Learning from Tuskegee

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I write this following a visit to the National Center for Bioethics in Research and Healthcare and the School of Nursing at Tuskegee University, Alabama, United States. At this time, we are also preparing for the launch of our new International Care Ethics (ICE) Observatory at the University of Surrey, in collaboration with the Ethox Foundation. The ICE Observatory will replace the International Centre for Nursing Ethics (ICNE). The history of Tuskegee University is intertwined with the history of slavery and the emancipation of African Americans. The first principal of the then school at Tuskegee, Booker T. Washington, was born into slavery and witnessed the reading of the Emancipation Proclamation in 1863. His autobiography details the life of a man, without bitterness, utterly committed to the transformative potential of education to improve the conditions of marginalised groups and the need for service to local communities. For one movie perspective on this period of American history, readers should see the recent film 12 Years a Slave, which shows the dehumanising impact of slavery and the complexity, cruelty and perversity of master/slave relationships in the southern states of the United States. The establishment of the National Center for Bioethics at Tuskegee University in 1999 followed another exploitative historical episode, this time relating to research ethics in the 20th century. The centre was supported by Executive Order, following an apology to research participants, from US President Bill Clinton in response to the exposure of the US Public Health Service (USPHS) Syphilis Study at Tuskegee. The study ran from 1932 to 1972. In all, 399 Black African Americans who were infected with syphilis were recruited into the USPHS study, designed to study the natural progression of syphilis, without being told the true nature of the study or that treatment was available following the discovery of antibiotics in the 1940s. Conversations with Tuskegee University staff and students, and subsequent reading, confirmed the importance of interdisciplinary bioethical perspectives. The scope of the discussion of bioethics was wide-ranging with reference to historical, sociological, economic and faith perspectives and relating to race, class, gender, age and sexual orientation, particularly as related to health and flourishing. A definition of this broader approach to bioethics is proposed by Tuskegee bioethicist and professor, Stephen Olufemi Sodeke, as follows: