It was just one woman’s story, and that was more than enough for a Commission member to find moral blame.
During the Presidential Commission for the Study of Bioethical Issues’ meeting today on the investigation of US researchers deliberately exposing and infecting Guatemalans with sexually transmitted diseases from 1946 to 1948, one member raised the story of Berta.
Berta, said Dr. John Arras, the Porterfield Professor of Biomedical Ethics and Professor of Philosophy at the University of Virginia, was a patient on a psychiatric ward who was injected with syphilis and not given treatment for three months after her initial exposure.
Arras noted the observations of the principal investigator for the study, Dr. John Charles Cutler, of Berta on one summer’s day. Arras said that Cutler wrote that it appeared Berta “was going to die. He did not specify why.”
That same day, Arras said that Dr. Cutler “put gonorrhea puss on her eyes, urethra and rectrum.”
Soon after, Berta died. She was one of 83 participants who died during the course of the studies. It was not clear whether the participants died as a result of being infected with sexually transmitted diseases. More than 1,300 Guatemalans were exposed to sexually transmitted diseases over the two years.
Arras said he brought up this single case because he was wrestling with the “distinction between blame and wrongdoing for some time.” He said he wanted to take great care in considering the ethics of the period, and he wanted to closely look at the standards of informed consent then.
“I, for one, have been extremely reluctant to bring the moral hammer down with full force on the question of moral blame,” he said. “However, the issue of informed consent is not the only question. I’m not talking about just the failure to inform. We’re talking about intentional deception. … I really do believe that a very rigorous judgment of moral blame can be lodged against some of these people.”
“The most powerful argument,’’ he said, “is to repeat a story.”