SEEKING JUSTICE FOR VICTIMS OF THE GUATEMALAN SEXUALLY TRANSMITTED DISEASE EXPERIMENTS 1946-1948.

• Author: Lee, Susan S.

Abstract

Between 1946 and 1948, researchers sponsored by the United States government intentionally exposed more than 1,300 Guatemalan men and women to sexually transmitted diseases without their informed consent. Many of the surviving victims and their descendants suffer from the effects of untreated syphilis, gonorrhea, and similar illnesses. But the general public did not become aware of these non-consensual human experiments for more than sixty years. After a researcher uncovered the experiments, the United States government apologized to the Guatemalan victims, but the victims received no compensation for their injuries. So far, the efforts of the victims to receive legal redress for their injuries have been unsuccessful.

This Article has two aims--one descriptive and the other conceptual. First, it seeks to bring awareness to the history and legacy of the Guatemalan sexually transmitted disease experiments. Second, it argues that litigation--even if unsuccessful--can play a role in amplifying the victims' voices in a way that acknowledges their pain and helps to repair harm that was done. Even if the United States government is immune from formal legal liability, the government and the corporate interests that benefitted from the Guatemalan experiments, have a moral obligation to compensate the victims. The lens of reproductive justice makes clear this obligation. By critically investigating the Guatemalan sexually transmitted disease experiments and their legacy, one can better understand how gender, race, socioeconomic class, geopolitical power, and even geography informed the initial decision to conduct non-consensual human experimentation in that country and why the victims have been unable to obtain formal legal recognition for their suffering.

INTRODUCTION

Between 1946 and 1948, researchers approved and funded by the United States government intentionally exposed over 1,300 people in Guatemala to sexually transmitted diseases without their informed consent. (1) The subjects of these unethical experiments were mostly prisoners, mental patients, sex workers, and members of the Guatemalan military. The United States researchers infected these patients with syphilis, gonorrhea, and chancroid without explaining to the patients what would happen to them, and in many cases, without offering treatment for the resulting diseases. (2) These sexually transmitted disease experiments came to light only in 2003, when a professor at Wellesley College presented the startling discovery she had made while conducting research on the infamous Tuskegee syphilis experiments. (3) Professor Susan Reverby found copious records of the previously secret Guatemalan experiments among the papers of Dr. John Charles Cutler, one of principal investigators at the Tuskegee Institute. (4) The Tuskegee experiments, which began in 1932, involved the intentional withholding of medical treatment for nearly thirty years--without the informed consent of the participants--from approximately 400 black, mostly poor men who were infected with syphilis. (5) Professor Reverby presented her findings to the American Association for the History of Medicine in 2003, and in 2010, President Obama issued a public apology to the President of Guatemala. (6)

This Article begins by exploring the background and significance of the Guatemalan sexually transmitted disease experiments. Part I places the research project in the context of the United States' relationship with Central American countries, and with Guatemala in particular, after World War II and during the beginning of the Cold War. (7) This Part goes on to describe the nature of the non-consensual human experimentation conducted by the United States government in Guatemala, with the approval and cooperation of the host country. (8) During this period, the United States government was conducting other non-consensual human medical experiments both domestically and abroad. (9)

Part II of this Article considers the ongoing efforts by victims of the Guatemalan sexually transmitted disease experiments (and their descendants) to access the United States legal system. Victims have brought two major lawsuits in United States courts, seeking financial compensation for physical harm that has been transmitted over several generations. (10) A third case, a human rights claim, remains stalled before the InterAmerican Commission of Human Rights Organization of American States. (11) But so far, justice remains elusive. Sovereign immunity and forum selection have presented challenges to those seeking restitution.

Part III of the Article frames the Guatemalan sexually transmitted disease experiments in the broader context of race and gender. It argues that the gross violations of Guatemalans' human rights remained out of the public record so long precisely because most of the subjects were of non-white, Latin American descent and since the study involved a great number of women as vectors and victims of diseases. (12) The experimenters treated Guatemalan women as having "expendable" bodies (likely already diseased) that could be sacrificed for the allegedly greater "good" of finding a cure for a venereal disease common among male Unites States military personnel. (13) Even when Guatemalan women were not directly the subject of the non-consensual experimentation, many were the wives or partners of men who were infected with sexually transmitted diseases during the experiments. Thus, the experiments should be understood as involving not only the subjects themselves, but also the intimate partners of those who were the subjects of the study. (14) Further complicating any analysis of the Guatemalan experiments are questions about gender, geography, race, and socioeconomics. (15)

Part IV of the Article suggests reproductive justice as a helpful lens for evaluating the impact and legacy of the Guatemalan sexually transmitted disease experiments. (16) The reproductive justice framework, with its focus on public resources, emphasizes that a crucial first step in accessing resources is ensuring that disadvantaged peoples' voices are heard. The legal system is a proper venue for the victims of the Guatemalan experiments and their descendants to share their stories and have their suffering acknowledged by not only governments and private actors, but also by the public. (17) In shedding light on the Guatemalan sexually transmitted disease experiments, this Article seeks to amplify the victims' quest for justice and acknowledgment.

1. United States Involvement in Guatemala, the Sexually Transmitted Disease Experiments, and Other Non-consensual Medical Research

   1. United States Political Involvement in Guatemala

      In 1944, toward the end of World War II, Guatemala experienced a political revolution that led to the democratic election of a civilian president who was friendly to the United States. (18) Initially, the United States had not focused much of its foreign diplomacy efforts on Central America, but this changed as Cold War tensions grew quickly. George Kennan's "Long Telegram" warned that "peaceful coexistence" between capitalist nations and socialist nations would be impossible, and he predicted that the Soviet Union would venture to bring otherwise unstable countries within Soviet influence. (19) In March 1947, President Truman announced to Congress what became known as the Truman Doctrine, which mandated the United States to "support free peoples who are resisting attempted subjugation by armed minorities or by outside pressures." (20)

      For these reasons, it is not surprising to learn that the United States Central Intelligence Agency kept a close watch over Guatemalan politics and began to monitor the country for communist influences. The United States' involvement in Guatemala in the 1940s was, in many ways, a precursor to later official pronouncements that the United States would act to protect countries in the Western Hemisphere from Soviet influence. (21) Close ties with Guatemala were key to keeping that country free and democratic. The scientific experimentation supported and funded by the governments of both the United States and Guatemala strengthened these ties by enabling the formation of contacts between United States researchers and Guatemalan leaders of hospitals, prisons, and the military. (22) Through these contacts, the United States gained firsthand information about the functions and operations of these Guatemalan institutions, and the institutions may have come to rely in turn on the expertise provided by United States contacts.

   2. Non-consensual Medical Experimentation by the United States Government and United States Companies

      Out of the atrocities of World War II and the subsequent Nuremberg Trials, there developed a clear international norm against non-consensual experimentation on human subjects. (23) As early as 1767, the common law had recognized a doctor's liability for treating a patient without the patient's consent, except in cases of emergency. (24) In the Enlightenment Era of the eighteenth century, there emerged an increased emphasis on patient autonomy. (25) A Norwegian physician was found liable in 1880 for failing to obtain a patient's consent before he intentionally used a surgical instrument contaminated with leprosy on her in order to better understand the disease's transmission. (26) In 1931, Germany made binding a set of directives issued in 1900 that prohibited experimentation on nonconsenting patients. (27) So, although it may be true that "acceptance and application [of an individual's right to determine what shall be done with his or her body] ... diffused slowly within the medical profession," (28) United States government officials and medical professionals undoubtedly were aware of their ethical obligations and the negative attention that would accompany any non-consensual human experimentation. (29)

      Notwithstanding these norms, the United States government...