Ethics in Medical Experiments

The Tuskegee syphilis study is one of the studies looked at for ethical violations in health care research. There are a few different violations that were part of this study. As Heintzelman (2003) notes, the study was conducted to see the course of untreated syphilis. They were subject to "spinal taps without anesthesia", and where subject to heavy metals therapy but were not given antibiotics when it became known that penicillin could treat syphilis. The latter in particular would form an egregious ethical violation, because the subjects could have been cured of their ailment, but the study continued anyway, meaning that the best interests of the subjects was not taken into consideration for this study. The subjects were never offered penicillin nor any way of exiting the study.
The ethical concerns also included the issue of informed consent. The true nature of the study was not revealed to the subjects. They were told that they were being treated for bad blood, which didn't hold any meaning in the medical sense. They did not know that they were being studied for syphilis and did not have informed consent at any point in the study, which went on for more than 40 years (CDC, 2017). Thus, the researchers behind the study not only made errors in judgment at the outset of the study, by not seeking out any form of informed consent, but they continued in their unethical behavior throughout the entire run of the study, until public outcry, investigations and lawsuits finally brought the study to a close.
The Willowbrook hepatitis case was another issue of egregious violation of ethics. In this case, The Willowbrook State School was a home for mentally disabled children. It had a high rate of hepatitis, which nearly all residents had. There was some question as to whether they received it via exposure to the water or via direct means, but there was reason to believe that many were injected directly with hepatitis and others were "fed hepatitis-contaminated feces" (NPR, 2008).
There are obvious ethical issues here. First, if there was any direct action to give people hepatitis, that would go far beyond an ethical violation; it would constitute a criminal act. This would have been done without any sanction as a medical experiment, as Willowbrook was not that sort of medical institution that it would normally carry out such experiments. But even beyond that, the fact that so many patients there had hepatitis and did not receive adequate treatment was another issue that represents an ethical lapse. When medical practitioners have someone in their care that cannot care for themselves, there is a duty of care. This duty of care appears to have been violated as a matter of practice at Willowbrook.
These cases represent an interesting question about medical ethics, because there were pretty much zero ethics involved. The reality is that these experiments were devoid of ethics from the outset. Nobody is entirely sure that an actual experiment was going on at Willowbrook, so right away that invalidates the entire idea that there was anything legitimate going on there. The Tuskegee was a bad experiment from the outset, but at least there the actions weren't as overtly criminal; there were actual researchers and one can conceive of how those researchers could have done better on the ethical front.
So with Willowbrook there were no legitimate researchers and no way to make whatever happened there ethical. With Tuskegee the first step would be informed consent, which there apparently was not. Because the participants did not know why they were being studied, they were unable to assert any rights when penicillin became the standard treatment for syphilis. At this point, the researchers should have given all the patients penicillin and then ended the experiment. That would have been, along with informed consent, the most important ways to make that experiment ethical, though there were probably other issues as well, like the very idea of the experiment.


References

CDC (2017). The Tuskegee timeline. Centers for Disease Control and Prevention. Retrieved March 24, 2018 from https://www.cdc.gov/tuskegee/timeline.htm

Heintzelman, C. (2003) The Tuskegee syphilis study and its implications for the 21st century. The New Social Worker. Retrieved March 24, 2018 from http://www.socialworker.com/feature-articles/ethics-articles/The_Tuskegee_Syphilis_Study_and_Its_Implications_for_the_21st_Century/

NPR (2008). Remembering an infamous New York institution. NPR. Retrieved March 24, 2018 from https://www.npr.org/templates/story/story.php?storyId=87975196