Unethical uses of humans as research subjects represent appalling chapters in the history of medicine.1 To ensure that effective protections against such abuses continue to evolve and improve, it is essential to continue to learn from historical examples. Sadly, a new example has recently come to light.
While conducting research on the Tuskegee study of untreated syphilis,2 Wellesley College Professor Susan Reverby recently reviewed the archived papers of John Cutler, a US Public Health Service (PHS) medical officer and a Tuskegee investigator. Instead of finding Tuskegee records, however, Reverby found the records of another unethical study. In this study, vulnerable populations in Guatemala—mentally incapacitated patients, prison inmates, sex workers, and soldiers—were intentionally exposed to sexually transmitted infections (syphilis, gonorrhea, and chancroid).