Historical Origins of the Tuskegee Experiment: The Dilemma of Public Health in the United States

Uisahak. 2017 Dec;26(3):545-578. doi: 10.13081/kjmh.2017.26.545.


The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of "the American race" against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.

Keywords: Bad Blood; Eugenics; Progressive Empire; Racial Pathology; the Public Health Service; the U.S. Surgeon General; Tuskegee Syphilis Experiment.

Publication types

  • Historical Article

MeSH terms

  • Alabama
  • Black or African American / history*
  • History, 20th Century
  • Humans
  • Male
  • Military Medicine / history
  • Nontherapeutic Human Experimentation / ethics
  • Nontherapeutic Human Experimentation / history*
  • Racism / history*
  • Research Subjects / history
  • Syphilis / history*
  • United States
  • United States Public Health Service / history*
  • Withholding Treatment / history