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Lecture 5

ANTH 227 Lecture Notes - Lecture 5: Medical Anthropology, Syphilis, Medical Ethics


Department
Anthropology
Course Code
ANTH 227
Professor
Dan Small
Lecture
5

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Anthropology 227 Medical Anthropology February 5th, 2013
Continuation of “Miss Evers’ Boys” and Ethics of Research
- 1970s: Stanford Study
A study conducted to see if the position people are assigned, if that would change how
they act. They took college students and assigned them roles in a prison (prisoners or
guards) and dehumanizing (taking their identity away from them). Meant to run 2
weeks. Got very out of control and abusive very fast and the study was shut down after
4-5 years.
- Miss Evers’ Boys (continued Part 2)
= forbidden experiment, the means does not justify the ends
Proposed study: study 400 men with syphilis, 200 as a control group study them
without any form of treatment, even though treatment is available
The subjects will be told that they are being treated for syphilis, but they are not.
They are kept healthy in every other respect in order to see the changes to health by
only syphilis.
“412 men with syphilis taken” and they are told that nothing has changed from the
beginning. They are convinced that any new procedures are just the same as previous
treatment
The idea was that treatment would come in 6 months, but it ended up being a total of
40 years without treatment even though a cure (penicillin) had been found (1942)
halfway through the experiment
Hertzimer reaction = penicillin can cure syphilis, but it may also kill them through an
allergic reaction with cases as severe as the men have
The end point of the study is considered to be after autopsy of the men there was
never going to be treatment
One of the motives: through scientific proof it can be shown that there is no
difference in how disease effects different races, for once and for all showing that we
are all equal
The syphilis began to get worse, taking over both physical and mental capacities (ex.
Weak legs, eyesight loss, paranoia)
The subjects truly believe they were patients = fundamental flaw, there was no
cultural accounting between researchers and patients
Ethical issues with the Tuskegee Study
- Blacklisted from being able to get treatment from any where even if they wanted to or
had the means
- **Withholding information about the care (or lack of) that they were being given
(with holding treatment and cure when it was found)
- Tried to make it seem that they were doing good by using race as a reason
- Even once a cure was found, they continued the study until autopsy could be taken
because they was no reason, study men taken as disposable
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The people that were a part of the study may have thought they were doing the wrong
thing. Until this study was exposed through the media (where after the president
apologized and it was exposed for what it was), the men continued life as if they did
not have syphilis they passed on syphilis to their families as well
Originally was not meant to be ethnocentric, was not intended to be a punishment
for a certain race those involved thought that they would be given the chance to
bring truth to people.
The doctor initially gave treatment, stopped and gave even “fake” treatments, hoping
to get money for the cure/treatment BUT even once it was apparent that would not
be the case, continued the study
Doing academic research is sometimes solely academic, does not make a difference in
peoples lives
Those who initiated the study appeared to be genuine (weren’t Nazi doctors)
-But there was never proper consent
Power roles behind the Tuskegee Study
Doctor, Nurse knowingly used their power to convince the men to participate in the
study “Doctor knows best”
The Board > Doctor > Nurse, but the Nurse had more direct influence/doctor over
the patients
The Board used social leverage “You can prove what black doctors can do”
Sometimes a key informant (ex. Nurse) = double agent, have influence so can recruit
people into the study for the benefit of the study
In the Tuskegee Study used influence Miss Evers to make people comply
Thinking about giving people payment for participating in your study
- Ex. Giving someone $50.00 for participating in the Tuskegee Study
- You have do a cultural assessment
IDEAS: Is there ever a justifiable reason for withholding treatment?
- Might say money
ex. Someone needs a treatment that is too costly that the person cannot afford
- Answer: n0
The “Gift”
- Clinical trial for a disease in marginalized populations that would otherwise not receive
any health care at all? Are they choosing this intervention under implicit duress because
it is the only option available? Is the study really a benefit? Is healthcare universally
available? Ex. Tuskegee: food, ride in case, medical care?
The goal at the end of research is to get a peer reviewed paper, not really to health the subjects
just an academic question and we leave it to others to apply
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