John Charles Cutler

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John Charles Cutler
Born(1915-06-29)June 29, 1915
Cleveland, Ohio
DiedFebruary 8, 2003(2003-02-08) (aged 87)
Pittsburgh, Pennsylvania
Education Western Reserve University, M.D. (1941)
Employer United States Public Health Service
Known forunethical medical experiments regarding syphilitic patients
Spouse(s)Eliese S. Cutler
Parent(s)Grace Amanda Allen
Glenn Allen Cutler

John Charles Cutler (June 29, 1915 – February 8, 2003) was a senior surgeon, and the acting chief of the venereal disease program in the United States Public Health Service. [1] [2] After his death, his involvement in several controversial and unethical medical studies of syphilis was revealed, including the Guatemala and the Tuskegee syphilis experiments.

United States Public Health Service division of the U.S. Department of Health and Human Services concerned with public health

The United States Public Health Service (USPHS) is a division of the Department of Health and Human Services concerned with public health. It contains eight out of the department's eleven operating divisions. The Assistant Secretary for Health (ASH) oversees the PHS. The Public Health Service Commissioned Corps (PHSCC) is the federal uniformed service of the USPHS, and is one of the seven uniformed services of the United States.

Syphilis Sexually transmitted infection

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents. The primary stage classically presents with a single chancre though there may be multiple sores. In secondary syphilis, a diffuse rash occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. In latent syphilis, which can last for years, there are few or no symptoms. In tertiary syphilis, there are gummas, neurological problems, or heart symptoms. Syphilis has been known as "the great imitator" as it may cause symptoms similar to many other diseases.

Tuskegee syphilis experiment Human Experiment

The Tuskegee Study of Untreated Syphilis in the African American was an infamous and unethical clinical study conducted between 1932 and 1972 by the U.S. Public Health Service. The purpose of this study was to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the United States government.

Contents

Early life and education

Cutler was born on June 29, 1915 in Cleveland, Ohio, to Grace Amanda Allen and Glenn Allen Cutler. [3]

Cleveland City in Ohio

Cleveland is a major city in the U.S. state of Ohio, and the county seat of Cuyahoga County. The city proper has a population of 383,793, making it the 52nd-largest city in the United States and the second-largest city in Ohio. Greater Cleveland is ranked as the 33rd-largest metropolitan area in the U.S., with 2,057,009 people in 2018. A Gamma + city, Cleveland anchors the Cleveland–Akron–Canton Combined Statistical Area, which had a population of 3,599,264 in 2018 and is ranked 17th in the nation.

He graduated from Western Reserve University Medical School in 1941, and joined the Public Health Service in 1942. In 1943 he worked as a medical officer in the U.S. Public Health Venereal Disease Research Laboratory on Staten Island.

Staten Island Borough in New York City and county in New York, United States

Staten Island is one of the five boroughs of New York City, in the U.S. state of New York. Located in the southwest portion of the city, the borough is separated from New Jersey by the Arthur Kill and the Kill Van Kull and from the rest of New York by New York Bay. With an estimated population of 479,458 in 2017, Staten Island is the least populated of the boroughs but is the third-largest in land area at 58.5 sq mi (152 km2). The borough also contains the southern-most point in the state, South Point.

Bioethics violations

Cutler oversaw the Terre Haute prison experiments and the syphilis experiments in Guatemala in the 1940s, during which doctors deliberately infected an estimated 1500 Guatemalans, including orphans as young as nine, [4] soldiers, prisoners and mental patients with syphilis without the informed consent of the subjects. [5] [6] This study not only violated the Hippocratic Oath but it echoed Nazi crimes exposed around the same time at the Nuremberg trials. [4]

The Terre Haute prison experiments were conducted by Dr. John C. Cutler in 1943 and 1944 under Dr. John F. Mahoney, the head of the Venereal Disease Research Laboratory of the US Public Health Service, to determine the effectiveness of treatments for sexually transmitted diseases. The test subjects were prisoners at the U.S. Penitentiary in Terre Haute, Indiana. They were given disclosures and consented to the experiments. A total of 241 prisoners participated in the study and received $100, a certificate of merit, and a letter of commendation to the parole board at the end of the study. The researchers deposited various strains and concentrations of gonorrhea into the penises of the test subjects. After several months, Mahoney noted that the method of inducing gonorrhea in humans was unreliable and could not provide meaningful tests of prophylactic agents.

Hippocratic Oath physicians oath

The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. Swearing a modified form of the oath remains a rite of passage for medical graduates in many countries.

Nuremberg trials series of military trials at the end of World War II

The Nuremberg trials were a series of military tribunals held after World War II by the Allied forces under international law and the laws of war. The trials were most notable for the prosecution of prominent members of the political, military, judicial, and economic leadership of Nazi Germany, who planned, carried out, or otherwise participated in the Holocaust and other war crimes. The trials were held in Nuremberg, Germany, and their decisions marked a turning point between classical and contemporary international law.

In 1954, Cutler was in charge of experiments at Sing Sing prison to see if a vaccine made from the killed syphilis bacterium, would protect prisoners against infection when he later exposed them to the bacterium. Those infected were later treated with penicillin. [2] [7]

Sing Sing US maximum security prison

Sing Sing Correctional Facility is a maximum security prison operated by the New York State Department of Corrections and Community Supervision in the village of Ossining, New York. It is located about 30 miles (48 km) north of New York City on the east bank of the Hudson River. Sing Sing contains about 1,700 prisoners.

Vaccine biological preparatory medicine that improves immunity to a particular disease

A vaccine is a biological preparation that provides active acquired immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future. Vaccines can be prophylactic, or therapeutic.

Penicillin group of antibiotics derived from Penicillium fungi

Penicillin was invented by Alexander Fleming. Penicillin is a group of antibiotics which include penicillin G, penicillin V, procaine penicillin, and benzathine penicillin. Penicillin antibiotics were among the first medications to be effective against many bacterial infections caused by staphylococci and streptococci. They are still widely used today, though many types of bacteria have developed resistance following extensive use.

Cutler became assistant surgeon general in 1958.

In the 1960s until November 1972, Cutler was involved in the ongoing Tuskegee syphilis experiment, during which several hundred African-American men who had contracted syphilis were observed, but left untreated. [5] [6]

In “The Deadly Deception”, the 1993 Nova documentary about the Tuskegee experiments, Cutler states, “It was important that they were supposedly untreated, and it would be undesirable to go ahead and use large amounts of penicillin to treat the disease, because you’d interfere with the study.” [8] [9]

In 1967 Cutler was appointed professor of international health at the University of Pittsburgh, where he also served as chairman of the department of health administration and acting dean of the Graduate School of Public Health in 1968–1969. [1] He died on February 8, 2003 at Western Pennsylvania Hospital in Pittsburgh. [1] The university started a lecture series in his name after his death, but discontinued it in 2008 when his role in the Tuskegee experiment came to the attention of a new dean. [10]

Related Research Articles

Albert Ludwig Sigesmund Neisser was a German physician who discovered the causative agent (pathogen) of gonorrhea, a strain of bacteria that was named in his honour.

Thomas Parran Jr. Surgeon General of the United States

Thomas Parran Jr. was an American physician and Public Health Service officer. He was appointed the sixth Surgeon General of the United States from 1936 to 1948, overseeing the notorious Tuskegee syphilis experiment and Guatemala syphilis experiment.

Neurosyphilis

Neurosyphilis refers to infection of the central nervous system in a patient with syphilis and can occur at any stage. The majority of neurosyphilis cases have been reported in HIV-infected patients. Meningitis is the most common neurological presentation in early syphilis. Tertiary syphilis symptoms are exclusively neurosyphilis, though neurosyphilis may occur at any stage of infection.

Parran Hall building in Pennsylvania, United States

Parran Hall is the former name of an academic building on the campus of the University of Pittsburgh on Fifth Avenue in Pittsburgh, Pennsylvania, United States. The building, constructed to house the Graduate School of Public Health, was completed in 1957, and designed by Eggers & Higgins, architects of the Dirksen Senate Office Building, in the International Style with a major addition by Deeter-Ritchey-Sippel and Crump completed in 1967. The school was founded in 1948 with a $13.6 million grant from the A.W. Mellon Educational and Charitable Trust. It was originally named after Thomas Parran Jr., a former head of the United States Public Health Service at the time the Public Health Service was sponsoring the Tuskegee experiment, in which patients with syphilis were studied but did not receive treatment for the disease.

Peter Buxtun American whistleblower

Peter Buxtun is a former employee of the United States Public Health Service who became known as the whistleblower responsible for ending the Tuskegee syphilis experiment.

The Public Health Advisor, or "PHA" is a type of public health worker which was established in 1948 by the United States Public Health Service in the Venereal Disease Control Division. Today they are hired primarily by the U.S. Centers for Disease Control and Prevention (CDC) and serve in many public health programs. This type of worker is unique in public health, because they begin their service at the entry level of public health doing what is known as "field work" or "contact epidemiology" which refers to the interviewing and locating of people who have been exposed to an infectious disease so as to offer them treatment and to reduce the epidemic. Following their initial work experiences, PHAs are exposed to a variety of public health programs across the United States, learning to function at all levels of the public health system. During their time of service, PHAs are called upon to respond to public health or humanitarian crisis. This article will briefly describe the history of the Public Health Advisor and will mention a few notable contributions made over the course of their history with the Public Health Service and later with the Centers for Disease Control and Prevention.

Guatemala syphilis experiment

The syphilis experiments in Guatemala were United States-led human experiments conducted in Guatemala from 1946 to 1948. The experiments were led by physician John Charles Cutler who also participated in the late stages of the Tuskegee syphilis experiment. Doctors infected soldiers, prostitutes, prisoners and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects. The experiment resulted in at least 83 deaths. Serology studies continued through 1953 involving the same vulnerable populations in addition to children from state-run schools, an orphanage, and rural towns, though the intentional infection of patients ended with the original study. On October 1, 2010, the U.S. President, Secretary of State and Secretary of Health and Human Services formally apologized to Guatemala for the ethical violations that took place. Guatemala condemned the experiment as a crime against humanity, and a lawsuit has since been filed.

Susan Mokotoff Reverby is a Wellesley College professor. She has written on the Tuskegee syphilis experiment, and she uncovered the syphilis experiments in Guatemala.

History of syphilis

The first recorded outbreak of syphilis in Europe occurred in 1494/1495 in Naples, Italy, during a French invasion. Because it was spread by returning French troops, the disease was known as "French disease", and it was not until 1530 that the term "syphilis" was first applied by the Italian physician and poet Girolamo Fracastoro. The causative organism, Treponema pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905. The first effective treatment, Salvarsan, was developed in 1910 by Sahachirō Hata in the laboratory of Paul Ehrlich. It was followed by the introduction of penicillin in 1943.

The outbreaks of sexually transmitted diseases in World War II brought interest in sex education to the Public and the government. During the late 1930s and early 1940s, military maneuvers increased worldwide and sexual hygiene and conduct became major problems for the troops. Soldiers and sailors on assignment overseas were often lonely, had time to spare, got homesick, or were just looking for female companionship. This resulted in many men having multiple sex partners, and as a result, became a major health concern. During the Great War, venereal diseases (V.D.) had caused the United States Army to lose 18,000 servicemen per day. Although by 1944 this number had been reduced 30-fold, there were still around 606 servicemen incapacitated daily. This drop in numbers was partly because of the Army's effort to raise awareness about the dangers faced by servicemen through poor sexual hygiene, and also because of the important developments in medicine. In late 1943 a case of gonorrhea required a hospital treatment of 30 days, and curing syphilis remained a 6-month ordeal. By mid-1944, the average case of gonorrhea was reduced to 5 days, and in many cases the patient remained on duty while being treated.

Eunice Rivers Laurie American nurse

Eunice Verdell Rivers Laurie (1899–1986) was an African American nurse who worked in the state of Alabama. She is best known for her work as the coordinator of the Tuskegee syphilis experiment from 1932 to 1972.

John Friend Mahoney American physician

John Friend Mahoney was an American physician best known as a pioneer in the treatment of syphilis with penicillin. He won the 1946 Lasker Award.

Dr. John Roderick 'Rod' Heller, was the head in 1943-1948 of what was then called the "Venereal Disease" section of the United States Public Health Service (PHS). He then became the director of the National Cancer Institute, and then president/chief executive officer of the Memorial Sloan-Kettering Cancer Center in New York City. He is best known for having been the assistant in charge of on-site medical operations in the Tuskegee syphilis study, a longitudinal clinical examination by PHS of untreated syphilis in U.S. African-American males. Very serious questions of medical ethics have been raised about this study and those involved in it.

La Follette-Bulwinkle Act

La Follette-Bulwinkle Act or Venereal Diseases Control and Prevention Act of 1938 sanctioned federal assistance to U.S. states establishing preventive healthcare for venereal diseases. The United States federal statute commissioned the United States Public Health Service for demonstrations, investigations, and studies as related to the control, prevention, and treatment of opportunistic infections. The public law amended the Army Appropriations Act of 1918 appending the judicial context which created the Division of Venereal Diseases within the Bureau of the Public Health Service.

Eugene Dibble

Eugene Heriot Dibble Jr. (1893–1968) was an American physician and head of the John A. Andrew Memorial Hospital at the Tuskegee Institute in Alabama. He played an important role in the Tuskegee Syphilis Study, which was a clinical study conducted on syphilis in African American males from 1932 to 1972.

William Carter Jenkins was an African American public health researcher and academic.

References

  1. 1 2 3 "John Charles Cutler. Pioneer in preventing sexual diseases". Pittsburgh Post-Gazette . February 12, 2003. Retrieved October 2, 2010. Dr. Cutler, a former assistant surgeon general of the U.S. Public Health Service, was part of a group that in 1944 worked out the ways penicillin could be used to treat syphilis.
  2. 1 2 "Sing Sing Tests Held Raising Hopes for Finding Preventive". The New York Times . December 9, 1954. Retrieved October 2, 2010. For several years penicillin has been used to cure syphilis. Dr. John C. Cutler, acting chief of the venereal-disease program of the Federal Public Health Service ...
  3. John Charles Cutler (1915–2003) in the Hubbard Family Tree, Ancestry.com
  4. 1 2 Rory Carroll: Guatemala victims of US syphilis study still haunted by the “devil’s experiment”, The Guardian , 8 June 2011.
  5. 1 2 McGreal, Chris (October 1, 2010). "US says sorry for 'outrageous and abhorrent' Guatemalan syphilis tests". The Guardian . Retrieved October 2, 2010. Conducted between 1946 and 1948, the experiments were led by John Cutler, a US health service physician who would later be part of the notorious Tuskegee syphilis study in Alabama in the 1960s.
  6. 1 2 "Wellesley professor unearths a horror: Syphilis experiments in Guatemala". Boston Globe . October 1, 2010. Retrieved October 2, 2010. That is when she came across files belonging to a deceased researcher named John C. Cutler, who had been involved in the later years of the Tuskegee project. “I expected to find something on Tuskegee,” Reverby recalled. “There was nothing. What he left behind were these records from the Guatemala study.”
  7. "Syphilis Preventive Seen by Scientists". Associated Press. December 8, 1954. Retrieved October 3, 2010. For several years doctors have been curing syphilis with penicillin. Dr. John Cutler, senior surgeon and acting chief of the venereal disease of the US …
  8. George Strait, ABC News Medical Correspondent, host (January 26, 1993). "The Deadly Deception". Nova. PBS.
  9. Amy Goodman, host; Susan Reverby, guest (October 5, 2010). "The Dark History of Medical Experimentation from the Nazis to Tuskegee to Puerto Rico". Democracy Now!. Pacifica Radio.
  10. Torsten Ove: "Presidential panel excoriates former Pitt dean", Pittsburgh Post-Gazette, 29 August 2011