The Tuskegee Syphilis Study Analysis

The Tuskegee Syphilis research was an ill-reputed medical study steered by the Public Health Service of the United States, involving hundreds of impoverished African males who were unknowingly suffering from syphilis, a sexually transmitted illness. The motive of the analysis was to observe and understand how untreated syphilis advanced. The participating males were offered free meals, medical care and burial insurance as incentives to participate. They were promised that they were to receive treatment for "bad blood", a colloquialism used to describe some conditions that were leading causes of death such as anaemia, Syphilis and fatigue. To track the full progression of the disease, participants were not given effective care and were even denied treatment even after penicillin; an antibiotic was proven to effectively treat syphilis. Due to the untreated condition, some men died while some experienced severe health complications (Nix, 2017).

This case presents ethical, and principle issues since research involving human participants should have a moral commitment to the concerned individuals aiming at protecting their rights and well-being. Human beings deserve protection and respect as indisputable rights. This should equally be the case when conducting research activities. In a research context, the reverence for individuals rights should be articulated, such as the right not to be mistreated or injured, the right to have an un-coerced consent to take part in given research as well as the right to confidentiality and privacy (Scott, 2013). The researchers must ensure the participants are not in any way exposed to burdensome, unreasonable and predictable risks. In occasions where a predictable risk is unavoidable, the research team must give appropriate information so that the participant can fully understand the risk involved. Scott, 2013 explains that the participant must be made aware of what will be required of them, such as the time required, any procedures that may be performed as well as any predictable risk or side effects. They must be having the capacity to understand all the information provided about the research and should be free from any coercion.

In the Tuskegee syphilis study, the participants were not given the right information on the research they will be in participation. The research team tells them that they are being treated for "bad blood" while in reality they are being examined in a study of Syphilis. They enter into the research with no prior information of any risk they are being exposed to and end up making an uninformed decision. To woe them to participate, the researchers give them incentives such as meals and free medical cover, to influence their decision of taking part in the study, considering they are impoverished (Nix, 2017). The men are also told that the research would only last for six months but lasts for forty years. These men participate in the dark; they have no true information about what they engage in. This research is exposing them to risks of dying, infecting their spouses and developing health issues but their ignorance drives them to participate. Despite the researchers knowing the kind of risks they were exposing the researchers to, they go to extents of denying them treatment, even after penicillin became a recommended cure for syphilis.

Two of the globally accepted fundamental principles underpinning research and the practice of healthcare is the principle of beneficence which means promoting good or seeking the best for the client and the principle of non-maleficence that states that there should not be an infliction of harm or evil to others. That means that the researchers should have sought the well-being of the male participants and not cause them harm as it happened. The rights of the participants should have taken precedence over the researcher's interests (World Medical Association, 2013).In such a case as the Tuskegee study, where the participants are exposed to the risk of death, the risk ought to have been proportional to the gains expected from the study.

Rawls, 1985 argues that in any research activity justice is conceptualised as fairness. His argument underscores the need for research participants to be benefited or compensated including the least of them all. The American Public Health Service was not eager to settle the ill-fated participants until a lawsuit was filed against them. 1n 1974, they paid the living participants and later reached out to the windows and orphans of the deceased in 1975. The study did not, however, error by including the participants who vulnerable only that they unethically enticed them without the necessary consent.

The Tuskegee research study attracted criticism and raised questions on self-regulation by medical researchers and other scientific communities. The medical field has been criticised for its lack of transparency and openness in its regulatory procedures and the absence of general public involvement (Sylvia R. Cruess, 2005). Self-regulation was initially introduced at the appeal of a medical specialist with an understanding that the medical field was unknown and esoteric to the common citizen and thus would be difficult to externally regulate it effectively. It is because practitioners are protective of their colleagues (Collier, 2012). This notion creates the need for external regulation especially by involving non-physicians. The presence of non-physicians theoretically thwarts intentions of professionals to speak in their language, act only to the needs of their members and aids to keep the insulation group attached to the public. The privilege of experts autonomy carries along a load of responsibility, and one of the best ways for medical practitioners and researchers is to establish greater efforts towards comprehending reasons for punitive actions against doctors and discover alternative techniques to minimize trends that fail them (Johnston, 2011). Additionally, obligations and right to self-regulate are aimed at protecting and serving patients.

However, this is a complex subject and involves many layers of oversight that aim to guarantee competence of the physicians such as licensing, certification and accreditation of training programs and medical schools. Though these regulatory guidelines have achieved the set objectives to a great extent, several obstacles have remained thorny to medical practice. For instance, it is still hard to provide assurances that the medical practitioners uphold credible competence, the approach to taking appropriate steps once problems emerge and the ability to regulate conflicting interests (Pittman, 2008).Whether left anonymous or regulated from the outside, the medical field needs to extra cautious in their profession especially as they deal with individuals who mostly are altruistic. If the profession is to remain esteemed, the interests of the patients should come first. Trust should be continuously netted from the ever-sceptical public they serve. The demand for more transparent and open regulations will increasingly strengthen and as such the public or those being served will have an increased input in regulatory procedures. The licensing boards, speciality associations, varsities, hospitals, and certifying bodies must work hand in hand with the interest of both practitioners and patients. Cruess, 2005 argues that some of the medical regulatory bodies have themselves had internal conflicts which diminished their credibility and as such more external regulations by non-actors offered real benefits to the profession. Despite efforts put in place by several actors a common challenge of understanding the technical medical field has put the average citizen or patient at a loss as it demands prolonged training. As a result, there has been a large discrepancy in the knowledge among medical professionals and members of the public.

Researchers hold certain responsibilities to the participants they intend to use in their study. Firstly, they are required to properly and adequately inform the participants regarding the kind of research or project they are undertaking. For instance, the participant needs to know all that is required of them such as the purpose of the research, the time frame, procedures that may be performed on them as well as any predictable or known risk and its side effects. It is, however, the duty of the researchers to ensure the participants are not in any way exposed to burdensome, unreasonable and predictable risks. Secondly, the research should obtain informed consent from the involved participants. The consent should be voluntary and free from any coercion. Thirdly, the information gathered in the research about the participants' well being should be left confidential. The researcher must protect all information gathered or collected from any unauthorised access, disclosure, use, loss or modification. This is essential to ensure there is a trust relationship between the participant and the researcher and ensures the integrity of the study.Additionally, the researcher bears the responsibility of answering any emerging questions and concerns from the participants in the course of the study and should also communicate any developments in benefits or risks of the research.In case there arises any unanticipated challenge such as injuries, the holds the responsibility of taking the requisite actions.

Vulnerable societies such as minors, pregnant women, terminally ill, elderly, visually and hearing impaired, refugees as well as people who are physically or intellectually challenged are inclined to participate in researchers as they are unjustifiably driven by various expectations and predicted benefits drawn from their participation ( ICH GCP, 1996). As such, researchers are burdened with a lot of caution when dealing with these groups mainly because of inclined ethical issues as well their safety. The researcher must have assiduous attention while designing the study as it demands unique requirements, recruitment and safety approaches (Shivayogi, 2013). With the complexity involved, the researcher may develop a comprehensive monitoring plan to ensure the continued safety of the specimen. This could incorporate compliance with advocated norms, ethical review bodies and all the relevant government agencies. Further, in case of changes to the risk to benefit ratio of the study, the researcher should be prompted to inform the participants and appropriately discontinue the study until the sour issues are corrected. Shivayogi, 2013 insists that for transparency and integrity to hold, the research bears the responsibility of informing the public and the entire scientific community of the vulnerable population used. It initiates public trust and keeps the entire research on par with the expected ethical norms. Confidentiality must also be upheld at all cost as it ensures the social fabric of the specimen involved is not endangered. The data used or information acquired should be the paramount responsibility of the researcher to ensure its security. In some cases or unique studies, the researcher should use authorised substitute decision makers for the participant for proper risk to benefit analysis and subsequent justice.

Conclusion

Conclusively, any research should hold the highest levels of ethical principles both from the researcher and specimen end. Professional researchers are required to keenly understand that they hold a huge burden of responsibility to the participant they involve in their studies. Objective observers of the 21st century hold that despite the need for external regulation, self-regulation amongst medical professionals and their respective bodies is superior and more effective. It remains incumbent amongst them to hold dignity of their profession and establish the releva...