“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
relevant U.S. administrative entities responsible for oversight, correspon- 
dence between Dr. Cutler and his superiors at the VDRL demonstrates a 
clearly defined, well-understood hierarchy regarding the design and conduct 
of the research. Complementing this correspondence are references to site 
visits conducted by more senior officials in PHS and evidence of the Surgeon 
General’s own knowledge of the work being conducted under his administra- 
tive purview. Rather than a faulty chain of command, there was a failure of 
both professional and institutional leadership in disregarding the excesses of 
the Guatemala experiments. 
Evaluating Historically Specific Mitigating Arguments 
There are other, more historically specific arguments that might also be 
offered to explain the actions of and potentially mitigate the culpability of 
the physicians and government officials who participated in the Guatemala 
experiments: 
■ That the experiments were conducted for national security purposes and 
therefore the conventional standards of medical ethics could be waived; 
■ That there was a powerful public health need for such experiments due to 
the prevalence of STDs such that the balance of risk and benefit justified the 
effort, however much it might compromise individual rights; and 
■ That although the conditions set out by Dr. Ivy of the AMA were cited as 
conventional, in fact, at the time, understanding of the moral norms for 
research by scientists and others was evolving and rules and principles were 
just beginning to be codified. 
The Radiation Experiments Commission addressed the national security 
defense when it found that “for the period 1944 to 1974 there is no evidence 
that any government statement or policy on research involving human 
subjects contained a provision permitting a waiver of consent requirements 
for national security reasons.” 698 However, there is evidence that government 
agencies in this period decided not to disclose certain experiments to the 
public for fear of government embarrassment and potential legal liability. 
It could be argued that the case of ionizing radiation experiments differed 
from that of STDs because the latter were of immediate and pressing concern 
104 
