This resource for The Least of My Brothers is intended to provide a brief orientation to the historical, cultural, and social context of the PHS Syphilis Study at Tuskegee. A complete list of sources can be found at the end of this page. You can also select the date of any item to see its source; select the date on the source to return to the item.
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Prologue (1849-1926) | Episode One (1926-1932) | Episode Two (1932-1942) | Episode Three (1943-1974) | Epilogue (1975-1997) | Sources
| 1849 | Worthington Hooker publishes Physician and Patient, the only comprehensive study of medical ethics by an American in the 19th century. In this work, Hooker champions the patient's right to information and denounces a physician's practice of deception. This idea drastically contradicted the prevailing view in medicine, endorsed by the AMA 1847 "Code of Medical Ethics," that deception is morally acceptable when the physician deems it to be in the best interest of the patient. |
| 1865 | The Ku Klux Klan (KKK), a secret and violent white-supremacist organization, is founded by veterans of the Confederate Army. It is disbanded by 1880. |
| 1870 | The Social Hygiene Movement is launched in an attempt to combat prostitution, venereal diseases, and the double standard of sexual morality. |
| 1871 | Congress passes the Ku Klux Klan Act in an attempt to stop the illegal activities of the KKK and other Southern vigilante groups. |
| 1873 | The Comstock Act is enacted, prohibiting the US Postal Service to send "indecent" pictures, writings, and pornography. This law also applies to materials intended to educate the public about birth control and venereal disease. |
| 1890 | In an attempt to stop the Ghost Dance, US federal troops massacre 350 Lakota, many of them unarmed women and children, at Wounded Knee, South Dakota. This marks the last armed engagement of the so-called Indian Wars. |
| 1896 | In Plessey vs. Ferguson, the Supreme Court rules that "separate but equal" treatment of black Americans is constitutional. |
| 1900 | American Army surgeon Walter Reed conducts yellow-fever experiments in Cuba. These studies employ one of the first formal procedures of informed consent, requiring all volunteers to sign a written informed consent document. Subjects are given $100 US dollars for receiving the yellow-fever inoculation and are compensated with a $100 "supplement" if they contract yellow fever. The practice of obtaining informed consent to participate in research is not widely followed until the 1960s. |
| 1901 | 105 documented lynchings of black Americans. |
| 1906 | Richard Clarke Cabot, Harvard physician and socio-medical ethicist, decries the widespread deceptive clinical practice of placebo-giving. Cabot argues it weakens the physician-patient relationship "because every placebo is a lie, and in the long run the lie is found out." |
| 1908 | Henry Ford introduces his Model T automobile. |
| 1910 | NAACP established. |
| 1914 | Social reformers look at venereal disease as one indicator of social conditions in America. Numerous "anti-venereal disease" groups work to improve medical and educational interventions in this public health area. |
| 1914 | Schloendorff v. New York Hospital establishes legal precedent for a patient's right of "self-determination" justifying an obligation to obtain consent for medical procedures. Numerous cases that follow are justified by this rationale, helping to establish a legal requirement for informed consent. Notably, cases cite Schloendorff v. New York Hospital as late as the 1950s and 1960s. |
| 1915 | The second Ku Klux Klan (KKK) is organized. This group, although preaching racism, is a mainstream organization with 4 million members at its peak in the 1920s - approximately one KKK member for every two African Americans in the US (black population, 1920 census: 10,463,131). |
| 1916 | Margaret Sanger opens a family planning clinic in Brooklyn. Authorities close the clinic shortly after its opening and arrest Sanger on charges of obscenity. |
| 1917 | United States enters World War I; more than 350,000 African Americans served in segregated units during the war. |
| 1919 | Black servicemen returning to the US from duty overseas are met frequently with hostility from whites. Of the 77 black Americans lynched this year, 10 are returned veterans. Race riots break out in numerous cities across the country as racial tensions escalate. |
| 1920 | First commercial radio broadcast, election day, via KDKA in Pittsburgh. People hear the results of the Harding-Cox presidential race before they read about it in the newspaper. |
| 1920 | The 19th Amendment gives women the right to vote. |
| 1925 | 17 documented lynchings of black Americans. |
| 1928 | The Cooperative Clinical Group for the study of syphilis is formed. As the first major systematic studies on syphilis in the United States, it also marks a growing trend in American medical research -- the collaborative study. |
| 1928 | Alexander Fleming discovers penicillin; however, it is not widely used until Ernst Chain and Howard Florey develop a powder form of it in 1939. |
| 1929 | Stock Market crashes, Great Depression begins |
| 1931 | University of Michigan physician Dr. J. Burns Amberson conducts the first randomized controlled trials while studying the efficacy of treatments for pulmonary TB. Randomization is determined by a coin toss. |
| 1933 | President Franklin Delano Roosevelt institutes the New Deal. |
| 1937 | First National Social Hygiene Day celebrated. |
| 1937 | Surgeon General Thomas P. Parran publishes his book about syphilis, Shadow on the Land. It is well received by the public and the medical community. |
| 1938 | Child labor is made illegal through the Fair Labor Standards Act. |
| 1938 | Venereal Disease Control Act is passed, allocating funding for rapid treatment centers to provide the latest in VD treatment. |
| 1940 | 5% of voting-age blacks are registered to vote. |
| 1941 | Japan attacks Pearl Harbor. |
| 1942 | The US government orders the internment of 110,000 Americans of Japanese descent. |
| 1942 | Women are allowed to serve in all branches of the Armed Forces in auxiliary or reserve units; the Marines open their recruitment to black men. |
| 1942 | American researchers begin clinical research to develop new drugs to treat venereal diseases. The lack of effective treatments and the importance of preventing the spread of disease among World War II soldiers justify this research. Over the next five years, a number of studies are conducted in prison populations to investigate the effectiveness of new drugs. |
| 1943 | Changes in social perception of venereal disease, brought about in part by the publication of Shadow on the Land (see 1937), cause a shift in focus from moral to medical interventions to address the problem of sexually-transmitted diseases. |
| 1944 | 250 race riots break out in 47 US cities. |
| 1945 | The United States drops two atomic bombs on Japan. |
| 1947 | Major League baseball becomes integrated when Jackie Robinson joins the Brooklyn Dodgers. |
| 1948 | First double-blind randomized clinical trial conducted by Dr. Austin Bradford-Hill on streptomycin. This experiment marks the beginning of the era of the randomized clinical trial. |
| 1948 | First network newscast, CBS-TV news, debuts. |
| 1948 | Alfred Kinsey's Sexual Behavior in the Human Male is published amidst much controversy, creating the foundation for sex research in the United States. His even more controversial "female" volume follows five years later. |
| 1948 | Truman issues order to desegregate the armed forces. |
| 1950 | Korean War begins. |
| 1950 | McCarthy launches anticommunism campaign. |
| 1954 | Brown vs. Board of Education ruling declares segregation unconstitutional. |
| 1955 | Fourteen-year-old Emmett Till is lynched in Money, Mississippi for "insulting" a white woman, and his murderers are acquitted by an all-white jury. Jet magazine publishes photos of Till's body on its cover, partially igniting the sentiments that propelled the nation into the Civil Rights movement. |
| 1955 | Rosa Parks refuses to give up her seat to a white man on a bus, marking the beginning of the Montgomery, Alabama bus boycott and the start of the Civil Rights Movement. |
| 1957 | Salgo v. Leland Stanford Jr. University Board of Trustees first uses the term "informed consent". The court finds that securing consent is insufficient; physicians have a duty to inform patients about the risks and alternatives of treatment in addition to treatment procedures and their consequences. |
| 1961 | Donald Oken, a Chicago physician, publishes a study in the Journal of American Medical Association reporting that 9 of every 10 physicians do not disclose diagnoses of cancer to their patients. The physicians surveyed maintained that sustaining a patient's hope is more important than truth-telling. |
| 1962 | US Congress passes the "Drug Amendments of 1962" which outline the requirements for human subjects research involving drugs. This law sets the standard for "well-controlled investigations" in clinical research. |
| 1963 | Martin Luther King, Jr. gives his I Have a Dream speech during the March on Washington. |
| 1963 | President John F. Kennedy is assassinated. |
| 1964 | One documented lynching of a black American. |
| 1964 | The Civil Rights Act of 1964, which is the broadest and strongest civil rights legislation since reconstruction, puts a legal end to Jim Crow. |
| 1965 | Watts riots in Los Angeles: 34 dead, 1000+ injured. |
| 1968 | Martin Luther King Jr. is assassinated in Memphis. |
| 1969 | Neil Armstrong becomes the first human to walk on the moon. |
| 1969 | Massive anti-Vietnam War demonstration in DC. |
| 1970 | Food and Drug Administration clarifies the "Drug Amendments of 1962" by providing definitions for the "well-controlled" studies. This clarification states that such "studies must (ideally) incorporate a contemporaneous control group assigned at random and 'permit qualitative evaluation' of treatment effects using 'appropriate statistical methods'." |
| 1974 | Nixon resigns in the wake of the Watergate scandal. |
| 1979 | Religious conservatives found the Moral Majority and become a strong influence in American politics. |
| 1982 | Scientists use the term "AIDS" for the first time to refer to an observed high incidence rate of Kaposi's Sarcoma (an AIDS-related cancer) in otherwise healthy gay men in the United States. |
| 1984 | Jesse Jackson becomes the first African American to make a serious bid for the Presidency, receiving 3.3 million votes in the Democratic primaries. |
| 1986 | Martin Luther King Day established as a national holiday. |
| 1991 | Clarence Thomas becomes the second black to sit on the Supreme Court amidst highly publicized allegations of sexual harassment by law professor Anita Hill. |
| 1992 | After Los Angeles police officers are acquitted of the 1991 videotaped beating of motorist Rodney King, riots break out in L.A. |
| 1992 | Carol Mosely-Braun first African American woman elected to the US Senate. |
| 1995 | Former football star OJ Simpson is acquitted of killing his former wife and her friend in one of the most widely publicized and racially divisive trials of the century. |
| 1996 | 63.5% of voting-age blacks are registered to vote. |
| 1997 | President Bill Clinton issues an official apology to the victims of the PHS Syphilis Study at Tuskegee. |
| 1849 | Worthington Hooker publishes Physician and Patient. Source: Beauchamp, Tom and Ruth Faden. A History of Informed Consent. New York: Oxford University Press, 1985. |
| 1865 | The first Ku Klux Klan (KKK) is organized. Source: "Ku Klux Klan." Wikipedia. http://en.wikipedia.org/wiki/Ku_klux_klan |
| 1870 | The Social Hygiene Movement is launched. Source: h. Jones, James H. 1993. Bad Blood: The Tuskegee Syphilis Experiment. New York: The Free Press. |
| 1871 | Congress passes the Ku Klux Klan Act . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1873 | The Comstock Act is enacted. Source: Langley, Winston E., and Vivian C. Fox, eds. 1994. Women's Rights in the United States: A Documentary History. Westport, CT: Greenwood Press. |
| 1890 | Massacre at Wounded Knee. Source: "Events in the West: 1890-1900." PBS Online. © 2001 The West Film Project. http://www.pbs.org/weta/thewest/events/1890_1900.htm |
| 1896 | Plessey vs. Ferguson. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1900 | Yellow-fever experiments in Cuba. Source: "The United States Army Yellow Fever Commission." University of Virginia Health Sciences Library Historical Collections. http://yellowfever.lib.virginia.edu/reed/commission.html#ic. |
| 1901 | 105 documented lynchings of black Americans.. Source: "African American Perspectives: Timeline of African American History," American Memory Project, Library of Congress. http://lcweb2.loc.gov/ammem/aap/timelin3.html |
| 1906 | Richard Clarke Cabot decries placebo-giving . Source: "Richard Clark Cabot." http://www.whonamedit.com/doctor.cfm/1906.html. |
| 1908 | Model T automobile. Source: "Technology Timeline." The American Experience. 2001. PBS Online. http://www.pbs.org/wgbh/amex/telephone/timeline/index.html |
| 1910 | NAACP established. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1914 | Social reformers focus on venereal disease. Source: American Social Health Association (ASHA), 2001. http://www.ashastd.org/aboutasha/history.html |
| 1914 | Schloendorff v. New York Hospital. Source: Beauchamp, Tom and Ruth Faden. A History of Informed Consent. New York: Oxford University Press, 1985. |
| 1915 | The second Ku Klux Klan (KKK) is organized. Source: "Ku Klux Klan." Wikipedia. http://en.wikipedia.org/wiki/Ku_klux_klan |
| 1916 | Margaret Sanger opens family planning clinic . Source: Langley, Winston E., and Vivian C. Fox, eds. 1994. Women's Rights in the United States: A Documentary History. Westport, CT: Greenwood Press. |
| 1917 | United States enters World War I. Source: "World War I and Postwar Society." African American Odyssey. http://memory.loc.gov/ammem/aaohtml/exhibit/aopart7.html |
| 1919 | Post-WWI race riots . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1920 | First commercial radio broadcast . Source: "KDKA Begins to Broadcast: 1920." A Science Odyssey: People and Discoveries. PBS Online. © 1998. http://www.pbs.org/wgbh/aso/databank/entries/dm28pe.html |
| 1925 | 17 documented lynchings of black Americans. Source: "African American Perspectives: Timeline of African American History," American Memory Project, Library of Congress. http://lcweb2.loc.gov/ammem/aap/timelin3.html |
| 1928 | Alexander Fleming discovers penicillin. . Source: "Alexander Fleming," A Science Odyssey: People and Discoveries. PBS Online. © 1998. http://www.pbs.org/wgbh/aso/databank/entries/bmflem.html |
| 1928 | The Cooperative Clinical Group for the study of syphilis is formed . Source: Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990. New York: Cambridge University Press, 2000. |
| 1929 | Great Depression begins. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1931 | Dr. J. Burns Amberson conducts the first randomized controlled trials.. Source: Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990. New York: Cambridge University Press, 2000. |
| 1933 | New Deal. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1937 | First National Social Hygiene Day celebrated.. Source: American Social Health Association (ASHA), 2001. http://www.ashastd.org/aboutasha/history.html |
| 1937 | Surgeon General Thomas P. Parran publishes Shadow on the Land. Source: Office of the Surgeon General. "Thomas P. Parran." http://www.surgeongeneral.gov./library/history/bioparran.htm |
| 1938 | Child labor is made illegal . Source: "Fair Labor Standards Act: What Does it Require?" US Department of Labor. http://www.dol.gov/elaws/esa/flsa/screen5.asp |
| 1938 | Venereal Disease Control Act . Source: American Social Health Association (ASHA), 2001. http://www.ashastd.org/aboutasha/history.html |
| 1940 | 5% of blacks registered to vote. Source: Thernstrom, Stephen and Abigail Thernstrom. 1997. America in Black and White: One Nation, Indivisible. New York: Simon and Schuster. |
| 1941 | Japan attacks Pearl Harbor. Source: "Internment History," Children of the Camps. PBS Online. ©1999. http://www.pbs.org/childofcamp/history/timeline.html |
| 1942 | Internment of 110,000 Japanese Americans. Source: "Internment History," Children of the Camps. PBS Online. ©1999. http://www.pbs.org/childofcamp/history/timeline.html |
| 1942 | Armed Forces open their recruitment . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1942 | Clinical research to develop new drugs to treat venereal diseases. Source: Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990. New York: Cambridge University Press, 2000. |
| 1943 | Changes in social perception of venereal disease . Source: American Social Health Association (ASHA), 2001. http://www.ashastd.org/aboutasha/history.html |
| 1944 | 250 race riots in 47 US cities. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1945 | US drops atomic bombs on Japan. Source: "Internment History," Children of the Camps. PBS Online. ©1999. http://www.pbs.org/childofcamp/history/timeline.html |
| 1945 | US drops atomic bombs on Japan. Source: "Timeline," The American Experience: Vietnam Online. © 1997. PBS Online. http://www.pbs.org/wgbh/amex/vietnam/time/ |
| 1947 | Jackie Robinson joins the Brooklyn Dodgers. Source: "Timeline," The American Experience: Vietnam Online. © 1997. PBS Online. http://www.pbs.org/wgbh/amex/vietnam/time/ |
| 1948 | Truman desegregates the armed forces. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1948 | Alfred Kinsey's publications. Source: "Publications," The Kinsey Institute for the Study of Sex, Gender, and Reproduction. © 2002. http://kinseyinstitute.org/publications/ |
| 1948 | First network newscast. Source: "Technology Timeline." The American Experience. 2001. PBS Online. http://www.pbs.org/wgbh/amex/telephone/timeline/index.html |
| 1948 | First double-blind randomized clinical trial conducted by Dr. Austin Bradford-Hill . Source: Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990. New York: Cambridge University Press, 2000. |
| 1950 | Korean War begins. Source: "Timeline," The American Experience: Vietnam Online. © 1997. PBS Online. http://www.pbs.org/wgbh/amex/vietnam/time/ |
| 1950 | McCarthy launches anticommunism campaign. Source: "Timeline," The American Experience: Vietnam Online. © 1997. PBS Online. http://www.pbs.org/wgbh/amex/vietnam/time/ |
| 1954 | Brown vs. Board of Education . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1955 | Rosa Parks refuses to give up her seat . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1955 | Emmett Till is lynched. Source: Metress, Christopher. 2002. The Lynching of Emmett Till: A Documentary Narrative. University of Virginia Press. |
| 1957 | Salgo v. Leland Stanford Jr. University Board of Trustees . Source: Beauchamp, Tom and Ruth Faden. A History of Informed Consent. New York: Oxford University Press, 1985. |
| 1961 | 9 of every 10 physicians do not disclose diagnoses of cancer to their patients. Source: Reiser, Stanley Joel. "Words as Scalpels: Transmitting Evidence in the Clinical Dialogue." http://utmed.com/studynotes/pd/WordsasScalpels.doc |
| 1962 | Drug Amendments of 1962. Source: Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990. New York: Cambridge University Press, 2000. |
| 1963 | Martin Luther King, Jr., I Have a Dream . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1964 | The Civil Rights Act of 1964. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1964 | One documented lynching of a black American. Source: l. "Lynching in America: Statistics, Information, Images," Famous Trials: The Shipp Trial. Doug Linder, 2003. http://www.law.umkc.edu/faculty/projects/ftrials/shipp/lynchstats.html |
| 1965 | Watts riots in Los Angeles. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1968 | Martin Luther King Jr. is assassinated . Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1969 | Neil Armstrong walks on the moon. Source: "Primary Mission Accomplished: 1969," NASA History Office. Updated February 5, 2003. http://www.hq.nasa.gov/office/pao/History/SP-4214/ch9-5.html |
| 1969 | Anti-Vietnam War demonstration in DC. Source: "Timeline," The American Experience: Vietnam Online. © 1997. PBS Online. http://www.pbs.org/wgbh/amex/vietnam/time/index.html |
| 1970 | Food and Drug Administration clarifies the Drug Amendments of 1962. Source: Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900-1990. New York: Cambridge University Press, 2000. |
| 1974 | Nixon resigns . Source: "Timeline," The American Experience: Vietnam Online. © 1997. PBS Online. http://www.pbs.org/wgbh/amex/vietnam/time/index.html |
| 1979 | Moral Majority founded. Source: "The Moral Majority." The Columbia Encyclopedia Online, Sixth Edition. © 2002 Columbia University Press. http://www.bartleby.com/65/e-/E-MoralMajo.html |
| 1982 | Scientists first use the term "AIDS" . Source: "In their own words: NIH Researchers recall the early days of AIDS," NIH. http://aidshistory.nih.gov/timeline/index.html |
| 1984 | Jesse Jackson makes bid for the Presidency. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1986 | Martin Luther King Day established. Source: "Martin Luther King, Jr." Wikipedia. http://en.wikipedia.org/wiki/Martin_Luther_King |
| 1991 | Clarence Thomas nomination and hearings. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1992 | Rodney King verdict. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1992 | Carol Mosely-Braun elected to Senate. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1995 | OJ Simpson trial. Source: Levine, Michael L. 1996. African Americans and Civil Rights: From 1619 to the Present. Phoenix, AZ: Oryx Press. |
| 1996 | 63.5% of blacks registered to vote.. Source: Thernstrom, Stephen and Abigail Thernstrom. 1997. America in Black and White: One Nation, Indivisible. New York: Simon and Schuster. |
| 1997 | Clinton's apology to victims of PHS Syphilis Study. Source: "Remarks by the President in Apology for Study Done in Tuskegee," May 16, 1997. http://clinton4.nara.gov/textonly/New/Remarks/Fri/19970516-898.html |
Thanks to Kara Lochridge and Summer Johnson for preparing this resource. An earlier, longer version by Victoria Berdon and Jennifer Flavin is also available.
Indiana University and WisdomTools, Inc., have made every effort to secure the necessary permissions and provide appropriate credits for materials used in this WisdomTools ScenarioTM and the related resources. In the event any questions arise as to the use of any material, we express regret for any inadvertent error and will be pleased to make the necessary corrections.
Development of The Least of My Brothers was funded by the Poynter Center for the Study of Ethics and American Institutions, Indiana University-Bloomington, and the National Institutes of Health.
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