The Tuskegee Health Experiment: A Question of Bureaucratic Morality? Were there precise moral and ethical issues that the case presents? Are they dependent upon race, color economic status, and/or geographical location? Why or why not?
The government bears the responsibility for ensuring that all human rights are well protected. In relation to the Tuskegee experiment, both the government and health organizations are supposed to conduct researches that meet moral and ethical standards. There were cases of the people used in the experiment being exploited by the researchers. This is why the health organizations and the government wanted to remove the doubts and prove that the practice was ethical and that there were no unethical and immoral cases (Beauchamp and James 200).
The first question that these organizations and the government wanted to research on is whether there were any precise moral and ethical issues. If the issues were present, were they based on race, economic status, color, or geographical location? In the Tuskegee research case, there were some precise moral and ethical issues that were discovered. The first one is informed consent (Paola, Robert and Lois 150). Humans have the potential for making personal choices or decisions. Their approval should be first sought before any experiment is carried out on them. It is believed that human beings are moral agents, autonomous, self-determined, and no experiment whether medical or from any other field should be carried out on them without their consent or approval. In the Tuskegee case, the research was carried out without the approval of the people used as samples. They went through a medical procedure not being aware that they were being used as samples. The researchers came out to defend themselves, but it was clear that they overlooked an American law.
Informed consent posits that a physician has a duty to reveal the probable consequences or risks of the proposed course of treatment. A physician becomes prudent if he or she can express the risks of the medication to the patient. The patient needs to know about the risks of medication because it involves his or her health. A physician must share such information so that a patient can make a choice on whether to go ahead with the medication, chose an alternative medication or avoid the medication. The reason is that the patient is intelligent and can make rational choices. Rationality often arises from assessing the costs and benefits of the situation (Gale Group, Gale Research Inc 262).
The law led to some researchers and lawmakers to develop a procedure that would be used if people were interested in carrying out research on others. Their consent is critical which is why these seven rules should be strictly followed. If a person does not adhere to any of the rules or is not willing to participate, then no researcher has any right to carry out research on the individual. The condition does not consider the importance of the research. The first requirement is to provide relevant information about the research to prove that it will help in enhancing knowledge and health. The second requirement is that the research should have a rigorous method or procedure. The third requirement is that it should have scientific requirements, should state any possible risks to the person and the community and the reasons why a particular person or community has been chosen for the experiment. The fourth requirement is to minimize all risks and enhance the benefits for the benefit of the people. Requirement number five is to involve unaffiliated individuals voice should also be heard. They should review the research and determine whether to continue or terminate the procedure. The sixth requirement is for the participants to agree voluntarily without being forced or blackmailed in any way. The last requirement is to have the privacy of the participants protected. They should also have the option to withdraw from the procedure and should be well monitored throughout the process.
The second issue raised is disclosure. This is the right of the willing participants to be taken through all the details of the procedure. This will also help them determine if they will be willing to go through the procedure or not. In this case, since the participants were not even aware that the procedure was carried out on them, they were not informed of the procedure. It was unethical because they might have gone through the process if given a chance might not agree to it (Beauchamp and James 205). Disclosure is also aimed at giving some form of trust between physicians and the participants. They feel free to discuss any issues related to the procedure. There also face the consequences of their actions and the terms and conditions as stipulated by the law. Disclosure ensures that participants are not defrauded off their rights.
The third main issue in this case is paternalism. Paternalism occurs when leaders who are in positions of power and authority limiting the freedom and responsibilities of subordinates. The intention is supposedly to act in the best interests of the subordinates. In such cases, the people in authority assume the role of deciding for their subjects (Gochman 203). In as much as the participants had little knowledge of the research being carried out, the physicians did not have the right to override their intentions because they knew that they could not understand the complex medical terms. They took advantage of the situation and performed some experiments on them merely because they did not have prior knowledge of what would happen. Even if a person does not understand the complex medical procedure, they have a right to know. The researchers in the Tuskegee experiment did not explain anything to the participants because they were not capable of understanding what the procedure was all about thus it was wrong. The participants also had a right to determine whether the procedure would be carried out on them or not even if the terms used were complex or simple to understand.
The three issues are not very much related to any geographical location, race or economic status. They are only concerned about morals and ethics that should have been followed no matter who the participants were, their color, economic status or where their place of origin. There are some cases of racism, but the researchers argued that the disease was thought to behave differently in different races. It is the reason they had to use both blacks and whites (Paola, Robert and Lois 151). They chose weak whites because they were in need of money and that they would not mind carrying out the experiment. The geographical location was argued that the disease was prevalent in some areas. It is the reason not all parts of America were used in the experiment.
How does the case reflect a potential weakness in the neutral competence assumption of the merit system? Need this be the case? How would you act to prevent such an occurrence as that described in the case?
In the neutral competence assumption of the merit system, the case reflects potential weaknesses. The reason is that the physicians carrying out the procedure should be competent and should not carry out the research for the benefit of some people to be all people in general. The research was aimed at benefiting many people; this is why it would be advisable for them to involve as many people as possible. The research was carried out without the consent of the participants. The probable reason was that they knew that very few people would be willing to go through the procedure. Since they wanted to satisfy their employer, they went ahead without disclosing to anyone and taking advantage of innocent people to carry out the research (Beauchamp and James 207). Such an action was unfair. To prevent such an occurrence, the researchers, should not have chosen anyone one based on the political and financial biases. All people would have been informed about the procedure.
Are there factor in the case that indicates that racial attitudes played a significant role in decision made? How might you have acted to reduce, if not eliminate, such attitudes? Under the circumstances, would you have acted any differently at all? Explain
I think that racial attitudes played a significant role in this case. In the selection of participants, majority of them were blacks. The only whites that were sued were only from poor backgrounds. Black administrators and politicians were also not part of the experiment (Paola, Robert and Lois 153). It shows that prominent people were kept out of the exercise because their influence would have prevented the exercise. Neutral competence in this case was not be exercised. Not even a black university was allowed to participate. The researchers only wanted to satisfy one party’s request leaving out other parties who would have created a big impact on the exercise. To reduce this effect, the researchers would have informed the black politicians and administrators of the exercise. They would also have involved whites whether poor or rich to show that the exercise was genuine and did not target an individual group of people. It would also have been clear that even if they wanted to carry out an experiment on black people, they should have given an explanation as to why the blacks were being used. Their seniors should have been informed in order to approve or decline the request. It would help in refuting claims of racism in the procedure. In this circumstance, I would have acted differently. I would let the black people know of my intention and that the research was for the benefit of all people. It would also help in adding knowledge, and people would be healthier because the new research would give solutions to some problems faced by the black people.
Were there factors in the case to indicate that the sample population was willing participants in the experiment? If so, as a participating administrator, would you continue in the experiment even though you might personally question morality? Why or why not?
In this case, there were no factors to show that the sample population had willing participants in the experiment. According to the report, people were intentionally denied information on the experiment. They were also not told that they had diseases and whether it would be viable. In short, they were never told anything about the experiment. The researchers intentionally took advantage of the participants’ ignorance, naiveté, and desperation to carry out the research. They only lied to them that they would create resistance from the rest of the black population. They gave in, and the experiment was carried out.
As an administrator for this case, I would never be part of an act that is morally and ethically wrong. All the fundamental principles of ethics and all morals should be followed to the letter. I would be held responsible if something went wrong. It can be illustrated by people who are going to war. They are only assured of peace and calm after the war, but there is no such assurance. As an administrator, I should ask myself what if everything does not turn out as expected. I would be held liable for all the outcomes of the procedure. In my case, I would never be part of something that does not support morality. It would be fair if I talked to all the participants in the experiment. I would only carry out an experiment to only those who would be willing. As for others, I would not force them to do anything against their will. I would also not like it if I was a participant, and such an experiment is carried out without my knowledge. I am supposed to treat other people the same way I expect them to treat me. There is no justification for what the researchers in the Tuskegee case did. It was immoral and unethical. In as much as they found a solution to the problem they had, it still does not justify their actions.
Are there similarities between Tuskegee and the FBI and the CIA in domestic and foreign affairs? Explain
The Tuskegee case was not dependent on race, or geographical location. It was more dependent on education and economic status. Only people who lacked knowledge and were not financially stable would agree to part of this experiment. They did not have a hint of what was happening to them during the experiment as long as there was money. This Tuskegee case is no different from other cases by the federal government both nationally and internationally. The FBI and CIA have been tagged in cases of racism where they perform some of their experiments on the minority in relation to race. In America, since the majority and most powerful are the whites, such experiments are carried out on the minority like the blacks. The whites feel superior to the blacks and never account for any of their actions against blacks. The rationale is that blacks are inferior.
Could you, as an administrator, at any time justify actions that you might personally feel were morally wrong? Explain your stand and discuss its impact upon the administrative process
As an administrator, if I am asked to justify my actions that were morally and ethically wrong, I would begin with the race issue. There are some health defects that tend to behave differently with certain races. In this case, few whites were sued because previous experiments were carried out on whites. This time, the experiment wanted to see the effect on black people. White people would not be used because their results were known. It shows that there was no discrimination only that blacks were the primary target in this case. There are other cases that have been performed in this manner and have been successful in the past. This could be why the experiment was carried out on people. No harm was caused on any of the participants (Beauchamp and James 210). It is to show that no one was affected. In some cases, a significant number of people are affected, but this was not the case. The experiment was a success. There are other instances where an experiment has to be launched for the benefit of other people, but no one is willing to participate. This forces that administrator to carry out the experiment without the knowledge of the participants. I would also say that the experiment was not racial (Beauchamp and James 212). The population consisted of many blacks, and it would have been helpful to know the different reactions of the white and black people. Other researches were also conducted by a minority, naiveté, and ignorant people. Like in 1939, in the University of Iowa, research was carried out on twenty-two orphans. None of the orphans were black nor were they affected by the experiment.
Works Cited
Beauchamp, Tom L, and James F. Childress. Principles of Biomedical Ethics. New York: Oxford University Press, 2013. Print.
Gale Group, Gale Research Inc. American Law Yearbook. New York: Gale Research, 2001
Gochman, David S. Relevance for Professionals and Issues for the Future. New York [u.a.: Plenum Press, 1997. Print.
Paola, Frederick A, Robert Walker, and Lois L. C. Nixon. Medical Ethics and Humanities. Sudbury, MA: Jones and Bartlett, 2010. Print.
