Ethical considerations of the human research: syphilis experiments and denial of drug therapy

Abstract

Syphilis has historically been considered a special disease as sexually transmitted disease and because no effective treatments were disposable for years. At the end of XV century first cases were reported and until beginning of XX century not scientific advances were made: Schaudinn and Hoffmann discovered the germ which caused disease in 1905 (Treponema pallidum) and few years later serological test for diagnoses were developed. Fleming had discovered penicillin in 1928 but it was not used in medical practice before World War II (WWII). Military physicians from United States used penicillin for treating syphilis in Pacific troops in December 1943 [1]. Treatment was successful and in 1947 penicillin had become the standard treatment for syphilis. Before it, syphilis was a multisystemic, chronic, painful and deadly disease. Due to penicillin, prospects changed radically. The successful was such as in middle 50’s incidence of syphilis was so low that many scientists believed that syphilis would be soon eradicated [2]. Once efficacy of treatment was established, any patient affected from syphilis should be treated with penicillin. However, numerous researches were performed on which, deliberately, patients did not receive any treatment just for studying disease spreads and they were even inoculated with syphilis to determine optimum treatment doses. In other cases treatment was not administered, even when infected patients could transmit the disease to their sexual partners and descendants. We comment three examples that illustrate this unethical approach.