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Bad Blood: The Tuskegee Syphilis Experiment
From 1932 to 1972, the United States Public Health Service conducted a non-therapeutic experiment involving over 400 black male sharecroppers infected with syphilis. The Tuskegee Study had nothing to do with treatment. Its purpose was to trace the spontaneous evolution of the disease in order to learn how syphilis affected black subjects.
The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of “bad blood”, a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications.
“Bad Blood” provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States.
Now, in this revised edition of “Bad Blood”, Jones traces the tragic consequences of the Tuskegee Study over the last decade. A new introduction explains why the Tuskegee Study has become a symbol of black oppression and a metaphor for medical neglect, inspiring a prize-winning play, a Nova special, and a motion picture. A new concluding chapter shows how the black community's wide-spread anger and distrust caused by the Tuskegee Study has hampered efforts by health officials to combat AIDS in the black community. “Bad Blood” was nominated for the Pulitzer Prize and was one of the “N.Y. Times” 12 best books of the year.
The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of “bad blood”, a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications.
“Bad Blood” provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States.
Now, in this revised edition of “Bad Blood”, Jones traces the tragic consequences of the Tuskegee Study over the last decade. A new introduction explains why the Tuskegee Study has become a symbol of black oppression and a metaphor for medical neglect, inspiring a prize-winning play, a Nova special, and a motion picture. A new concluding chapter shows how the black community's wide-spread anger and distrust caused by the Tuskegee Study has hampered efforts by health officials to combat AIDS in the black community. “Bad Blood” was nominated for the Pulitzer Prize and was one of the “N.Y. Times” 12 best books of the year.
297 pages, Paperback
First published January 1, 1981
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Displaying 1 - 30 of 85 reviews
September 11, 2010
A must read for all aspiring biomedical and behavioral researchers. I couldn't write my dissertation without it.
July 4, 2021
“Bad Blood” altered a long running myth, in my mind, that the government deliberately inoculating syphilis into Black male sharecroppers, during the 1930s as part of the Tuskegee Study. In this book, by author James H. Jones, it’s delineated how the Public Health Service (PHS), in Macon County, Alabama, [in & around the county seat of Tuskegee] wanted to study “effects” of untreated syphilis and its consequence on cardiovascular & neurological trauma, in Black bodies. The nontherapeutic experiment was aimed at compiling data on the effects of the spontaneous evolution of syphilis in Black males, without informed consent. The subjects involved in this human experimentational study were poor, uneducated, and mostly illiterate.
The sacred Hippocratic Oath held by physicians [to treat the ill to the best of one’s ability] was clearly ignored!
The sacred Hippocratic Oath held by physicians [to treat the ill to the best of one’s ability] was clearly ignored!
February 24, 2020
I began reading this book for a seminar in January and finished it this month. Extremely well documented, this history tracks the events leading up to and during the Tuskegee Syphilis Study, along with the aftermath of public outrage. Jones also covers the impact of the study on perceptions during the height of the AIDS crisis, and the destruction of trust in government public health officials that stemmed from the study. A chilling chapter in American history, it is one with implications for how we think about public health, as well as the trust and authority granted to public health officials who may well not deserve it.
August 18, 2014
Exhaustively researched and elegantly written, Bad Blood: The Tuskegee Syphilis Experiment is both a wonderfully detailed history of the infamous Tuskegee Syphilis Experiment and an incisive analysis of the effects of institutionalized discrimination on marginalized segments of a population. From the ingrained racism that led many early 20th century doctors to believe that blacks and whites respond differently to various diseases (despite a complete lack of supporting evidence) to the blind faith that many in the early- to mid-century had in medical researchers to police themselves responsibly and ethically to the tendency of the Tuskegee Experiment’s directors to willfully blind themselves to the ethically questionable nature of their endeavor, this book provides an excellent and chilling lesson both on how cultural environments and personal foibles can unknowingly influence something as ostensibly objective as scientific inquiry, and on the absolute necessity of the placement of ethics as the foremost consideration in all biomedical research. Jones follows his historical critique of the Experiment with a treatment on the effects of the Experiment’s legacy on the early years of the AIDS crises, which I found particularly eye opening. After reading the history of the experiment and seeing the disturbing parallels, in both cultural perceptions and in institutional reactions, between syphilis early in the century and AIDS later in the century, the fact that conspiracy theories popped up among many black and gay people in the wake of AIDS makes more sense to me now than it did before (not to say that the theories themselves make any sense, simply that the emotional impetus behind them is understandable). This book is a must-read for any burgeoning scientist and should be required reading in all research ethics classes.
January 5, 2014
Insightful and appalling, this thorough history of the notorious Tuskegee Study in rural Alabama gives a comprehensive view of the background, origins, implementation, discovery and fall out of one of the darkest chapters in the countries public health history. Through a combination of cultural, bureaucratic and dogmatic precepts the study begins and moves along, gaining momentum from 1932 until 1972 when a dogged critic breaks the story to the Associated Press. The final chapter addresses the AID epidemic and the tragic and unfortunate effects of Tuskegee on inner-city African Americans along with the culture of mistrust, suspicion, fear and anger that is it's legacy.
December 5, 2014
Wonderfully-written with much detail, this book describes the study and the efforts made to bring it to light. The author, an attorney from the area, took up the cause at the behest of one of the victims. Culminating in an apology from President of the United States Bill Clinton, the book describes the process that was used to lure the men into the study and keep them there for 40+ years. Sadly, many of the men who were involved in the study had died by the time the formal apology and restitution were made, but attention must be paid so that this never happens again.
This entire review has been hidden because of spoilers.
September 5, 2016
If this book didn't make you furious, then you need to re-read it. Apparently the Hippocratic Oath to "Do no harm" didn't apply to African-Americans at the time. The experiments were conducted between 1939 and 1972--less than 77-44 years ago. Wives and children even contracted syphilis (which as we know, is fatal). THIS is why Black Lives Matter...
February 10, 2013
This is an eye-opening account of flagrant Human Rights violations in the name of science during an embarassing period in American history. If you, for one second, believe "Our Government" is a benevolent and just body this book will change your mind. Read this book. Sadly, it is NON-FICTION.
September 23, 2018
Scholarly and readable history of the Tuskegee Syphilis study. Takes a close look at the mentality of those who conducted the study and of those who remained oblivious for years to the violations of human rights that it entailed.
September 15, 2013
Proof that at least one historian did something useful once, rather than writing about things like Western movies. This was an informative, rage inducing case study of racist medical experimentation in America, whose research also went to support the class action legal action brought about by the victims and their descendants.
December 28, 2007
Incredibly true story... forces the reader to pause to wonder how something like this could happen and continues to happen around the world.
December 27, 2014
A chilling account of what the government did to its citizens. Makes you wonder what other type of experiments they are conducting now.
October 13, 2020
As a public health student, this was maybe the 20th time I had heard of the Tuskegee Syphilis Experiment, so I was a little dismayed by the prospect of reading a whole book about it. If you’ve never come across the infamous Study before, this book is certainly a comprehensive overview and a good place to start. Published in the decade immediately after the Tuskegee Study came to light, “Bad Blood” was probably groundbreaking historical work at the time.
For those unfamiliar with the Tuskegee Study, it started out as a Public Health Service initiative in 1932. A previous prevalence survey, also conducted by the Public Health Service, revealed that syphilis rates in Macon County, Alabama were as high as 35%. Public health officials sensed an opportunity. A study of untreated syphilis among white men in Oslo, Norway had recently been concluded in 1910 with the results published in 1929. Never mind that the Oslo Study was a retrospective one, or that the study was halted after the discovery of Salvarsan, the first effective treatment for syphilis. No. The public health officials in the United States were determined that syphilis was distinctly different across races. This insistence, as author James H. Jones shows, was born out a racist belief that white people and Black people were significantly biologically distinct, to the extent that several common illnesses affected the races differently. With a prevalence rate of 35%, how could physicians and public health workers resist the temptation to see how syphilis destroyed poor, rural,
uneducated and untreated Black men over time?
It goes without saying that this book is difficult to read at times - the atrocities just keep coming. First they single out illiterate and indigent Black men. Then they never tell them they had syphilis, saying only they had “bad blood.” They never obtain consent from anyone. Indeed, later in the book a health official justifies continuing the study by saying it would be practically impossible to obtain consent from such ignorant people. They tell the men they should be grateful to receive medical treatment that most people can’t afford. That “treatment,” by the way, is often aspirin pills that of course do absolutely nothing for syphilis. They trick the men into getting lumbar punctures that they advertise with a flyer labeled “special free treatment.” At the time the study began, treatments for syphilis did exist - a noxious combination of arsenic and mercury - but they were expensive, lengthy, and riddled with side effects. Initially required by their donor to provide some treatment to the participants, the men in the study received short courses of arsenic and mercury, but far below the threshold deemed therapeutic. When the study was continued past the original 8 months, officials justifying withholding treatment because, they reasoned, the men would never be able to afford it on their own anyway. They didn’t want any of the men to die without the chance to perform autopsies, so a list of all the men in the study was circulated to private physicians, local hospitals, and clinics - if any of the men showed up seeking treatment for syphilis, the study organizers were to be contacted. Many attempts at seeking treatment were blocked. There was literally a conspiracy against these men. All of this happened long before penicillin was discovered as a cure for syphilis - a cure that was, of course, systematically denied to the men for several more decades.
I happened to look up the Tuskegee Study FAQ on the CDC’s website, and I was shocked. It reads:
“Q. When did the U.S. Public Health Service Syphilis Study at Tuskegee become unethical?
A. The study became unethical in the 1940s when penicillin became the recommended drug for treatment of syphilis and researchers did not offer it to the subjects.”
Is this a joke? Is the CDC trying to save face? The study was ALWAYS unethical. It was unethical from the very beginning. It was based on racist medicalization of Black men. It took advantage of poverty, race, and lack of education. There was never consent. There was duplicity at every stage. That FAQ is shameful.
“Bad Blood” is very much the work of a historian. Although James H. Jones makes it clear that the Tuskegee Study was unethical from the start, he relays events in a relatively emotionless manner. Indeed, many of the racist quotes are shocking enough to speak for themselves, but I was a little surprised that he didn’t do more editorializing. The most interesting chapter by far was on Nurse Rivers, the Black nurse who was largely responsible for keeping the men in the study over the years. Even though she knew the men were denied treatment even after the discovery of penicillin, she denied any wrongdoing. Jones must contend with this frankly baffling historical figure with some of his own reasoning, instead of merely relying on documents to tell the story for him. Indeed, I thought a NYT review of the book put it well: “If anything, Mr. Jones is far too evenhanded, far too dispassionate, in making this point. He renounces heavyhanded moral indignation.” Considering the subject matter, the book is surprisingly dry and, at times, hard to follow. It’s certainly detailed and well-researched, but it lacks heart.
For those unfamiliar with the Tuskegee Study, it started out as a Public Health Service initiative in 1932. A previous prevalence survey, also conducted by the Public Health Service, revealed that syphilis rates in Macon County, Alabama were as high as 35%. Public health officials sensed an opportunity. A study of untreated syphilis among white men in Oslo, Norway had recently been concluded in 1910 with the results published in 1929. Never mind that the Oslo Study was a retrospective one, or that the study was halted after the discovery of Salvarsan, the first effective treatment for syphilis. No. The public health officials in the United States were determined that syphilis was distinctly different across races. This insistence, as author James H. Jones shows, was born out a racist belief that white people and Black people were significantly biologically distinct, to the extent that several common illnesses affected the races differently. With a prevalence rate of 35%, how could physicians and public health workers resist the temptation to see how syphilis destroyed poor, rural,
uneducated and untreated Black men over time?
It goes without saying that this book is difficult to read at times - the atrocities just keep coming. First they single out illiterate and indigent Black men. Then they never tell them they had syphilis, saying only they had “bad blood.” They never obtain consent from anyone. Indeed, later in the book a health official justifies continuing the study by saying it would be practically impossible to obtain consent from such ignorant people. They tell the men they should be grateful to receive medical treatment that most people can’t afford. That “treatment,” by the way, is often aspirin pills that of course do absolutely nothing for syphilis. They trick the men into getting lumbar punctures that they advertise with a flyer labeled “special free treatment.” At the time the study began, treatments for syphilis did exist - a noxious combination of arsenic and mercury - but they were expensive, lengthy, and riddled with side effects. Initially required by their donor to provide some treatment to the participants, the men in the study received short courses of arsenic and mercury, but far below the threshold deemed therapeutic. When the study was continued past the original 8 months, officials justifying withholding treatment because, they reasoned, the men would never be able to afford it on their own anyway. They didn’t want any of the men to die without the chance to perform autopsies, so a list of all the men in the study was circulated to private physicians, local hospitals, and clinics - if any of the men showed up seeking treatment for syphilis, the study organizers were to be contacted. Many attempts at seeking treatment were blocked. There was literally a conspiracy against these men. All of this happened long before penicillin was discovered as a cure for syphilis - a cure that was, of course, systematically denied to the men for several more decades.
I happened to look up the Tuskegee Study FAQ on the CDC’s website, and I was shocked. It reads:
“Q. When did the U.S. Public Health Service Syphilis Study at Tuskegee become unethical?
A. The study became unethical in the 1940s when penicillin became the recommended drug for treatment of syphilis and researchers did not offer it to the subjects.”
Is this a joke? Is the CDC trying to save face? The study was ALWAYS unethical. It was unethical from the very beginning. It was based on racist medicalization of Black men. It took advantage of poverty, race, and lack of education. There was never consent. There was duplicity at every stage. That FAQ is shameful.
“Bad Blood” is very much the work of a historian. Although James H. Jones makes it clear that the Tuskegee Study was unethical from the start, he relays events in a relatively emotionless manner. Indeed, many of the racist quotes are shocking enough to speak for themselves, but I was a little surprised that he didn’t do more editorializing. The most interesting chapter by far was on Nurse Rivers, the Black nurse who was largely responsible for keeping the men in the study over the years. Even though she knew the men were denied treatment even after the discovery of penicillin, she denied any wrongdoing. Jones must contend with this frankly baffling historical figure with some of his own reasoning, instead of merely relying on documents to tell the story for him. Indeed, I thought a NYT review of the book put it well: “If anything, Mr. Jones is far too evenhanded, far too dispassionate, in making this point. He renounces heavyhanded moral indignation.” Considering the subject matter, the book is surprisingly dry and, at times, hard to follow. It’s certainly detailed and well-researched, but it lacks heart.
July 7, 2021
Ausführliche und eindrückliche Aufarbeitung eines der bedeutendsten Skandale der Medizingeschichte.
Beängstigend mit welchen Mitteln Rassismus und Homophobie rationalisiert wird. Die immense Auswirkung des Experiments ist einer der vielen historischen Ereignisse, die das Verhältnis zwischen der amerikanischen Gesellschaft & Regierung, und den verschiedensten Minderheiten bis heute schädigt.
Als Kurzfassung einfach „Skegee“ von JID (2021) anhören
Danke James
6/10 📖
Beängstigend mit welchen Mitteln Rassismus und Homophobie rationalisiert wird. Die immense Auswirkung des Experiments ist einer der vielen historischen Ereignisse, die das Verhältnis zwischen der amerikanischen Gesellschaft & Regierung, und den verschiedensten Minderheiten bis heute schädigt.
Als Kurzfassung einfach „Skegee“ von JID (2021) anhören
Danke James
6/10 📖
August 29, 2020
This classic by historian James H. Jones chronicles the 40-year experiment (1932-1972) done on 400 poor, black males in Macon County, Alabama. The book traces the history of the “study” but more importantly documents the repercussions of systemic racism among the educated medical professionals involved.
The study began with good intentions and began when no good treatment or ethical standards were available. However, once penicillin was available the PHS (Public Health Service) and other doctors did not provide it to the patients and allowed their wives and children to become infected without their knowledge as well. The men cooperated for sandwiches, aspirin, and burial payments (if they allowed autopsy the study would pay for their burial – this was a huge incentive as this was the poorest county in Alabama). They were told the spinal taps (very painful and in some quite debilitating) were spinal “shots” and the doctors let the men think they were getting medicine for their “bad blood”. There was zero benefit to being in the study and it provided no therapeutic value to the men or their families. US Funds were used to finance the program.
The goals of the study were twofold – first was to use the blood serum of those infected to develop accurate testing (two commercial tests were developed) and second to determine long term effects of syphilis in black males as opposed to white at autopsy. It began under a profoundly racist premise – that black males were different than whites and that syphilis would cause more cardiovascular disease in blacks and higher neurological disease in whites (due to an assumption that blacks had a higher sex drive while whites had higher IQs).
This group of patients were not volunteers. In 1927 there was a law that syphilis must be treated, and the study doctors deliberately lied to and denied these men treatment. When the WW2 draft began the USPHS and Board of Health officials made sure these men were exempted from it as they would have been tested and found to be positive for syphilis at that time. The men were told they were being “treated” for their “bad blood”.
The men could not provide “informed consent” as they were never told they had syphilis or what the affects might be (including that they could pass it to their wives and therefore their children congenitally) nor were they informed there was a treatment once penicillin had been discovered.
To make matters even worse, the study was voided scientifically early on as some of the men received small doses of arsphenamine and also because members of the control group and study group were shuffled as some men were treated accidentally and / or became positive for syphilis. (The point of the study as defined was to review at autopsy how untreated syphilis affected blacks.)
The doctors/the system involved could not see the racism inherent and the immorality of the study. They did not recognize that they were performing human experimentation very like the Nazi’s, even with bureaucratic review.
The updated edition of the book concludes with a chapter on AIDS and how the Tuskegee study directly caused suspicion and hampered efforts to educate and treat AIDS in the black community. (The Tuskegee Institute was recruited early on to provide labs, help with exams, x rays, and spinal taps specifically to lend credence to the syphilis study.) The repercussions of this experiment are still with us societally.
The Tuskegee Syphilis Experiment did lead to the formalization of independent medical review boards and medical ethics guidelines and practices. It led to the policy of informed consent. President Bill Clinton officially apologized. A civil lawsuit was settled out of court and provided for the families of those that could be found. An excellent and important read if you are interested in Black Studies or Medical History.
The study began with good intentions and began when no good treatment or ethical standards were available. However, once penicillin was available the PHS (Public Health Service) and other doctors did not provide it to the patients and allowed their wives and children to become infected without their knowledge as well. The men cooperated for sandwiches, aspirin, and burial payments (if they allowed autopsy the study would pay for their burial – this was a huge incentive as this was the poorest county in Alabama). They were told the spinal taps (very painful and in some quite debilitating) were spinal “shots” and the doctors let the men think they were getting medicine for their “bad blood”. There was zero benefit to being in the study and it provided no therapeutic value to the men or their families. US Funds were used to finance the program.
The goals of the study were twofold – first was to use the blood serum of those infected to develop accurate testing (two commercial tests were developed) and second to determine long term effects of syphilis in black males as opposed to white at autopsy. It began under a profoundly racist premise – that black males were different than whites and that syphilis would cause more cardiovascular disease in blacks and higher neurological disease in whites (due to an assumption that blacks had a higher sex drive while whites had higher IQs).
This group of patients were not volunteers. In 1927 there was a law that syphilis must be treated, and the study doctors deliberately lied to and denied these men treatment. When the WW2 draft began the USPHS and Board of Health officials made sure these men were exempted from it as they would have been tested and found to be positive for syphilis at that time. The men were told they were being “treated” for their “bad blood”.
The men could not provide “informed consent” as they were never told they had syphilis or what the affects might be (including that they could pass it to their wives and therefore their children congenitally) nor were they informed there was a treatment once penicillin had been discovered.
To make matters even worse, the study was voided scientifically early on as some of the men received small doses of arsphenamine and also because members of the control group and study group were shuffled as some men were treated accidentally and / or became positive for syphilis. (The point of the study as defined was to review at autopsy how untreated syphilis affected blacks.)
The doctors/the system involved could not see the racism inherent and the immorality of the study. They did not recognize that they were performing human experimentation very like the Nazi’s, even with bureaucratic review.
The updated edition of the book concludes with a chapter on AIDS and how the Tuskegee study directly caused suspicion and hampered efforts to educate and treat AIDS in the black community. (The Tuskegee Institute was recruited early on to provide labs, help with exams, x rays, and spinal taps specifically to lend credence to the syphilis study.) The repercussions of this experiment are still with us societally.
The Tuskegee Syphilis Experiment did lead to the formalization of independent medical review boards and medical ethics guidelines and practices. It led to the policy of informed consent. President Bill Clinton officially apologized. A civil lawsuit was settled out of court and provided for the families of those that could be found. An excellent and important read if you are interested in Black Studies or Medical History.
February 12, 2008
What a terrible story!! I don't mean terrible in the sense that the book was bad but in the sense that I can't believe this actually happened. For 40 years black men with syphilis in Alabama were a part of an experiment in which they were seen by doctors but not treated for their disease, even after penicillin became widely available as a treatment for syphilis. The worst part of the entire thing: no one ever told these men that they had the disease; they thought they were being monitored because they had "bad blood."
The requisite stuff: would I recommend it? Yes, definitely. Who should read it? Well, personally I think anyone with a conscience, but it is at times very difficult going reading wise. It is a history, not only of the experiment at Tuskeegee, but the author sets it all up with a history of the disease & of the Public Health Service, and most interestingly, a history of medical care for African-Americans going back to slavery days. So it may not be everyone's cup of tea.
This would have been outrageous on a basic scale if the originators of this experiment were working alone, but as the author shows, it seems that the work was well known in medical circles. The work was documented over the 40-year period in medical journals, discussed at medical conferences and was not simply the product of the Public Health Service but had the backing of Tuskegee Institute (and you have to ask yourself WHY?, especially during the 1950s and 1960s when Alabama was a hot spot in the civil rights movement), the Veteran's Hospital, multiple medical practitioners (both African-American and White) throughout the state who signed death certficates and let the principals know when a certain subject was hospitalized or died, and the list goes on and on. The author also discusses the "ethical" question and shows clearly that beginning in the 1930s, physicians covered each other & basically made up their own ethics as they went along. Even after it was discovered that Nazi scientists were doing human experimentation at the concentration camps, and after the Trials at Nuremberg when human experimentation was brought into public view, the scientists conducting the Tuskegee experiment didn't have any qualms about continuing the project. Alabama passed several laws requiring the reporting of infectious disease and still somehow through all of the revisions of these laws, the Tuskegee people were not held accountable nor were they required to follow the law.
I would have to add that this study was completely racist: some of the justifications given in the course of the study just floored me. For example, on page 23, the author notes that physicians realized that it would be only natural for African-Americans to have the highest incidence of syphilis since "personal restraints on self-indulgence did not exist...the smaller brain of the Negro had failed to develop a center for inhibiting sexual behavior," and on 24, "the Negro man will not abstain from sexual intercourse if thre is the opportunity for indulgence." On page 48, re the white image of black sexuality: "Blacks suffered from venereal diseases because they would not, or could not, refrain from sexual promiscuity." One further justification for the experiment was as a comparison between untreated syphillis in African-American people and untreated syphilis in Whites; there had been some sort of experiment done prior to this in Norway with white people.
I could go on and on, but suffice it to say that I was totally outraged after reading this book. And I think that is a good thing.
If you want to add another chapter to your knowledge of African-American history, PICK UP THIS BOOK!
read: 2/01/2005
The requisite stuff: would I recommend it? Yes, definitely. Who should read it? Well, personally I think anyone with a conscience, but it is at times very difficult going reading wise. It is a history, not only of the experiment at Tuskeegee, but the author sets it all up with a history of the disease & of the Public Health Service, and most interestingly, a history of medical care for African-Americans going back to slavery days. So it may not be everyone's cup of tea.
This would have been outrageous on a basic scale if the originators of this experiment were working alone, but as the author shows, it seems that the work was well known in medical circles. The work was documented over the 40-year period in medical journals, discussed at medical conferences and was not simply the product of the Public Health Service but had the backing of Tuskegee Institute (and you have to ask yourself WHY?, especially during the 1950s and 1960s when Alabama was a hot spot in the civil rights movement), the Veteran's Hospital, multiple medical practitioners (both African-American and White) throughout the state who signed death certficates and let the principals know when a certain subject was hospitalized or died, and the list goes on and on. The author also discusses the "ethical" question and shows clearly that beginning in the 1930s, physicians covered each other & basically made up their own ethics as they went along. Even after it was discovered that Nazi scientists were doing human experimentation at the concentration camps, and after the Trials at Nuremberg when human experimentation was brought into public view, the scientists conducting the Tuskegee experiment didn't have any qualms about continuing the project. Alabama passed several laws requiring the reporting of infectious disease and still somehow through all of the revisions of these laws, the Tuskegee people were not held accountable nor were they required to follow the law.
I would have to add that this study was completely racist: some of the justifications given in the course of the study just floored me. For example, on page 23, the author notes that physicians realized that it would be only natural for African-Americans to have the highest incidence of syphilis since "personal restraints on self-indulgence did not exist...the smaller brain of the Negro had failed to develop a center for inhibiting sexual behavior," and on 24, "the Negro man will not abstain from sexual intercourse if thre is the opportunity for indulgence." On page 48, re the white image of black sexuality: "Blacks suffered from venereal diseases because they would not, or could not, refrain from sexual promiscuity." One further justification for the experiment was as a comparison between untreated syphillis in African-American people and untreated syphilis in Whites; there had been some sort of experiment done prior to this in Norway with white people.
I could go on and on, but suffice it to say that I was totally outraged after reading this book. And I think that is a good thing.
If you want to add another chapter to your knowledge of African-American history, PICK UP THIS BOOK!
read: 2/01/2005
May 6, 2023
TL;DR: Jones presents an informative, insightful and well-researched study on a highly controversial medical experiment that allows the reader to determine which side of history (and science) they stand on. A great read.
_____
_____
I’ve heard about the study tangentially, usually poking its head out when it comes to cultural apprehension around care in the American medical industry (eg. vaccinations, mis/diagnoses, the pandemic, maternal care, etc), and peripherally in school, but I’ve never heard it so well clarified and contextualized as in James H. Jones’ account.
Though it’s clear which side of the controversy Jones leans toward, he is incredibly fair when surfacing various forms of research and evidence — from firsthand accounts to census data — from all sides. In this way, he leaves room for the reader to come to her own conclusions about the ethics and morality of the Tuskegee Experiment.
Jones approaches the subject with sensitivity while being (somehow) concise and thorough. I learned a lot about the disease itself, the complexities that both doctors and patients faced, nuances and processes within the healthcare industry, power dynamics in healthcare, the carriage of and accountability to American ideals, and more. I’ve also read Booker T. Washington’s Up from Slavery a few times before this, so it’s interesting to see this study in parallel with the Tuskegee Institute and Washington’s own ideas about methods for uplifting the Black race.
Whether it was intentional or not, this is a great example of how unchecked power dynamics can lead to abuse, and how the intricacies of race relations can become so intertwined with power systems (health) that even the most well-meaning people, or people who are members of oppressed groups, can find themselves working against their own goodwill (eg. Nurse Rivers who must grapple with those “two warring ideals”). Jones’ attention to the subtlest details — personal agendas, scientific advancement (clout), medical experimentation, once-in-a-lifetime job opportunities, etc. — illustrate how various participants, over a 40-year span, can become complicit in a seemingly beneficial study (according to the original doctors) that spirals out of control.
To be a part of a community and instinctively understand that historical events have yielded (what feels like) natural-born attitudes is one thing; to have the how so well-documented is another. Bad Blood makes the residue of the Black community’s modern attitudes toward the traditional healthcare system (and vice versa) much easier to trace.
Adding the name Peter Buxtun to my short list of history’s white allies, who serves as an example of the necessity of being steadfast and dogged in turning the tide.
Hiccups in editing and consistency are forgivable in light of the strong, easy-to-follow case Jones has presented.
_____
“No scientific experiment inflicted more damage on the collective psyche of black Americans than the Tuskegee Study.”
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I’ve heard about the study tangentially, usually poking its head out when it comes to cultural apprehension around care in the American medical industry (eg. vaccinations, mis/diagnoses, the pandemic, maternal care, etc), and peripherally in school, but I’ve never heard it so well clarified and contextualized as in James H. Jones’ account.
Though it’s clear which side of the controversy Jones leans toward, he is incredibly fair when surfacing various forms of research and evidence — from firsthand accounts to census data — from all sides. In this way, he leaves room for the reader to come to her own conclusions about the ethics and morality of the Tuskegee Experiment.
Jones approaches the subject with sensitivity while being (somehow) concise and thorough. I learned a lot about the disease itself, the complexities that both doctors and patients faced, nuances and processes within the healthcare industry, power dynamics in healthcare, the carriage of and accountability to American ideals, and more. I’ve also read Booker T. Washington’s Up from Slavery a few times before this, so it’s interesting to see this study in parallel with the Tuskegee Institute and Washington’s own ideas about methods for uplifting the Black race.
Whether it was intentional or not, this is a great example of how unchecked power dynamics can lead to abuse, and how the intricacies of race relations can become so intertwined with power systems (health) that even the most well-meaning people, or people who are members of oppressed groups, can find themselves working against their own goodwill (eg. Nurse Rivers who must grapple with those “two warring ideals”). Jones’ attention to the subtlest details — personal agendas, scientific advancement (clout), medical experimentation, once-in-a-lifetime job opportunities, etc. — illustrate how various participants, over a 40-year span, can become complicit in a seemingly beneficial study (according to the original doctors) that spirals out of control.
To be a part of a community and instinctively understand that historical events have yielded (what feels like) natural-born attitudes is one thing; to have the how so well-documented is another. Bad Blood makes the residue of the Black community’s modern attitudes toward the traditional healthcare system (and vice versa) much easier to trace.
Adding the name Peter Buxtun to my short list of history’s white allies, who serves as an example of the necessity of being steadfast and dogged in turning the tide.
Hiccups in editing and consistency are forgivable in light of the strong, easy-to-follow case Jones has presented.
June 6, 2020
On May 9th, I started reading this book in the midsts of Ahmaud Avery’s horrifying death video release. Then on May 25th, I was still reading this book when we woke up to the news of George Floyd’s murder.
Fifty years have passed since the uncovering of the Tuskegee study, “some” progress has been made but we still have not changed and attacked the systemic racism imbedded deeply in American society. I wanted to share what I learned from reading this book and it’s relevance in these days:
1. In 1932, what had started as a control treatment experiment became a non-therapeutic human experiment.
2. The original study started by using 412 participants with syphilis and 204 control participants. All of them Black.
3. Participants were misinformed; they were told they had bad blood and many unethical tactics were used to make them believe they were receiving treatment for their ailments.
4. Not even after the Nuremberg trials, and the creation of the declaration of Helsinki, had a seed of doubt been planted in the health officials and doctors who were involved in the study. All of them White.
5. In 1962, new guidelines for human experimentations were created after the Thalidomide scandal, which included an informed consent, but no informed consent was ever given to the participants of the Tuskegee study.
6. The participants of the Tuskegee study were treated as guinea pigs for a study that would not prevent, find, nor treat a single case.
7. It wasn’t until 1972 when a non-black individual was able to bring this study to light as a violation to human rights; the study was conducted for 40 years.
8. There were other people (no more more than five) that spoke out against the study but these people did not pursue the cause hence no action was taken.
Systematic racism has been perpetuated by white people in power that do nothing; this attitude affects every facet of black lives and other minority populations. According to history, it takes someone from the majority “white people” to be appalled and moved to action in order to create change. If you are interested in biomedical sciences, ethics, and regulation you should read this book.
Fifty years have passed since the uncovering of the Tuskegee study, “some” progress has been made but we still have not changed and attacked the systemic racism imbedded deeply in American society. I wanted to share what I learned from reading this book and it’s relevance in these days:
1. In 1932, what had started as a control treatment experiment became a non-therapeutic human experiment.
2. The original study started by using 412 participants with syphilis and 204 control participants. All of them Black.
3. Participants were misinformed; they were told they had bad blood and many unethical tactics were used to make them believe they were receiving treatment for their ailments.
4. Not even after the Nuremberg trials, and the creation of the declaration of Helsinki, had a seed of doubt been planted in the health officials and doctors who were involved in the study. All of them White.
5. In 1962, new guidelines for human experimentations were created after the Thalidomide scandal, which included an informed consent, but no informed consent was ever given to the participants of the Tuskegee study.
6. The participants of the Tuskegee study were treated as guinea pigs for a study that would not prevent, find, nor treat a single case.
7. It wasn’t until 1972 when a non-black individual was able to bring this study to light as a violation to human rights; the study was conducted for 40 years.
8. There were other people (no more more than five) that spoke out against the study but these people did not pursue the cause hence no action was taken.
Systematic racism has been perpetuated by white people in power that do nothing; this attitude affects every facet of black lives and other minority populations. According to history, it takes someone from the majority “white people” to be appalled and moved to action in order to create change. If you are interested in biomedical sciences, ethics, and regulation you should read this book.
July 9, 2025
I have had this book, unread, on my shelves for many a year. Recommended by my now dead father - who was, himself, a doctor and researcher who conducted research involving patients of his family practice in Wales as subjects. Having now spent a couple of days reading it, I can see why he thought it so important and revelatory. The book, written in clear and un-emotional prose suited to its inflammatory subject matter, should be essential reading for anyone interested or involved in research. The self-deception of otherwise well-meaning professionals throughout the study highlights points to the need for training and more robust public involvement and oversight in research and clinical medicine. The researchers here failed to spot or act on misgivings right until the study was exposed in 1972. Without adequate public involvement and oversight - and even with it - the potential to hoodwink too-often credulous patients to do what doctors want and not what is in their interest remains.
When reflecting on patients' seemingly irrational distrust of recommended advice and treatments e.g. COVID vaccination, it is well to remind ourselves that some of this distrust, at least, comes from egregious examples of moral blindness and racism as exemplified by the Tuskegee Syphilis experiment.
When reflecting on patients' seemingly irrational distrust of recommended advice and treatments e.g. COVID vaccination, it is well to remind ourselves that some of this distrust, at least, comes from egregious examples of moral blindness and racism as exemplified by the Tuskegee Syphilis experiment.
July 7, 2010
Educational but not overly academic. It definitely helps you understand how this could have happened, how people could justify participation and how to never let this kind of outrageousness ever happen again. Much more nuanced than expected.
August 22, 2019
Wow. I had learned about this in medical ethics training both in my public health training and in medical school. This is a the gruesome detailed story of the entire research study - how it started, why it started, the rationale, and the amazing fact that it was allowed to continue from 1932 to 1972 and how many members of the medical community, NIH, Public Health Service, continued to rationalize for years that somehow this was ok. Not only that but the study was relatively worthless because the methodology was flawed by including partly treated subjects in their "untreated" group. It's a pretty disgusting book to read - but demonstrates everything that could be ethically wrong with human research.
July 20, 2022
After reading about the history of vaccine clinical trials held by the major pharmaceutical companies and knowing the many African-Americans were COVID vaccine hesitant, I became curious about the Tuskegee syphilis experiment. This gave a comprehensive, easy-to-understand explanation of exactly what happened.
As usual, the treatment of the blacks who were in the experiment is horrific, and the people in charge of the experiment were convinced that they were morally righteous in conducting the experiments, out to improve the lives of blacks. A tale as old as time, it appears. Good book, even if very upsetting!
As usual, the treatment of the blacks who were in the experiment is horrific, and the people in charge of the experiment were convinced that they were morally righteous in conducting the experiments, out to improve the lives of blacks. A tale as old as time, it appears. Good book, even if very upsetting!
August 17, 2014
This book was boring when Dr. Jones assigned it in his history class years ago at UH, and (I am grieved to report) it is precisely as boring as I remember it to be. How anyone could made such an inherently dramatic subject such a chore to read about is anyone's guess, but I just couldn't make myself continue past page 2. Too bad. I know it's a worthy subject.
December 7, 2015
This is a very interesting read, it can be a little difficult and dry at times but it was not what I was expecting. This was a documented and publicized experiment that continued for 40 years. An eye opening read on the treatment and protection of people participating in medical science experiments.
November 30, 2016
Used this book for the graduate level community health course. Excellent for discussion. By looking at this book as a case study for learning from mistakes, it gives great examples of how community health initiatives could/should be done to improve trust (and in the end health) between providers/researchers and the community.
June 18, 2023
The Tuskegee experiment was a horrible way for the government to treat Black men. No humanity whatsoever!!!
May 17, 2019
great story, not told in a gripping fashion. AIDS chapter seems forced, no real transition there for me.
May 14, 2012
Although a bit slow-moving at times, this is a very important book with a lot of humanity for all the difficulty of its subject matter. It makes it more comprehensible, without ever justifying, how it could happen that human beings were willingly kept untreated, and able to spread, a horrible disease. Some of those conditions are human pride of course, and a tendency to continue down a path once it has started, but it is also clear that it is poverty and a lack of education that makes these kinds of abuses possible, and the book does a nice job of conveying the broader problems to society, without forgetting the impact on the individual.
The other interesting fact from the book, which is missed in a lot of information about the experiment, is that of the original test pool, all of the men had received some treatment for syphilis, so even though the stated purpose was to study untreated syphilis, that never happened--it only prevented treatment from happening, including after better treatments became available. It is amazing and awful.
The other interesting fact from the book, which is missed in a lot of information about the experiment, is that of the original test pool, all of the men had received some treatment for syphilis, so even though the stated purpose was to study untreated syphilis, that never happened--it only prevented treatment from happening, including after better treatments became available. It is amazing and awful.
June 25, 2013
This book surprised me. I didn't know as much as I thought about the experiment, a victim of modern misconceptions. I didn't realized that it had started out as a humanitarian relief program that transformed under changed leadership and lack of funding. The callous reactions of modern doctors involved in the program surprised me too. As late as the 1970s, despite the blatant deception, rationalized science and obvious uselessness of the experiment, they still didn't believe that they did anything wrong. That boggles my mind. I was also surprised to learn that the sharecroppers in Macon Alabama were still as poor in the seventies as they were int he thirties. It reads a little dry, but the content is afascinating look at why marginalized groups are justifiably distrustful of government health institutions and a detailed examination of racsim and medical ethics in twentieth century America.
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