Epidemiology Issues - Past & Present
Problem #1: The Public Health Service Syphilis Study (1932-1971)
The U.S. Public Health Service Syphilis Study at Tuskegee, popularly and hereafter referred to as the Tuskegee Syphilis study, is infamous clinical research in Macon County, Alabama, USA, from 1932 to 1972. The target population was black men suffering from syphilis. The sample was made up of uneducated black men, approximately six hundred, of which about four hundred were suffering from syphilis. The uninfected group, about two hundred, served as the control group. The study aimed to determine whether the reaction to syphilis among blacks was similar to whites and determine how long a human being could live with untreated syphilis (Reverby, 2012). In this discussion, the Tuskegee Syphilis Study will be evaluated to establish ethical violations from a Biomedical research perspective.
Based on reflections on the dictates of ethical biomedical research that has human beings as participants, it is clear that the Tuskegee Syphilis Study violated several ethical requirements;
i. Lack of informed consent there is no evidence of the study participants being informed correctly, on the studys purpose and their part, consenting willingly to participate in the study. Moreover, the study included uneducated black men which would indicate a purposive sampling method, despite there being educated black elites in the Tuskegee local at the time.
ii. Deception and none beneficence although there was no known cure for syphilis at the time, the study was designed initially to make treatment available for African-American men. This clarifies that the researchers intended to carry out therapeutic measures such as providing a cure for or control of syphilis among the study participants. The study participants were also deliberately misinformed on why some of the procedures were carried out; for example, spinal taps were disguised as necessary and special free treatment for bad blood.
iii. Withholding of vital information at some point, funding to avail drugs for the study participants was cut, a point from which the study turned to be a natural history study. Hundreds of the study participants infected with syphilis were kept in the dark about developments in the industry and the research progress.
iv. A clear violation of non-maleficence is evident that the researchers didnt institute any measures to avoid harming the study participants. There were measures taken to ensure harm to the study participants;
Even after penicillin was determined to be a safe and effective treatment for syphilis in the 1940s, the study participants infected with syphilis were denied antibiotics
The researchers colluded with the military and local area healthcare professionals to prevent treatments of the study participants
The study continued up to and until 1972
The results of the study were the death of 28 men, 100 disability cases, and 19 congenital syphilis cases (newborns with syphilis)
v. Racism and clear inclusion of vulnerable groups of people even though the study targeted population was black men, racisms come in when they include only uneducated black men, which in this case is a vulnerable group of people, given race relations in the U.S. at the time, and the history of slavery. Also, the vulnerable group used for the study would not benefit from their participation in the study.
vi. Endangering men and their families at the time of the Tuskegee Syphilis Study, there was no known treatment for syphilis. Moreover, it is ethically required that the dangers of any new medication must be first investigated using animals. Therefore, it is obvious that the study participants were guinea pigs, and the lack of treatment resulted in some women contracting the disease from men who were participating in...
…searched. The first keyword was the basic search, after which the advanced search was done to include the Boolean operatives.
3. Apply basic and advanced search. Illustrate your results from PubMed or other databases (make a screenshot of the page with search results using three Boolean operators AND, OR, NOT; using specifying filters).
Keywords/Search phrases
PubMed results
Screenshot
Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants.
1 article
(Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants) AND (standard red cells transfusion)
1 article
(Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants) OR (standard red cells transfusion)
32 articles
(Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants) NOT (standard red cells transfusion)
0 results
The first basic search using the keyword Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants yielded only two articles. Still, after filtering using the criteria discussed in 4 below, only a single article was included. Likewise, the second keyword, which utilized the Boolean operative AND, i.e. (Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants) AND (standard red cells transfusion), yielded only 2 articles. After filtering the results, only a single article was included. The third keyword was a little more productive. The keywords used for the third search used the Boolean operative OR, i.e. (Effect of fresh red cells transfusion on intraventricular hemorrhage in premature infants) OR (standard red cells transfusion) and the search yielded 2540 results, but after filtering, only 32 articles where included. The last keywords utilized the Boolean operative NOT, and it yielded 0 results.
4. List inclusion criteria for the studies.
The articles that were included in the tudy had to satisfy a pre-established criterion, which included;
The articles were to have been published in English
Available in free full-text on PubMed
Conducted using a…
