(CN) - American scientists infected hundreds of Guatemalans with syphilis in a series of nonconsensual medical tests sanctioned by the U.S. government, a class action filed Monday claims in Washington, D.C. Some experiments focused on orphaned children.
The government began conducting these experiments in Guatemala beginning in 1946 despite growing contempt over similar practices uncovered in Nazi concentration camps and on American soil, according to the federal complaint.
During the 40 years that the Venereal Disease Research Laboratory within the U.S. Public Health Service (PHS) conducted limited experiments on black men already infected with syphilis in Tuskegee, Ala., it also secretly infected other human subjects. The PHS set its sights on Guatemala after unsuccessfully trying to infect prisoners at a Terre Haute, Ind., federal penitentiary with gonorrhea, according to the complaint.
"The medical team and U.S. entities took advantage of the fact that ethical limitations in the United States were enforced, while in Guatemala, they were not," according to the complaint. "But, as the parties involved fully recognized, these ethical limitations were not unique to the United States, nor did they apply only on U.S. soil; the ethical limitations were part of international law and, as such, transcend any particular country and apply to humans everywhere. Nuremberg made abundantly clear that all humans have the right to be free from nonconsensual medical experimentation. The medical team and U.S. entities involved unquestionably violated that right by going to a country where they were less likely to be caught or punished for engaging in unethical practices. Trying to escape the law by violating it in a country known for weak enforcement is reprehensible."
Project leaders selected Guatemala because they carried "racialized assumptions about syphilis ... presuming that the disease was more frequent in those of Latin descent than in others," according to the complaint.
"From their offices in the United States, PHS and other U.S. entities decided to seek a location where they would be able to carry out more invasive methods of inoculation without ethical scrutiny," the complaint states. "This decision to move to Guatemala was part of a deliberate plan to continue the Tuskegee testing offshore, where it would not be subject to the same level of oversight as in the United States."
Manuel Gudiel Garcia and six other named plaintiffs filed the suit on behalf of thousands of Guatemalans affected by the experimentation. "The plaintiffs believe that there are thousands of potential class members; the nonconsensual human medical experimentation involved at least 700 test subjects and thousands of others were impacted as a result of defendants' nonconsensual human medical experimentation," according to the complaint.
The class claims that PHS performed the experimentation in Guatemala to study the effects of penicillin treatments and the most effective way to infect a person with the disease, "an experiment that would not have been permitted in the United States."
Though penicillin was being widely used in the post-World War II era to cure syphilis, doctors hoped to discover something akin to a morning-after cream that could be applied directly after possible exposure.
The class claims that, between 1946 and 1948, Assistant Surgeon General Dr. John Charles Cutler led the Guatemala project in concert with Guatemalan officials and PHS-trained doctors. It remains uncertain whether the project actually ended in 1948 as officially reported, according to the complaint.
In addition to systematically infecting soldiers, prisoners, mental patients and prostitutes with the disease, the class says PHS attempted to study the presumed Latino disposition to the disease through experimentation on orphaned children.
"To test this, Dr. Cutler and his staff only worked with Guatemalans who were syphilis-free when the human experimentation began," according to the complaint.
In the first arm of the project, PHS used U.S. taxpayer dollars to pay Guatemalan prostitutes infected with gonorrhea or syphilis to have sex with inmates in the national penitentiary. If a prostitute was not infected, PHS doctors "placed an inoculum of the diseases on their cervixes before the sexual visits," according to the complaint.
According to a document quoted in the class action, "a merry twinkle came into [Surgeon General Thomas] Parran's eye" as malaria specialist G. Robert Coatney, who had performed prison malaria studies, visited the Guatemalan project in February 1947 and told Parran back in the United States, "You know, we couldn't do such an experiment in this country."
After PHS doctors exposed Guatemalans to the disease, they did very little follow-up to ensure that their test subjects recovered, according to the complaint.
Displeased with the low rates of infection in the prison project, the doctors performed blood tests on orphaned children in attempt to vindicate "racialized notions of medical science."
"The doctors and U.S. government entities performed invasive testing of 438 orphaned Guatemalan children between the ages of six and sixteen using blood tests to discover why many of the uninfected men in the prison study had falsely tested positive for venereal disease," the class claims.
Other orphans are thought to have been infected by the PHS, according to the complaint, although such details are not discussed in publicly available reports.
Then the PHS doctors turned to mental patients, whom they inoculated by "scraping the head of the patient's penis with a hypodermic needle and then introducing directly to the raw skin liquid bacteria cultured from the open genital sores of other Guatemalan men."
Such methods were "both unprecedented and unequivocally impermissible in the United States and throughout the civilized world."
Female mental patients were also infected through their arms, faces or mouths because "it was frowned upon in Guatemala for men, even physicians, to view a female body."
PHS bribed their way into the national orphanage and mental institution by providing the staffs with cigarettes and medication that was in scarce supply, such as malaria treatments.
"Worse still, most of the officials at the mental asylum thought at first that 'inoculation' was just another type of drug, not actively being affected," the class claims.
Cutler, the assistant surgeon general, allegedly targeted the next group of Guatemalans, soldiers who could give consent, after his supervisor raised ethical issues over testing prisoners, mental patients and children. To infect soldiers the PHS used prostitutes, as with the prisoners, and used penis injections.
The Guatemala experimentation was brought to light by Professor Susan Reverby, a medical historian with Wellesley College. President Barack Obama and two Cabinet secretaries apologized to the Guatemalan government and people in October 2010. A month later, the government convened
a panel to investigate the activities of the PHS, and the Institute of Medicine, part of the National Academy of Sciences, convened its own investigative committee.
Represented by Terrence Collingsworth with Conrad & Scherer, the class seeks damages and injunctive relief from nine government officials, including U.S. Department of Health and Human Services Secretary Kathleen Sebelius.