In my WR 100 class “Ethical Missteps in Public Health,” students explore key events in public health history—and, more specifically, the Progressive Era—that spurred the development of codes of ethics that continue to inform public health research and policy to this day. Prior to such codes, the conduct of doctors acting as researchers was guided primarily by subjective judgment, a model borrowed from the doctor-patient relationship and characterized by so-called “medical beneficence.” Not surprisingly, doctor reliance on subjective judgment was tainted with personal prejudice and misconceptions, including the belief that race, ethnicity and social status were confirmations of biological difference. Two public health milestones, the now notorious Tuskegee Study of Untreated Syphilis and the 1927 Supreme Court Case Buck v. Bell, starkly illustrate the kinds of abuses that arise in the absence of stringent protections for human subjects. It may be tempting for practitioners and students of public health to harshly judge the conduct of physicians whose research and social policies left a legacy of such profound human suffering. In her compelling and thorough exploration of these missteps, however, Jamie Tam argues for a more nuanced approach, cautioning that a perhaps more forgiving understanding of these events, informed by the context of their time, better serves the prevention of such missteps in the future.
— MELANIE SMITH
WR 100: Ethical Missteps in Public Health