From 1932 to 1972 the U.S. Public Health Service (PHS) tracked the nonmedicated course of syphilis, a disease that is caused by the bacterium Treponema palladium, among 399 patients and 201 controls at Tuskegee Institute (now Tuskegee University). In the region around Tuskegee in Macon County, Alabama, the PHS, in conjunction with the county health department and the Rosenwald Foundation, initially began a survey and small treatment program for African-Americans with syphilis.

The study goals and research methods soon shifted in response to financial limitations, and the project became the longest nontherapeutic observational study on human beings in medical history, manifesting major violations of basic human rights and ethical precepts. The legacy of government-sanctioned refusal to treat syphilis continues to influence the reluctance of African-Americans and other ethnic minorities to participate in government-funded clinical trials, contribute to organ and tissue donation campaigns, support biomedical research initiatives, and be involved...