“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
“In the last gonorrhea experiment utilizing natural exposure we 
used two girls over a four night period with four men exposed 
to them. Each man had as many contacts as he wanted during 
the evening so that the tota[l] time of exposure averaged over ten 
minutes with most men having two and some three exposures. 
There was no doubt of the presence of the gonococci in the women, 
as that was proven culturally twice each night, but after two weeks 
of observation no infection developed in any of 16 men. It may 
be that the infection had gone too long in the sources, so that we 
are getting ready now to expose our men to the infection as early 
in its course as possible. At the same time, or in the next run we 
shall use alcohol again, for to date our only success has come in 
the case of a man who had alcohol prior to exposure. It seems that 
clandestine affairs, with respect to gonorrhea, are far safer than 
ever before imagined.” 397 
In response, Dr. Mahoney, whose doubts about the feasibility of intentional 
infection contributed to the decision to terminate the Terre Haute work, 398 
advised his junior colleague on June 30 to follow a contact only (i.e., sexual 
intercourse) regimen: “we are anxiously awaiting your report of the transmis- 
sion experiments utilizing contact only. This is of vital importance if we are 
to carry out the studies outlined.” 399 By August, Dr. Mahoney had advised 
Dr. Cutler that “ [i] t is becoming obvious also that experimental infection 
cannot be produced with sufficient frequency to assure an adequate back- 
ground for a study of prophylaxis. Because of the circumstances your opinion 
as to the advisability of discontinuing the gonorrhea phase of the project for 
the time being would be appreciated.” 400 Dr. Cutler responded that “we might 
well continue [the experiments] a while longer to get as much information as 
possible now that we have a set up here.” 401 
Despite Dr. Mahoney’s concerns, the researchers increased the number of arti- 
ficial inoculation experiments relative to the sexual intercourse experiments 
beginning in August. While the researchers conducted 13 sexual intercourse 
experiments and eight artificial inoculation experiments between February 
and July 1947, they conducted nine sexual intercourse experiments and 32 
artificial inoculation experiments between August 1947 and July 1948. 402 
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