Customer Reviews

Bad Blood: The Tuskegee Syphilis Experiment, New and Expanded Edition

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"Bad Blood" is a carefully researched and excellently written account of one of the most horrendous and despicable acts perpetrated by the United States Government, the Tuskegee Syphilis Experiment.

In 1932, four hundred illiterate and semi-literate black sharecroppers in Alabama who were diagnosed with syphilis were selected for an experiment sponsored by the U.S. Health Service, whose purport was to demonstrate that the course of untreated syphilis runs differently in blacks as opposed to whites. It was "race medicine" of the worst kind and, as a newspaper editorial stated when the experiment finally came to light 40 years later, it was ethically on a par with the medical experiments in the Nazi death camps.

The men selected for the study were for the most part uneducated (only one man had reached the eighth grade and none had gone to high school), they were never explained the purpose of the study, and they were given no medicine to help their advancing symptoms. Even after penicillin was found in the 1940s to halt or significantly reduce the symptoms of the disease, it was withheld from the patients, who were left to suffer horrible deaths from advanced syphilis one by one.

In 1972 the experiment was finally brought into the open by a young law student who passed the information to the Associated Press, and when the story broke on Page One of newspapers across the country, it caused a national firestorm. Journalists, public officials, and ordinary citizens were outraged by the news accounts. Incredibly, when the doctors involved in the experiment were asked for an accountability, their response was a collective shrug and a "so what?"

The most explosive reaction, needless to say, was in the nation's black communities, which maintained that the government would never have run such an experiment on 400 white test subjects. The bitter legacy left by the Tuskegee Experiment is the fear and mistrust among many African-Americans of the entire medical establishment, and the suspicion that AIDS is a man-made disease created by the government with the express purpose of killing off blacks and gays; people who hold this belief, when asked why they think the government would do such a thing, invariably point to the Tuskegee Experiment as an example of what the government is capable of. The legacy of suspicion and mistrust generated by the Tuskegee Experiment may take generations to undo, and all of us, black and white, will be the losers.

Judy Lind

I am not a doctor, a researcher nor an ethicist. I am an African American woman who grew up in southern Virginia, has heard off-the-cuff references to the Tuskegee incident almost all of my conscious-life, and finally wanted to read its details. While I agree with one reviewer who pointed out that the text does not read like a "thriller," I found the writing easy to understand as an indictment of racism whether systemically or individually manifest. I appreciate that the author took great care to provide a general framework of how people respond to the medical establishment (e.g. "follow the doctor's orders") while also detailing the way by which the doctors deliberately manipulated that trust to ensure the compliance of rural black men and black members of the profession. The latter is important - the author shows compliance and allegiance among the black medical officials who were pulled into the experiment, subtly encouraged by monetary or status rewards. I also like how the author painstakingly pulled together the text of meetings, memos and memoirs to show how bureaucracy, tradition and group think work to create racist outcomes - it suggested a universality to it, not a "only in the medical establishment" or "only in the South" version of events. And the author's telling of how all the institutions and individuals, when caught, backpedaled or otherwise covered up their role in the experiment was just amazing... Highly recommended.

One of the least known facts of U.S. history is the government sponsored syphilis experiment conducted upon 399 African-American men from 1932 to 1972. Over the course of these five decades, the U.S. Public Health Service exploited African-American sharecroppers in its effort to determine if the long-term affects of syphilis were different for black people than it was for white people. During the trials, the doctors who conducted the experimentations intentionally denied these men treatment; never informed them of syphilis' destructiveness to their health; and ignored the fact that these men were infecting their respective wives and sexual partners with the disease. As the experiments continued, doctors calculatedly deceived the subjects, informing them that they were suffering from what was categorized as: "bad blood". As the disease ravaged the minds and bodies of these unsuspecting men, no effort was made by the physicians of the Public Health Service to either inform them regarding the disease or provide them with treatment in an effort to curtail its devastating effects.

Jones presents a detailed, non-sensationalized writing that delves into the ignorance, racism and outright inhumanity that was entrenched throughout the United States; the medical arena; and society in general prior to and during these horrific experiments. He provides a plethora of documentation to substantiate the bigotry and callousness of the medical field during the era, and acknowledges the data provided by individuals who participated in the experiments or who conveyed valuable information. By the end of the experimentation, at least 28 of the men had died of syphilis; over 100 died of related complications; at least 40 of their wives had been infected, and over 20 of their children had been born with congenital syphilis.

Bad Blood should be read by all those who are of the opinion that the upper echelons of U.S. society (in this case, the medial profession and the government itself) are above despicable acts that border on genocide. Clearly there is no conspiracy "theory" here...instead we find conspiracy FACT! Perhaps former U.S. President Bill Clinton's statement regarding the Tuskegee Syphilis Experiments encapsulates the incident best in his speech to the last eight survivors of the experiments in 1997: "The United States government did something that was wrong-deeply, profoundly, morally wrong. It was an outrage to our commitment to integrity and equality for all our citizens...clearly racist".

The "study" of the natural history of syphilis in black men is important to understand. Because it involved US federal funds and US federal researchers, it was a key demonstration that serious ethical problems in research were a mainstream event rather than a fringe problem; awareness of this project fueled concern for regulatory oversight and led to the development of federal regulations. James Jones' revelations were key to this process, and everyone involved in human subjects' research should read this book. Overall, the book is well researched and well presented. One of the more frightening aspects of Tuskegee is subtle, and doesn't get as thorough a treatment as it could have; that is, some of the outrageous features of the project were not the result of single outrageous decisions, but were rather the sum of many smaller errors. These are harder for a researcher to dismiss as things s/he could never have done. As a physician, I can comfortably say that I would never deliberately deny effective therapy to someone with a serious illness. But I can not as glibly say that I would have been the one to stand up and rebel when a protocol committee in the late 1940s or early 1950s decided that the evidence for penicillin's effectiveness in advanced syphilis was not QUITE good enough to mandate terminating the project. There are also some rough spots in some of the technical information, most glaringly a rather startlingly inaccurate description of what's involved in a spinal tap. Those are small issues, though. Overall, this is an excellent book that makes it abundantly clear why Tuskegee is so important to our thinking about research ethics, and helps the reader understand why certain racial and ethnic groups have a distrust of medical research.

This book is probably one of the first of the expose type to zero in on medical culpability in the US. Most people tend to think that only Germany was capable of doing the atrocities that occurred during WWII. It was these atrocities that led to the Nuremburg Code of conduct for physicians and scientists, yet it was known prior to the Germans butchery that other countries including the US and England were equally responsible for using human beings for questionable experiments. As a student in medical school I came across references to this book and others like it. My interest lay in the fact that as a Deaf person, I know what it is like to have doctors treat me with disrespect and patronizingly. I started researching into how lack of education leads to people being taken advantage of by the medical establishment. In my research, so many referred back to this particular book, I decided I just had to read it. Not only have I read it but I have lent it to others who share my concern that there are medical practitioners out there like Kervorkian who would have no problem putting to death or using for unethical experiments, people who they view as less than people. Jones did a magnificent job of research and follow-up with those involved in this horrible fiasco. Not only were these doctors racist, but they considered anyone with lower education to be only as useful as animals...to an extent they treated these men with less care and concern then they treat animals used in experiments today. Jones was more than fair, including reasons for why these doctors and nurses, both black and white, did not perceive this long on-going experiment as being wrong. It is partially due to his exposure of this experiment, that other minority groups including the disabled are looking carefully at the medical establishment for bias and prejudice, for neglect and outright denial of fair medical treatment and availability of treatment. Every medical student, public health student, science student, educator, and frankly everyone should read this book. I am deeply concerned that if we don't pay attention to the ethics of all the new science and medical information being found, we will once again allow someone somewhere in our nation the opportunity to use a particular group of people for their own unethical purposes. We cannot afford to turn a 'blind' eye to this happening again. Karen L. Sadler, Science Education, University of Pittsburgh, klsst23@pitt.edu

This book was excellent and informative. However, readers should know that it is written in a research style, almost like a text book (sometimes putting the reader to sleep-and the reason I am only rating it four stars), as opposed to being written by an investigative reporter (and reading like a thriller). The book is extremely well documented. The author was intimately involved with helping lawyer Gray (Rosa Parks' lawyer) prosecute the case against the federal government, by providing much of the documentation given in this book. He began work on the book while a student in Harvard's bioethics program in 1972, and only subsequently becoming involved with lawyer Gray.

The book is a complete history from the conception of the experiment, until its termination, including the viewpoints of ALL participants. In addition to learning about the experiment itself, I learned a lot about life in the rural American South, which I had not previously known, and a lot about the disease of syphilis that I hadn't known. Some examples: I didn't know that 30-40 percent of blacks in the rural South were infected, nor that the disease crosses the placental barrier, which caused a lot of syphilitic babies. The book includes pictures of syphilitic skin lesions, and discusses multiple complications of the late stages of the disease.

The book also delves into the moral and racial issues extensively. There is an updated chapter at the end comparing the syphilis crisis to the AIDS crisis, and discusses why so many blacks are distrustful of doctors and hospitals-this experiment simply being one of the most recent examples of how this segment of our society as lied to, and taken advantage of.

What was MOST shocking to me about this book was that I was born in 1955, and this experiment continued into the mid-1970's. The FIRST time it was questioned on moral grounds was about 1962, and throughout the 60's, most doctors did not even QUESTION the morality! The story was broken the same day as Sargent Shiver's having obtained psychiatric counseling-the latter story I heard about extensively, and the former not at all! Before buying this book, I had never even heard of this medical experiment, and I just can't believe things like this were taking place IN
THE UNITED STATES OF AMERICA until the mid-1970's!!!

I own two copies of this important book. One to loan out to friends who believe that such a thing could not happen here in the United States, and, another copy to keep safely tucked away in my personal library.

If the victims of this "Medical Experiment" had been Jewish and the perpetrators had been German, the entire workforce of the US Public Health Service would be tracked down and suitably punished for their "Crimes Against Humanity".

Now, there is AIDS. People with African ancestory are genetically far more succeptable to AIDS than any one else. After reading this book, one wonders.....

I loved the loving care with which this book was written. The horror of the Tuskegee Syphilis Study was that there truly was no evil intent on the part of the doctors involved, and all believed that the "patients" truly benefitted, receiving health care they otherwise would not have received for other ailments that they could not have afforded treatment for otherwise. In fact, the Tuskegee "patients" received health care for aches and pains that neither their neighbors nor even their wives and children were able to access, because of their "privileged" status as part of the "government study." Placing the story squarely in the context of its time, Jones does not excuse those who bear the responsibility for the choices they made regarding the men involved in the study, but attempts to explain to the best of his ability why those in authority made the decisions they made, even to the point of placing a black nurse in the pivotal position of overseeing the consistency of the study and maintaining contact with the study "subjects" while the doctors themselves were rotated every year as part of their own "educational" history. Even Tuskegee itself was run by black doctors who chose to look the other way when they knew, had to know, the detrimental decisions that were being made. That is how power works. That is how it worked then, and that is how it works today. Is it because of Tuskegee that the Public Health System lacks credibility? Or is it because of the ongoing and persistent ignorance and incompetence of the Public Health System itself? The system is infested with politics, funding fiascos and unethical practices. It didn't start with Tuskegee, and it certainly didn't end there. This is a very important part of the story, and should be mandated reading for anyone who wants to understand the controverted manipulations of the Public Health System. It is only the beginning, however. Don't stop there.

I own two copies of this important book. One to loan out to friends who believe that such a thing could not happen here in the United States, and, another copy to keep safely tucked away in my personal library.

If the victims of this "Medical Experiment" had been Jewish and the perpetrators had been German, the entire workforce of the US Public Health Service would be tracked down and suitably punished for their "Crimes Against Humanity". Sound like a sily analogy? The Nazi's came to power in 1932, the same year this experiment was begun by the US National Health Service. The Nazi's were defeated in 1945, whereas, this experiment really did not end until the 1970's! Each year, the US government spends millions of Tax Payer dollars to track down ex-Nazi's for crimes committed in a foreign country while the National Health Service retiree's collect Tax Payer dollars in the form of pensions even though they denied proper medical treatment for US citizens!

Now, there is AIDS. People with African ancestory are genetically far more succeptable to AIDS than any one else. After reading this book, one wonders.....

Bad Blood is with one of the most outstanding piece of work in dealing with the history of my people that has ever been put together in book form. I have a personal connection with it's history. My mother Florence N. Mitchell father was one of victims who was subjected to the oppression, hardship and the mistreatment of our people during those times of our history. One of the lawyer's who handled that case is still alive and was a student of my parents and one of my Dad's outstanding football players during the early part of the fifties in a small college in Salisbury N.C. (Livingstone College) Thank God for what MLK stated when he said that, "A change is going to come"

Wayland Mitchell
Anchorage, Alaska