Abstract
Miss Ever’s Boys is a film based on the Tuskegee Study conducted among the blacks for 40 years in the US. The film recapture the events that depicts gross violation of ethical principles that guides human subjects in scientific studies. In the project, the sample population (399 black adult males) were infected with syphilis and put under no medication over the study’s period. Another 201 acted as controlled group into the study. The project has received a lot of criticism due to the inhumane approach used by the researchers including Miss Ever (Eunice Rivers Laurie in real life). This paper looks into various ethical principles violated during the project. These principles include justice, nonmaleficence, beneficence and autonomy.
Firstly, the Tuskegee project as depicted in the film violates the principle of respect for autonomy. Medical practitioners and researchers are principally required to allow the patients or research samples to make their independent judgment without coercion or deception. The subject must get an elaborate information on the subject including dangers and benefits (McCormick, 2018). These information help them to make voluntary and informed decisions without coercions. In scenarios involving children or adults incapacitated (thus unable to make rational decisions), they must be represented by close family member or an authorized person. In other words, the patient or subject must give an informed consent before any inclusion into the research group.
In the case of Miss Ever’s Boys, the government through Public Health Service (PHS) did not inform the participants on the dangers of the project. In fact, most of them made their decisions based on the potential benefits like free meals. Besides, the government only targeted the vulnerable section of the population as they were to sway to join the project. For instance, most of the recruits to the Tuskegee Project were uneducated and poor adults. Their level of education and economic status made them vulnerable hence easily manipulated by state to take part in the study. The government thus violated their rights to make autonomous and informed consent by failing to failing to provide adequate information on the subject.
Secondly, the project violated the principle of beneficence. Primarily, this principle demands that healthcare givers be beneficial to the patients and also takes necessary steps to minimize or prevent any harm (McCormick, 2018). Similarly, a researcher using human subjects has a responsibility to keep them away from any potential harm. It is unethical for medical practitioners or researchers to intentionally harm their patients or human subjects respectively. In the US, all researchers intending to use human subjects must get approval from The Human Research Ethics Committee for commencing the projects. The committee protects the participants from harm and exploitation by the researcher.
In Miss Ever’s Boys, it is evident the government through Public Health Service (PHS) grossly violated the beneficence principle in several fronts. Firstly, the researchers intentionally infected the participants with syphilis, a deadly disease at the time. A significant number of the participants died prematurely after the commencement of the study. Secondly, the researchers including the nurse did not make any intervention to minimize or prevent harm among the participants. The doctors even failed to administer penicillin to the subjects after its discovery in 1940. Penicillin was one of the effective drugs in treating bacterial infection at the time. Besides, the doctors understood the disease was advancing as and becoming more dangerous with each stage. In 1940 when the penicillin was discovered most of the participants were already in devastating stage. In addition, the doctors failed to put into account the community health and risked the lives of other hundreds of people. It is not clear the number of people that got infection after sleeping with participants. But there is no doubt the number could run in hundreds or even thousands if we consider the multiple effect. It was immoral and unethical for the Public Health Service to expose the entire community to syphilis infection while conducting this study.
Thirdly, the project violated the principle of nonmaleficence. This principle requires that health practitioners not to cause harm to their patients either through commission or omission (McCormick, 2018). They have a responsibility to protect their patients or human subjects at all cost. It is irresponsible and unethical for a healthcare giver to intentionally or unintentionally harm their patients due to negligence. In the Tuskegee Project, the doctors and nurse caused harm to the patients through both commission and omission. They introduced the syphilis bacteria in healthy adults hence causing the harm through commissioning. Secondly, they failed to introduce any medical intervention (including penicillin in 1940s) to save the patients from death hence harm through omission. In fact, Miss Ever (Eunice Rivers Laurie) knowingly misled the patients on their conditions. In essence, Miss Ever and other doctors failed in their responsibility of providing holistic medical care to their patients. They failed to show commitment to the well-being of both the society and individuals under their care. It is notable that the nonmaleficence and beneficence have slight difference. Nonmaleficence is non-stopping duty whereas in beneficence the caregiver has limited responsibility.
Finally, the action betrayed the principle of justice in healthcare delivery. In medical profession, caregivers are required to exhibit fairness while discharging their duties. In other words, patients with equal conditions should get similar treatment regardless of their race, religion or sexual orientation. Similarly, patients with serious complications or require emergency services must get first priority during treatment. The cases in Tuskegee project depicts a lot of injustice against the black male used in the study. Firstly, they were denied access to medical care against a condition that had proper medication. Secondly, they received unfair treatment from the government that had sole responsibility to protect them from diseases or provide medication. Instead, it is the same government that authorized the introduction of harmful bacteria into their body. Essentially, they were mistreated based on their skin color and nothing else. The government further committed an injustice to the whole community by knowingly exposing them to syphilis risks by intentionally infecting 399 people.
Conclusion
The film Miss Ever’s Boys s depicts a lot of unethical practices adopted by the nurses and doctors in Tuskegee Project. They violated nearly all the ethical principles in medical practice. Miss Ever (Eunice Rivers Laurie) and her colleagues intentionally mislead the participants thus violating the principle of respect for autonomy. Additionally, they violated both the principle of nonmalifence and beneficence through acts of commission and omission. Finally, the whole project was founded on racial discrimination as it targeted only the black males hence violating the principle of justice.
References
McCormick, T. R. (2018). Principles of Bioethics. Retrieved from ETHICS IN MEDICINE; University of Washington School of Medicine: https://depts.washington.edu/bioethx/tools/princpl.html#prin2