Research & Evidence-Based Practice Ethical Issues in Nursing Research Miss Evers’ Boys

The 1997 television movie “Miss Evers’ Boys,” directed by Joseph Sargent and starring Alfre Woodard as Eunice Evers, R.N. and Laurence Fishburne as Caleb Humphries, one of her patients, tells the heart-wrenching story of the maltreatment of black syphilis research subjects in Tuskegee Alabama. There are vast ethical implications to the "Tuskegee Study of Untreated Syphilis in the Negro Male," which began in 1932 at the behest of the U.S. Public Health Service and only ended 40 years later in 1972 due to congressional inquiry. This study, “the longest nontherapeutic experiment on human beings in medical history,” aimed to determine whether syphilis progresses the same in blacks and whites (Thomas & Quinn, 1991). A government doctor says, in a thinly-veiled racist tirade at the beginning of the movie “You people have one of the highest concentrations of syphilis in the country.”

The researchers contend that “we have to make them understand we only want to make them well,” but this is a lie. Miss Evers plays an active role in recruiting patients for the experiment, telling them it will cure their “bad blood” a catch-all term for different diseases in common parlance at the time. Participants were not allowed to ask questions about the study and were even misled as to the purposes behind it. She makes an exception for her friend, Caleb Humphries, who she tells about the experiments true intentions and that she knows of possible treatments that could be administered, but won’t be using them because the “doctors know what’s best” (Sargent, 2001). Despite offering a cure, the experiment provided no cure, experimental or otherwise, and later even denied patients the penicillin cure which had been developed. Miss Evers ensnared participants unwittingly by denying them informed consent and lying about the reasons and methods of the study. She jokes that by offering potential research participants a free lunch, she is “fattening [them] up for the kill]” (Sargent, 2001) These men are taken aback at first, but then realize it is a joke; however, her statement holds more truth than jest, as the free “doctorin’” provided to them costs them their lives through negligence: they are given placebos and their syphilis is allowed to progress (Sargent, 2001). Translating the white doctor’s language into a black vernacular, Miss Evers uses her cultural knowledge to deceive the patients for the benefit of the government’s and doctor’s twisted ends. Miss Evers should have done anything in her power, utilizing the chain of command or going to outside resources to protect her patient’s wellbeing. She knew that informed consent was lacking and that patients were withheld treatment to observe disease progression. Miss Evers comforts her “boys” but withholds the treatments and cure which would save them from suffering the effects and possible mortality of syphilis. By observing the disease progress and administering placebos, rather than treating the study participants as soon as a valid treatment became available, Miss Evers acted in disregard of the Hippocratic oath to abstain from harming and failed to obtain informed consent before carrying out medical research. According to the government doctor, there is no budget to treat the disease, but “the data we’ve collected is worth its weight in gold,” thus demonstrating how the government placed greater weight on obtaining information than helping poor patients (Sargent, 2001).

There are gross ethical violations involved, which if perpetrated in modern times would likely result in loss of licensure, battery charges, and expose the researchers and the government to the possibility of further civil litigation (Rao, 2008). The shadow of this experiment hangs over the black community, their medical providers, and those who attempt to study disease in the black population. AIDS research in the black community has provoked warranted fears over ethical issues due to the travesty of justice carried out by Miss Evers and her higher-ups during the Tuskegee syphilis experiment (Thomas & Quinn, 1991).

References

Rao, K. S. (2008). Informed consent: An Ethical obligation or legal compulsion? Journal of Cutaneous and Aesthetic Surgery, 1(1), 33.

Sargent, J. (Director). (2001). Miss Evers' boys (1997) [Motion picture]. United States: HBO Home Video.

Thomas, S. B., & Quinn, S. C. (1991). The Tuskegee Syphilis Study, 1932 To 1972: Implications For HIV Education And AIDS Risk Education Programs In The Black Community. American Journal of Public Health, 81(11), 1498-1505.