Direct contact through oral, anal, and
vaginal sex• Pregnant women can pass it on to
babies• S/S– Sores from where entered body– Rashes in secondary stage
• Latent stage– Damage internal organs
• Treat with Penicillin
![Page 9: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/9.jpg)
Data from study Data for the experiment was to be collected from autopsies of the men, and they were thus deliberately left to degenerate under the ravages of tertiary syphilis—which can include tumors, heart disease, paralysis, blindness, insanity, and death. “As I see it,” one of the doctors involved explained, “we have no further interest in these patients until they die.”
![Page 10: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/10.jpg)
Penicillin• By 1947 Penicillin had become
standard treatment to cure syphilis• Instead of closing the study and
giving the cure, the scientists withheld treatment from participants
![Page 11: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/11.jpg)
Treatment• Treatment of time– bismuth, neoarsphenamine, and
mercury but only 3% survive with those– Token treatment = good PR but didn’t
really do anything
![Page 12: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/12.jpg)
End of Study• Study ended in 1972 after the AP
exposed the study in a series of articles–More than 25 years after the known cure
• Consequences of study– 28 people died from syphilis– 100 died from related diseases– 40 wives and 19 children infected with
syphilis
![Page 13: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/13.jpg)
Basic Principles Required to follow today…
• Autonomy• Veracity• Beneficence • Non-malficence• Confidentiality • Justice• Fidelity • Code of Ethics• Scope of Practice• Patient’s Rights
![Page 14: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/14.jpg)
Activity
• Scavenger hunt! – With your SLP group, you are to use one of the
“babies” to look up the term listed on the screen and give me an example of it that makes sense. The first group to do so wins a point the team with the most points wins
![Page 15: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/15.jpg)
Patient Autonomy
• What is? • Why is it important?• Example…
![Page 16: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/16.jpg)
Patient Autonomy
• Autonomy: right of patients to make decisions about their medical care – Medical Provider can’t influence decision– Medical provider must educate pt. but can’t make
decision for pt.
![Page 17: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/17.jpg)
Veracity
• What is it? • Why is it important?• Example…
![Page 18: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/18.jpg)
Veracity
• The ethics of telling the truth• Accountable for what they tell the patient• White lies not okay…
![Page 19: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/19.jpg)
Beneficence
• What is it?• Why is it important• Example…
![Page 20: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/20.jpg)
Beneficence
• Action that is done for the benefit of others. Beneficent actions can be taken to help prevent or remove harms or to simply improve the situation of others.
• Doctors must refrain from harming pts. • Weigh benefits vs. risks of treatment (big issue
in Miss Evers’ Boys)
![Page 21: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/21.jpg)
Non-Malficience
• What is it? • Why is it important? • Example…
![Page 22: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/22.jpg)
Non-Malficience
• Do no harm.• Physicians must refrain from providing
ineffective treatments• Not acting with malice toward patients. • Some beneficial treatments may also have
inherent risks
![Page 23: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/23.jpg)
Confidentiality
• What is it?• Why is it important?• Example…
![Page 24: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/24.jpg)
Confidentiality
• Duty to keep patient’s confidence• Full and frank disclosure from pt. to MD—so
that diagnosis can occur• Shouldn’t reveal what was said (with
exception to when pt. threatens bodily harm to self/others)
![Page 25: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/25.jpg)
Justice
• What is it?• Why is it important?• Example…
![Page 26: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/26.jpg)
Justice
• Fair distribution of health care resources• Elimination of discrimination, whether based
on race, gender, age, socioeconomic status, ethnicity, religion, or any other social category
![Page 27: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/27.jpg)
Fidelity
• What is it?• Why is it important?• Example…
![Page 28: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/28.jpg)
Fidelity
• Patients’ interests first in mind above all others
• Maintenance of patient trust and confidences• Obligates them to carry out their promises to
care for patients with faithful attention
![Page 29: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/29.jpg)
Code of Ethics
• What is it? • Why is it important?• Example
![Page 30: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/30.jpg)
Code of Ethics• Competent medical care
– Dignity and compassion• Professionalism • Respect the law• Continue to study, apply, and practice knowledge relevant to
the field• Respect the rights of patients, families, and colleagues
– Confidentiality • Access to medical care for all• Patient needs before personal preferences• Aid in and better the community
![Page 31: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/31.jpg)
Scope of Practice
• What is it?• Why is it important?• Example…
![Page 32: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/32.jpg)
Scope of Practice
• Used by national and state/provincial licensing boards for various professions that defines – procedures, actions, and processes that are
permitted for the licensed individual. • What you are allowed to do as a professional– Nurse vs. Doctor– Athletic Trainer vs. Physical Therapist
![Page 33: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/33.jpg)
Patient’s Rights
• What is a patient’s rights?• Why are they important?• Example…
![Page 34: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/34.jpg)
Patient’s Rights
• Right to access of easily understandable health information
• Right to choice of providers • Access to emergency service• Taking part in treatment decision• Respect and non-discrimination• Confidentiality • Complaints and appeals processed fairly and in a
timely manner
![Page 35: The Syphilis Experiment](https://reader034.fdocuments.us/reader034/viewer/2022051402/5681641f550346895dd5de0a/html5/thumbnails/35.jpg)
Assignments• ICC Terms Assignment • Reaction Paper