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S‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍elect one of the following topics from Chapter 9 and discus

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S‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍elect one of the following topics from Chapter 9 and discuss the ethical issues presented by the topic/cases and how we could prevent those issues from coming up in the future. William Beaumont Nazi medical Research Joseph Mengele American Military Research n WWII The Tuskegee Syphilis Study HIV prevention in Africa Secret American Government Medical Experiments The Krieger Lead Paint Study Jesse Gelsinger’s death The Olivieri Case Be sure to view the information on the Tuskegee Syphilis Study that is in the required resources section of this week’s course. (Tuskegee Syphilis Study timeline, the Presidential apology and the presentation by Dr. Vanessa Northington Gamble on the Tuskegee Syphilis Study). **Do not forget proper referencing!** I WOULD LIKE YOU TO WRITE ABOUT " TUSKEGEE SYPHILIS STUDY" Thank you. Here is the info from E-Text and you can use another resources. THE TUSKEGEE STUDY (OR “STUDY”) Nature and History of Syphilis Past victims of untreated syphilis included Cleopatra, King Herod of Judea, Char- lemagne, Henry VIII, Napoleon Bonaparte, Frederick the Great, Catherine the Great, Christopher Columbus, Paul Gauguin, Franz Schubert, Albrecht Dürer, Johann Wolfgang von Goethe, Friedrich Nietzsche, John Keats, and James Between 1900 and 1948, and especially during the two world wars, American reformers mounted the Syphilophobia Campaign. Reformers emphasized that prosti- tutes spread syphilis and that it rapidly killed. As an alternative for men to visiting prostitutes, they advocated clean, active sports, or “Muscular Christianity.” Anti-syphilis crusaders split twice over methods to prevent spread of syphilis: once during World War I over giving out condoms and again during World War II over giving out penicillin. In each conflict, reformers who wanted to reduce the harm of syphilis battled those who wanted to reduce illicit This conflict repeated over the next century in battles about venereal diseases, prostitution, alcoholism, drug addiction, gambling, and sex education. The Harm Reduction Movement (HRM) focuses on reducing the associated harms of these behaviors, not on moral censure or eliminating the behaviors. Moralists who oppose HRM attack the illicit behavior and view HRM as enabling it, for example, by teaching men how to use condoms. During the world wars, the armed services adopted HRM. Commanders who needed healthy troops ordered the release of condoms in the first war and penicillin in the second. After the wars, returning troops continued to use both, normalizing these practices. Physicians today treat syphilis with penicillin. Such treatment has been possible only since 1948, when penicillin became available to everyone. Schaudinn discovered in 1906 the spirochete that causes syphilis. It is a chronic, contagious bacterial disease, often venereal and sometimes congenital. It has three stages. In the first stage, primary syphilis, spirochetes mass and produce a primary lesion, a chancre (pronounced “SHANK-er”). During this stage, syphilis is highly infectious. After the chancre subsides,‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍ the disease spreads silently for a time, but then produces an outbreak of secondary symptoms such as fever, rash, and swollen lymph glands. In the second stage of latent syphilis, spirochetes disseminate from the primary lesion throughout the body, producing systemic and widespread lesions, usually in internal organs. Syphilis may then spread silently from 1 to 30 years. During this stage, symptoms vary so widely that syphilis was once known as the Great Pretender. In the last stage of tertiary syphilis, chronic destructive lesions damage the car- diac and neurological systems. Syphilis then may produce paresis (slight or incomplete paralysis), gummas (gummy or rubbery tumors), altered gait, blindness, or lethal narrowing of the aorta. Beginning in the sixteenth century, to treat syphilis physicians applied the heavy metal mercury as a paste on the back. During the nineteenth century, they similarly administered another heavy metal, bismuth. Neither mercury nor bismuth killed the spirochetes, though they ameliorated symptoms. In 1909, after the spirochete causing syphilis had been identified, two researchers—a German, Paul Erlich, and a Japanese, S. Hata—tried 605 forms of arsenic and discovered a “magic bullet” against it in combination of 606 heavy metals (which included arsenic). Erlich humbly called this Salvarsan (implying salvation from syphilis); its generic name is After finding that it cured syphilis in rabbits, Erlich injected it intra- muscularly into men with syphilis. At first, Salvarsan seemed to work wonders, and during 1910, physicians greeted Erlich with standing ovations. Later, syphilis recurred in some patients treated with Salvarsan, and some died, either from syphilis or from Salvarsan. Erlich maintained that the drug had been given incorrectly, but he still developed a less toxic form, Neosalvarsan. Physicians injected Neosalvarsan intramuscularly in 20 to 40 dosages over a year, charging patients a dollar per visit. For full treatment, patients needed both time and money. Neosalvarsan was no one-time treatment for syphilis, as penicillin later was. Between 1890 and 1910, Norwegian Caesar Boeck studied the natural course of untreated syphilis in 1,978 subjects. He correctly believed that heavy metals removed only the symptoms of syphilis. Because they killed some syphilitics, he studied whether subjects might fare better if left untreated. In 1929, Boeck’s successor, J. E. Bruusgaard, selected 473 of Boeck’s subjects for further Bruusgaard learned that of subjects who had had syphilis for more than 20 years, 73 percent were asymptomatic. Because this discovery dra- matically contradicted the Syphilophobia Campaign, the leaders of this movement resisted the fact that syphilis did not universally kill, much less did not do so rapidly (foreshadowing similar battles later about AIDS). Even more disturbing to the Syph- ilophobia Campaign, Bruusgaard confirmed that some latent syphilitics might never develop symptoms at all. So when the Tuskegee Study began in 1932, Boeck’s and Bruusgaard’s studies had caused physicians to question the received views about the natural cou‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍rse and treatment of syphilis.

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