Bad Blood: The Hidden Horror of the Tuskegee Syphilis Study

In September of 1932, Public Health Service officials visited Tuskegee, Alabama, where they recruited 600 Black men to receive treatment for “bad blood.” The men didn’t realize they had become unwitting participants in one of the most controversial medical studies in recent times.

Of the study’s participants, 399 of the men were suffering from the advanced stages of syphilis, which at that time was incurable, while the other 201 served as controls. Under the guise of offering medical treatment, the Public Health Service set out to study the effects of untreated syphilis in Black men. Doctors enticed the poor, mostly illiterate Macon County residents to take part in return for free medical examinations, rides to the clinic, and hot meals on examination days. For the participants, many of whom had never even visited a doctor, the offer seemed too good to refuse.

A Secretive Study

Deception was integral to the Tuskegee Syphilis Study. The men did not know they were actually participating in an experiment, and were kept in the dark about the true nature of their diagnosis. They were also unaware they weren’t receiving treatment at all: The drugs they were administered were either inadequate or completely ineffective. At one point, they were even given diagnostic spinal taps, a painful and often complex procedure the doctors referred to as a “special treatment.”

Though the study was originally meant to last for six months, the Public Health Service decided to continue it when the participating doctors deemed that only autopsies could determine the damage the disease caused. In other words, the doctors would keep tabs on the men until they died.

To ensure nothing would interfere with the experiment, doctors in Macon County were given a list of the subjects and instructed to refer them to the Public Health Service if they sought medical treatment. The Public Health Service even hired Eunice Rivers, a Black nurse, to maintain contact with the men and ensure their continued participation. All the while, the experiment's subjects were left to degenerate—when untreated, syphilis can cause bone deformations, heart disease, blindness, and deafness.

A medical breakthrough came in 1947, when penicillin became the standard treatment for syphilis. Despite this, the doctors involved in the Tuskegee study opted not to treat the men so they could continue to monitor the disease's natural progression. As historian Dr. Crystal Sanders tells Mental Floss in an email, “By withholding treatment, doctors subjected these men, their spouses, and their offspring to serious health problems and death.”

The End of the Experiment

The study was not without its critics. When Public Health Service official Peter Buxtun learned about the experiment in 1966, he expressed grave moral concerns to the Centers for Disease Control. After numerous organizations, doctors, and scientists still opposed ending the study, Buxtun took matters into his own hands and leaked information about the experiment to Associated Press journalist Jean Heller.

On July 26, 1972, The New York Times ran a front page story exposing the study. Public outrage immediately ensued, but by then the damage was done. At least seven of the men had died from syphilis, while more than 150 had died from heart failure, a condition commonly linked to the infection. Forty spouses had also contracted syphilis, and 19 children were born with the condition. Some of the infected women, who believed the study was legitimate medical care, were turned away when they attempted to enroll. 

Once the study became public knowledge, the Department of Health, Education, and Welfare promptly ruled that the 40-year-long experiment come to an immediate end. Yet despite the national outcry, none of the medical professionals involved in the study were prosecuted. “They maintained that they had done nothing wrong,” Sanders explains. “Some even went so far as to assert that the Black male subjects would never have been treated anyway given their financial circumstances, so their study did not harm them.”

With the experiment finally over, the government appointed Dr. Vernal G. Cave to lead a team of Black doctors to investigate. He found that while the experiment was being carried out, at least 16 articles about it had been published in various medical journals. So why had it taken so long to bring the study to an end?

“The subjects were Black and poor and did not warrant much attention from the powers that be,” Sanders says. “Additionally, very few people with the political and social capital to ask questions would have been suspicious of a study underwritten by the federal government and carried out by medical practitioners who had the respect of the local white society.”

A Public Reckoning

In 1973, the National Association for the Advancement of Colored People (NAACP) filed a class action lawsuit on behalf of the study's participants and their families, and the following year a $10 million out-of-court settlement was reached. The U.S. government also agreed to provide free medical treatment to the study’s surviving participants, as well as their family members who became infected during the experiment.

The story of the Tuskegee Syphilis Study was brought to the screen 14 years later in the made-for-TV movie Miss Evers’ Boys. When the study’s participants saw the film, they were disappointed by its portrayal of the series of events. It suggested the men had received treatment for their condition, and shifted the blame from the federal government to a fictitious Black doctor and a Black nurse. As a response to the film, the participants enlisted the help of attorney Fred Gray to make sure the nation understood the truth behind the study.

In March 1997, Gray wrote a letter to president Bill Clinton requesting the victims receive a formal apology. Two months later, and more than 50 years after the experiment began, Clinton delivered his apology in a speech at the White House. By that time, only eight of the men were still alive.

“The United States government did something that was wrong — deeply, profoundly, morally wrong,” Clinton said. “What was done cannot be undone. But we can end the silence. We can stop turning our heads away. We can look at you in the eye and finally say on behalf of the American people, what the United States government did was shameful, and I am sorry.”

Though the last survivor of the study died in 2004, the experiment has had a lasting effect on the African-American community. A 2016 study found that after the Tuskegee study was exposed, the life expectancy of Black men decreased by 1.5 years, with a marked decrease in patient-physician interactions [PDF]. “There is a long history of poor Black people seeking preventative care and getting anything but that,” Sanders says. “I wholeheartedly believe that there is a connection between present-day African American distrust of the medical field and the Tuskegee Syphilis Experiment.”