ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
THE WHITE HOUSE 
WASHINGTON 
November 24, 2010 
MEMORANDUM FOR DR. AMY GUTMANN 
Chair, Presidential Commission for the Study of 
Bioethical Issues 
SUBJECT: 
Review of Human Subjects Protection 
Recently, we discovered that the U.S. Public Health Service 
conducted research on sexually transmitted diseases in Guatemala 
from 1946 to 1948 involving the intentional infection of 
vulnerable human populations. The research was clearly 
unethical. In light of this revelation, I want to be assured 
that current rules for research participants protect people 
from harm or unethical treatment, domestically as well as 
internationally. 
I ask you, as the Chair of the Presidential Commission for the 
Study of Bioethical Issues, to convene a panel to conduct, 
beginning in January 2011, a thorough review of 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. I also request that the Commission oversee a 
thorough fact-finding investigation into the specifics of the 
U.S. Public Health Service Sexually Transmitted Diseases 
Inoculation Study. 
In fulfilling this charge, the Commission should seek the 
insights and perspective of international experts, including 
from Guatemala; consult with its counterparts in the global 
community; and convene at least one meeting outside the 
United States . I expect the Commission to complete its work 
within 9 months and provide me with a report of its findings 
and recommendations. 
While I believe the research community has made tremendous 
progress in the area of human subjects protection, what took 
place in Guatemala is a sobering reminder of past abuses. It 
is especially important for the Commission to use its vast 
expertise spanning the fields of science, policy, ethics, and 
religious values to carry out this mission. We owe it to the 
people of Guatemala and future generations of volunteers who 
participate in medical research. 
vi 
