US's apology is not enough

Guatemalan president Alvaro Colom at a press conference after revalations following the syphilis experiments revalations. Photograph: Johan Ordonez/AFP/Getty Images

If medical researchers could infect their subjects with the disease new medicine was supposed to treat, the world would be a terrifying place.

As a response to the dehumanisation wrought by human experimentation in the second world war, the Nuremberg Code, and later the Helsinki Code in 1967, were developed to govern ethics in medical research. Both instruments — constituting the pre-eminent international standards on these issues – propound the need for informed consent in all research, and prohibit experiments where injury, disability or death to the participant is reasonably expected. The Helsinki Code expressly warns that the "interest of science and society should never take precedence over considerations related to the wellbeing of the subject."

Recent discovery by a Wellesley College professor, Susan Reverby, of a US-funded syphilis inoculation project in Guatemala in the 1940s has brought ethics in medical research back into public focus. Records show that in these studies, infected prostitutes were deployed to have sex with men in prisons. Syphilitic growths on the testicles of infected rabbits and from infected men were used to inoculate inmates who were subjects in these studies. This exposé also uncovered the involvement of the Guatemalan government.

The US has been remarkably robust in issuing an apology, calling these research practices "unethical", "abhorrent" and "reprehensible". It has promised "a thorough investigation into the specifics of this case" and pledged to launch a Presidential Commission for the Study of Bioethical Issues to "review and report on the most effective methods to ensure that all human medical research conducted around the globe today meets rigorous ethical standards."

Ariel Dulitzky, a professor of law at the University of Texas law school and an expert on the inter-American system of human rights, is of the view that the US apology does not go far enough, and believes there should be financial compensation to the victims and their descendants. He is emphatic that the apology should have been directed to "the victims, and not the present Guatemalan president [Álvaro Colom], as the government at the time had been complicit in the research".

The Inter-American Commission on Human Rights has dealt with a comparable matter that concluded with a friendly settlement between the government of Peru and the descendants of a victim in 2003. María Mamérita Mestanza was a mother of seven children in Peru, who was pressured to accept sterilisation as part of a compulsory and systematic government policy for altering the reproductive behaviour of poor, Indian and rural women. She died as a result of a "sepsis" and bilateral tubal blockage in 1998.

In issuing its opinion, the commission observed that "any violation of an international obligation that results in injury brings with it the duty for adequate reparation, which can most justly be done through compensation of the victim, investigation of the facts, and administrative, civil and criminal penalties for the responsible parties." The Peruvian government agreed to address all these areas in the case of Mestanza, and included a pledge to change the laws and public policies on reproductive health and family planning, eliminating discriminatory approaches and respecting women's autonomy.

The way that this case from Peru was handled supports the view that adequate reparations – include monetary redress and criminal investigations – in Guatemala matter. Some would also argue that the Guatemala study constituted torture or cruel, inhuman and degrading treatment, and as such, the US has an obligation under international law to pursue criminal investigations and provide the victims with adequate financial compensation.

(source:guardian.co.uk)