REVIEWING ETHICAL STANDARDS IN CONTEXT 
VI 
One final view that some suggest might mitigate the moral culpability of the 
participants, though it will not excuse it, is that the ethical conventions of 
that era were evolving and were frequently violated in practice. On this view, 
it would be unfair to hold certain researchers to standards to which many 
researchers did not abide. Depending on the stakes involved, we might not 
require professionals to place themselves at substantial personal risk, including 
compromising their career prospects, in order to change the status quo by 
insisting on certain ethical norms. Here it is important to distinguish between 
moral heroism, which is not morally required of an individual, although it is 
praiseworthy, and simply the act of standing up against a bad practice. The 
failure to stand up to a bad practice cannot be excused. In this case the stakes 
for failing to stand up to practices as bad as those in the Guatemala experi- 
ments were high indeed. They extended not only to the dignity but also to 
the health and well-being of highly vulnerable persons. The discussions about 
using different techniques of exposure to pathogens of one group or another 
suggest that the vulnerability of their subjects was apparent to these investiga- 
tors . 705 Additionally, the doctors involved were not all subordinate or junior 
in their status; some were in positions of high responsibility in government. 
Their failure to exercise moral leadership cannot be excused, and their failure 
led to practices that were so wrong as to be fairly characterized as heinous. 
Those who committed these actions were not under any unusual pressure to 
do so. They thought that they were above the rules, and went to some lengths 
to shield themselves from normal institutionally imposed scrutiny. 
The Guatemala Experiments — Looking Back, Looking Ahead, and 
Apportioning Blame 
The Guatemala case differs from some potentially analogous cases in the post- 
World War II period in ways that facilitate the process of reaching moral 
judgments. This comprehensive discovery and review of historical documents 
reveal a great deal of discussion among the protagonists that demonstrates 
their awareness of relevant ethical considerations and the corresponding reac- 
tions that would follow if their activities became widely known. This is true 
even during a time of evolution of interpretation and specification of moral 
principles in human research. In other words, the contemporaneous actions 
and words of the principal actors constitute their own moral indictment. 
107 
