“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
Many unanswered questions drove the Commission’s work at the outset of 
its historical review and throughout the investigation process. Among the 
overarching questions to be examined were: 
■ What occurred in Guatemala between 1946 and 1948 involving a series of 
STD exposure studies funded by the U.S. PHS? 
■ To what extent were U.S. government officials and others in the medical 
research establishment at that time aware of the research protocols and to 
what extent did they actively facilitate or assist in them? 
■ What was the historical context in which these studies were done? 
■ How did the studies comport with or diverge from the relevant medical and 
ethical standards and conventions of the time? 9 
In seeking to answer these questions, the Commission cast a wide net. It 
began with the original records documenting the Guatemala activities found 
by Wellesley College professor Dr. Susan M. Reverby at the University of 
Pittsburgh in June 2003. 10 Dr. John C. Cutler, who directed the studies in 
Guatemala and later served as a faculty member at the University of Pitts- 
burgh, donated the records to the university in 1990. Dr. Reverby had 
presented her findings from these records at a May 2010 meeting of the 
American Association for the History of Medicine. 11 Thereafter, she contacted 
Dr. David Sencer, former Director of the Centers for Disease Control and 
Prevention (CDC), who notified the CDC of this information. Upon learning 
of these records, the CDC immediately undertook a review of them at the 
university. In September 2010, the university contacted the CDC to request 
the transfer of the material to the federal government, and the documents 
were subsequently transferred to the U.S. National Archives and Records 
Administration. 12 The National Archives provided the Commission with 
copies of these records in December 2010. 
The Commission also sought information from other government and 
nongovernmental sources. Staff independently reviewed documents in nine 
archives, including the National Archives and the University of Pittsburgh 
Archives, and three libraries, including the library of the Pan American 
Health Organization (PAHO) headquarters. PAHO’s predecessor organi- 
zation, the Pan American Sanitary Bureau (PASB), sponsored the research 
4 
