PREFACE 
U.S. government researchers observed the progress of their infections. 5 The 
similarities between the two cases were stark. The cases arose from the same 
laboratory of the Public Health Service, the Venereal Disease Research Labo- 
ratory (VDRL), involved some of the same researchers, and focused, in part, 
on the same disease. Both cases also involved deliberate efforts to deceive 
experimental subjects and the wider community that might have objected 
to the work. But other factors distinguished the research in Guatemala from 
that conducted in Tuskegee. The research in Guatemala ended long before 
the work in Tuskegee stopped and took place over a much shorter period. 
Subjects in Guatemala were deliberately exposed to infections, were members 
of different populations, and were citizens of a foreign country. 
As additional details about the research emerged, President Obama directed 
the Commission to undertake both a forward-looking assessment of research 
ethics and an historical review of events that occurred in Guatemala between 
1946 and 1948. 6 On November 24, 2010, he charged the Commission, begin- 
ning in January 2011, to “oversee a thorough fact-finding investigation into 
the specifics” of the Guatemala research. The President also charged the 
Commission to undertake “...a thorough review of [current] human subjects 
protection to determine if federal regulations and international standards 
adequately guard the health and well-being of participants in scientific studies 
supported by the federal government.” 8 
The Commission began its work in January 2011. It held three public 
meetings addressing the President’s requests. During these meetings, the 
Commission heard from experts in law, history, medicine, and ethics, and 
received testimony from members of the public. With dual responsibilities 
to give a full and fair accounting of events largely hidden from history for 
nearly 65 years and also provide an assessment of the current system, the 
Commission decided to publish two reports. This is the first report, a histor- 
ical account and ethical assessment of the Guatemala experiments. It aims 
to uncover and contextualize as much as can be known at this time about 
the experiments that took place nearly 65 years ago. It also aims to inform 
current and continuing efforts to protect the rights and welfare of the subjects 
of U.S. -sponsored or -conducted research. The second report on this topic, to 
be published in late 2011, will address contemporary standards for protecting 
human research subjects around the world. 
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