“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
easily accessible population. The Orphanage generated and meticulously 
maintained medical records for each child from the moment of admittance, 
facilitating screening for previous infection or other complicating factors. 292 
Three children showed serologic patterns highly suggestive of syphilis. The 
researchers treated all three with penicillin and the children showed a slight 
decline in serologic titer the following year, though none became seronega- 
tive. 293 Eighty-nine children demonstrated some level of serologically positive 
reaction, but only 55 received a clinical work-up. 294 Forty-nine children then 
underwent lumbar punctures for further diagnosis. 295 
Additional experiments involving 441 “Ladino” children between the ages of 
5 and 14 years from the highlands of Guatemala, and 2 77 “Indian” children 
between the ages of 6 and 14 years from Totonicapan, Guatemala were also 
undertaken. 296 These children were involved in blood serology testing only; 
no lumbar punctures were reported. 297 
Although Dr. Cutler’s rationale — at least in part — for testing children 
appeared to be to validate serological methods for prophylaxis research, 
the exposure experiments in the Penitentiary in May 1947 began before the 
research in children started, 298 and was over in September 1948, 299 long 
before the testing in children ended in 19 49. 300 Furthermore, Dr. Cutler 
later changed his mind about the utility of the experiments in children. In 
1955 he concluded that effective validation of the serological test methods 
needed to come from comparisons with better matched populations to the 
prophylaxis experiments, that is, “an adult group coming from the same 
society as the prisoners.” 301 
Leprosarium 
The researchers conducted serological experiments with 51 leprosy patients, 
nearly the entire population of a leprosarium just outside of Guatemala 
City. 302 Given the high rates of false positive serologic tests for syphilis seen in 
other Guatemalan populations, along with published reports of false positive 
reactions in leprosy patients, the investigators sought to examine serologic 
tests for syphilis when both factors — disease state and nationality — were 
combined. 303 The researchers did not find any clinical evidence of syphilis, 
but positive serologic results appeared higher than in other Guatemalan 
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