After nine months and reviewing 125,000 pages of records, the Presidential Commission for the Study of Bioethical Issues found that the Guatemalan studies of sexually transmitted diseases (STDs) were “Ethically Impossible.”

The commission’s chief findings included the following:

• Dr. John C. Cutler led the study, which had 1,308 research subjects who were intentionally exposed to syphilis, gonorrhea, and/or cancroid.

• Subjects were prisoners, soldiers, and psychiatric patients.

• Commercial sex workers, who did not consent to the study, were infected with STDs and used to transmit disease.

• Hundreds of Guatemalan soldiers were infected with STDs through sexual exposure, superficial inoculation into the penis, deep inoculation into the penis, and superficial inoculation following sexual exposure. Their average age was 22 years old. There is no evidence that they gave consent or received compensation for the study. The researchers’ own words suggest that they did not consider their subjects to be volunteers.

• Research staff for the experiments included leaders and senior medical personnel of the government of Guatemala, as well as U.S. researchers and officials.

• In 1947, New York Times science editor Waldemar Kaempffert described rabbit experiments with penicillin and intentional exposure to syphilis. Kaempffert said it would be “ethically impossible” to undertake such research with humans. But what he didn’t know was that Cutler already had begun initiating that exact kind of experiment in Guatemalan prisoners and psychiatric patients.

• The National Research Council (NRC) reviewed the Guatemalan study in 1946, and on its subcommittee on venereal diseases were public health system doctors, as well as representatives from the U.S. Army, the U.S. Navy, the Veterans Administration, and several universities. The NRC approved funding for the study.

• Cutler’s research team treated some of the subjects for STDs.

• They also conducted serology testing of 1,384 orphan children and subjected the children, who were used somewhat as control subjects, to physical exams, blood draws, and — sometimes — lumbar punctures.

• The study never accomplished its goal of testing the orvus-mapharsen prophylaxis wash as a prophylaxis for syphilis.

• Some prisoners objected to the study but were not withdrawn, and 83 people died during the experiments from causes that were not well documented.

The commission’s report can be found at http://bioethics.gov/node/654.