Roy B
Department of Psychiatry, Albany Medical College, NY 12208, USA.
J Natl Med Assoc. 1996 May;88(5):315-22.
In 1929 the Julius Rosenwald Fund, in conjunction with the Public Health Service (PHS), sponsored a syphilis seroprevalence study in the South characterized as a humanitarian effort to benefit the health of rural African Americans. The study reported extraordinarily high rates of positive Wassermann tests, even among children. Despite the unreliability and nonspecificity of this test, modern authors continue to indict these subjects as syphilitic. However, there was no consistent relationship between syphilis and a positive Wassermann test. Additional treponemal pathogens that potentially caused false-positive tests could explain the results. After public outcry to the Tuskegee Syphilis Experiment, the Rosenwald study acquired new significance. It was used as evidence to bolster the argument that Tuskegee was a consequence of humanitarian motives that became captive to misguided methods of researchers at the Venereal Disease Division of the PHS. Humanitarianism implies the acknowledgement of a right invested in the recipient; health is an end in itself. However, African Americans were necessary as a source of cheap labor for competition in the world cotton markets and as a restraint on the market value of white labor in manufacturing. The administrative structure of the PHS, not zealous individuals, adopted utilitarianism as its paradigm for human research. Syphilis seroprevalence was a calculated use of public health as a means to economic development.
1929年,朱利叶斯·罗森瓦尔德基金与公共卫生服务局(PHS)联合在南方发起了一项梅毒血清流行率研究,该研究被描述为一项旨在造福农村非裔美国人健康的人道主义努力。该研究报告称,瓦色曼试验阳性率极高,甚至在儿童中也是如此。尽管这项试验不可靠且不具特异性,但现代学者仍继续将这些受试者判定为患有梅毒。然而,梅毒与瓦色曼试验阳性之间并没有一致的关联。其他可能导致假阳性试验的密螺旋体病原体可以解释这些结果。在公众对塔斯基吉梅毒实验提出强烈抗议后,罗森瓦尔德研究有了新的意义。它被用作证据来支持这样一种观点,即塔斯基吉实验是人道主义动机的结果,但却被公共卫生服务局性病科研究人员错误的方法所左右。人道主义意味着承认受助者拥有的权利;健康本身就是目的。然而,非裔美国人作为世界棉花市场竞争中廉价劳动力的来源以及对制造业中白人工人市场价值的一种限制是必要的。公共卫生服务局的行政结构,而非热心的个人,采用功利主义作为其人体研究的范式。梅毒血清流行率是将公共卫生作为经济发展手段的一种蓄意利用。