“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
The original plan for the Guatemala experiments — what Dr. Cutler argued 
brought them to Guatemala initially — was to test the orvus-mapharsen 
prophylaxis wash as a prophylaxis for syphilis in prisoners exposed to 
infected commercial sex workers. The purpose was to develop more effec- 
tive preventative tools for U.S. military personnel. This experiment never 
happened. 321 Instead, the researchers faced difficulties in diagnosing syphilis, 
reliably inducing infection (through the use of commercial sex workers), and 
procuring a compliant subject population. The experiments, upon review, 
appear to lack logical progression: baseline experiments for background 
infection rates were conducted after prophylaxis experiments began and new 
experiments were started before the results for pilot experiments were known 
(see Figure 6). 322 Intentional exposure experiments began in the Guatemalan 
Army and focused almost equally on efforts to infect as efforts to test a 
prophylaxis for gonorrhea. As in Terre Haute, the researchers never mastered 
a technique with which to infect subjects. 
The majority of the intentional exposure experiments took place in the Guate- 
malan Army on 60 different days and involved gonorrhea and chancroid. 
The researchers conducted gonorrhea, chancroid, and syphilis experiments 
at the Psychiatric Hospital on 33 different days. Intentional exposures in the 
Penitentiary were relatively few, occurring on 24 different days, and were 
limited to syphilis. 323 While Dr. Cutler’s retrospective reports suggest a logical 
progression in the experiments from one population to the next, and from 
one type of experiment to another, this step-wise progression is often absent 
from the contemporaneous records and the aggregate data he collected (see 
Figure 7). 
Dr. Cutler’s contemporaneous records note 83 deaths during the course of 
the experiments. 324 The exact relationship between the experimental proce- 
dures and the subject deaths is unclear. When Dr. Cutler wrote his 1933 
Final Syphilis Report, he noted a “steady loss of patients by death” that he 
attributed primarily to tuberculosis and to the fact that “both acute and 
chronically ill patients” were used. 325 The researchers planned “to perform 
autopsies on all patients so that special spirochetal and histologic experi- 
ments could be made.” 326 
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