While researching documents for our book on children as raw material for experimentation, Greg Dober discovered files at the University of Pittsburgh showing former U.S. Surgeon General Thomas Parran Jr. as the intellectual inspiration of the infamous Tuskegee Syphilis Study. The discovery presents university trustees with a dilemma:
Keep Parran's name on the school's public health building in honor of one of the giants of 20th-century medicine or remove it because of his connection with some of the most egregious and unethical medical experiments in the nation's history.
In addition to leading the Public Health Service's Venereal Disease Division, Parran was a key adviser to President Franklin Roosevelt and architect of New Deal health-policy. His 1937 book, Shadow on the Land, became a clarion call for a concerted public health campaign against syphilis and gonorrhea.
Parran was also instrumental in building support for the passage of Social Security, the establishment of the World Health Organization, cleaning polluted rivers and streams, and demanding truth in pharmaceutical advertising. He appeared on the cover of Time magazine in 1934, and two years later Roosevelt appointed him surgeon general. After leaving government in 1948, he was tapped to create and lead a public health program at the University of Pittsburgh Medical School.
Regrettably, Parran's great work, impressive resume, and proud legacy are besmirched by his ethical violations. The truth of his association with horrendous experiments using impoverished Alabama sharecroppers, federal prison inmates, and an array of vulnerable subjects in Guatemala who were purposefully infected with syphilis were already known. But newly discovered evidence disclosing his role as the architect of the Tuskegee study may have caused his already troubling case to reach the tipping point.
Like many virologists and "microbe hunters" of the last century who made significant contributions to science, Parran suffered from a moral blindspot. Consumed by conquering dreaded diseases such as pellagra, polio, tuberculosis, and hepatitis, the safety and well-being of test subjects used in clinical trials was deemed unimportant. For Parran's goal was ending the devastation caused by sexually transmitted diseases. Sins of omission and commission in the pursuit of scientific knowledge was not only acceptable, it was necessary.
But this "ends justify the means approach" allowed the Public Health Service to withhold treatment to hundreds of syphlitic black men for decades, and infect more than a thousand Guatemalan prisoners, mental patients, and prostitutes in postwar syphilis experiments. Those acts were later considered so egregious that in 2013 the American Sexually Transmitted Disease Association removed Parran's name from the organization's Lifetime Achievement Award.
Pitt trustees now must confront evidence showing Parran was more than a distant bureaucrat during the Tuskegee study. New documents disclose that Parran believed the African American population of Macon County, Ala., was perfect for a nontreatment exercise. "If one wished to study the natural history of syphilis in the Negro race uninfluenced by treatment," Parran wrote in January 1932, "this county would be an ideal location for such a study."
Parran also obtained funds to sustain the experiment at a critical time, and never considered ending the study or giving the men penicillin, a proven treatment by the late 1940s.
Parran wouldn't be the first esteemed physician to fall from grace and have his name removed from an award or edifice. Dr. Joseph DeJarnette had his name taken off a Virginia mental-health facility in 2001 after it was discovered he had championed Nazi eugenics policies and supported increased sterilization efforts in the United States.
More recently, the so-called "Father of Space Medicine" fell to earth when allegations of Dr. Hubertus Strughold's involvement in Nazi concentration camp medical experiments earned greater credibility. The controversy caused the Space Medicine Association to end the annual presentation of an award given in Strughold's honor.
Pitt trustees may choose to maintain their allegiance to the school's first dean of public health. If so, they should establish a fund and ongoing program in Parran's name to foster greater knowledge of ethical breaches in medical research and the importance of conducting studies consistent with the best traditions of the profession.