REVIEWING ETHICAL STANDARDS IN CONTEXT 
VI 
Contemporaneous Standards for Ethical Research in 1946-1948 
The norms of medical ethics for a given era are often difficult to identify 
in detail. They are a complex mixture of written statements, practices, and 
attitudes. The era in which the research in Guatemala occurred was certainly 
one in which ethical standards were in flux. The medical experimenters of the 
years immediately following World War II were swimming in a sea of change 
that, several decades later, produced decisive shifts in the tides of moral 
awareness and regulation. Retrospective moral judgments can therefore be 
hazardous. With the passage of time, the accumulation of experience, and the 
luxury of reflection, it can be easy to feel morally superior to our predecessors. 
Despite these challenges, it is possible to develop and apply a standard for 
moral judgments about past actions and, to some degree, to conclude that 
actions and actors were blameworthy. In the case of the Guatemala experi- 
ments, retrospective moral judgment is facilitated by a rich historical record 
of the experimenters’ own words and behavior in the years prior to the 
onset of these studies, behavior that expressed and endorsed a self-imposed 
moral metric that can be held against their activities. What bears particular 
emphasis is that this historical record includes not only practices but also self- 
indicting statements by the researchers themselves. 
To be sure, these investigators were operating within a culture of medical 
research that often treated moral norms pragmatically, primarily as defenses 
against meddling “do-gooders” who would impinge upon their all-important 
work, rather than as genuine moral imperatives based upon respect for persons. 
In 1947, such an attitude might have characterized the majority of medical 
researchers and, indeed, some researchers might still harbor such views today. 
Nonetheless, during this period basic tenets bearing on informed consent and 
risk reduction were beginning to be widely recognized and followed in prac- 
tice. Many researchers, especially public health investigators, were familiar 
with Walter Reed’s yellow fever experiments at the turn of the century during 
which Spanish workers were recruited and agreed to be exposed to mosquitoes 
to test the theory that the insects carried yellow fever. 671 Legal standards artic- 
ulated early in the 20th century included an individual’s right to determine 
what shall be done with his or her body, although acceptance and application 
of these norms diffused slowly within the medical profession. 672 
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