“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
Guatemala between 1946 and 1948 was clearly and grievously wrong. The 
Commission’s aim in conducting a more comprehensive historical investiga- 
tion was to fully uncover the facts surrounding the experiments and offer a 
fair-minded and unvarnished ethical assessment. 
In sum, the PASB 18 and VDRL activities in Guatemala led by Dr. Cutler 
took place from approximately July 1946 to December 1948, with follow-up 
work continuing through 1953. 19 PASB built and supplied a venereal disease 
research laboratory in Guatemala City to support the work and negotiated 
agreements that gave the researchers authority to work with officials and insti- 
tutions across the Guatemalan government, including public health service 
treatment centers for venereal diseases, government hospitals, medical instal- 
lations and officers of the military, institutions caring for orphans and the 
insane, and the penal system. Many aspects of the research were collabora- 
tive. Costs were borne by the PASB (for administration, travel, construction, 
and supplies), the U.S. Public Health Service Venereal Disease Division 
(providing and paying directly for staff and supplies as well as funding the 
grant issued from the Research Grants Office of the then U.S. National Insti- 
tute of Health), and the government of Guatemala (directly funding staff and 
supplying facilities). 
The studies encompassed research on three STDs — syphilis, gonorrhea, 
and chancroid — and involved the intentional exposure 20 to STDs of 1,308 
research subjects from three populations: prisoners, soldiers, and psychiatric 
patients. 21 Of the 1,308 subjects exposed to an STD, the researchers docu- 
mented some form of treatment for 678 subjects. 22 Commercial sex workers, 23 
who in most cases were also intentionally infected with STDs, were used 
to transmit disease. In addition, to improve diagnostics, the researchers 
conducted diagnostic testing of 5,128 subjects 24 including soldiers, prisoners, 
psychiatric patients, children, 25 leprosy patients, 26 and Air Force personnel at 
the U.S. base in Guatemala. 27 This diagnostic testing, which included blood 
draws as well as lumbar and cisternal punctures, 28 continued through 1953. 29 
Most of the information about the experiments in Guatemala available to the 
Commission comes from the records Dr. Cutler donated to the University of 
Pittsburgh Archives Service Center (the Cutler Documents). The documents 
include several final reports on the STD experiments authored in the 1950s 
6 
