“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
Dr. Cutler said they chose subjects in the Psychiatric Hospital based on 
“custodial considerations” such as expected date of release and absence of 
homosexual behavior, but there are several examples of the researchers inten- 
tionally exposing men they also noted to be “active homosexuals.” 464 It is 
possible that the subjects involved in the experiment spread syphilis beyond 
the experimental boundaries through homosexual contact, 465 but Dr. Cutler 
dismissed this possibility in his 1955 Final Syphilis Report. He reported 
observing no clinical evidence of syphilis spread in this manner. 466 
Dr. Carlos Salvado, the Director of the Psychiatric Hospital, collaborated 
on the syphilis and gonorrhea experiments and made staff available to assist 
the researchers. 467 Dr. Cutler credited Dr. Salvado with suggesting use of 
the psychiatric patients in experiments “since we had available a certain and 
sure cure for syphilis....” 468 Dr. Cutler added that “[Responsible medical offi- 
cials representing all groups concerned” together decided to undertake the 
syphilis inoculation experiments at the Psychiatric Hospital. Dr. Cutler justi- 
fied this decision by pointing out that “[m] embers representing the VDRL 
had previous experience in inoculation of volunteers both with gonorrhea 
and syphilis,” after which he cited the Terre Haute experiments as well as 
an “unpublished observation” he made with Dr. Arnold “on inoculation of 
volunteers with Nichols strain T. pallidum obtained from rabbit testicular 
syphilomata quick frozen and maintained in solid carbon dioxide refrigera- 
tion.” 469 Dr. Cutler argued that “organizations concerned” had been involved 
in malaria 470 and infectious hepatitis inoculation experiments, 471 “so that 
there was a large background of experiences in the methods of working in 
human inoculation and with the safeguards for the individuals concerned.” 472 
Such an opportunity, the researchers believed, would “provide conclusive 
answers to a large number of questions of great importance, not only in the 
matter of prophylaxis but also concerning progress of national and international 
control of venereal disease then in action or proposed for the future.” 473 Once 
in the Psychiatric Hospital, questions to which “conclusive answers could be 
expected to be found,” Dr. Cutler later wrote, included the following: 
■ Whether the orvus-mapharsen prophylaxis was effective in the prevention 
of syphilis; 
- How the orvus-mapharsen prophylaxis compared with those in use at the time; 
58 
