Clinton's Tuskegee Apology: Accepted?

The 40 year long Tuskegee study basically led on hundreds of black Americans, who were poor and had few health alternatives, to believe that they were receiving legitimate medical care for syphilis. The cold, hard truth, however, revealed that researchers were allowing syphilis to progress even to deadly levels in their participants--even after a cure (penicillin) was discovered. It was only after this scandal was revealed through the media that this awful study was terminated in 1972, and President Bill Clinton later issued an apology to the Tuskegee victims in 1997. The question is whether or not a simple public apology is enough to restore African American trust in the US government again.

Clinton begins his apology by thanking the eight survivors of the study for appearing in person as well as family members associated with all the participants in the study, which I think is not only a gesture done out of politeness/etiquette but also a display of gratitude for being given the chance to own up to the government's mistakes. Clinton then stresses the importance of remembering the study rather than forgetting it, in order to begin making amends and building "a better present and a better future." I agree with this statement because by remembering this incident, it's as if America has learned a lesson that it will not forget. He continues by stating that the US government performed a "clearly racist" act that was morally wrong and that which questioned the government's commitment to the integrity and equality of its citizens.

I found one section of Clinton's speech to be especially powerful and very true:

No power on Earth can give you back the lives lost, the pain suffered, the years of internal torment and anguish. What was done cannot be undone. But we can end the silence. We can stop turning our heads away. We can look at you in the eye and finally say on behalf of the American people, what the United States government did was shameful, and I am sorry.

I'm glad that he mentioned this rather than just saying "I'm sorry." He makes it known that the government has come to terms with its wrongdoing, and even though there is nothing to make everything better, at least this is the beginning of a path towards rebuilding African American (and possibly other ethnicities) trust in the US government. As Clinton says, "An apology is the first step, and we take it with a commitment to rebuild that broken trust."

Clinton then follows with several plans to rebuild trust in the US government:
1) Build a Tuskegee memorial and establish a center for bioethics in Tuskegee to strengthen bioethics training.
2) Increased community involvement and mandatory informed consent and local review in federally-funded and mandated research; find ways to best involve more minority communities in research and health care.
3) Strengthen researchers' training in bioethics.
4) Increase and broaden understanding of ethical issues and clinical research; provide postgraduate fellowships to train bioethicists among minority groups.
5) Extend the National Bioethics Advisory Commission charter to October of 1999.

And Clinton ends by saying that the eight survivors who appeared to this apology (as well as their family members) were showing that they had retained the power to forgive--that this was all a lesson for America. I think Clinton's apology was a good first step in the attempt to regain trust in the US government... I say "attempt" because I don't know if I myself would be able to forgive anyone for doing what the Tuskegee researchers did--even though I or members of my ethnicity were not directly involved. However, I believe that Clinton said all that needed to be said--from gratitude, to acknowledgment (of the government's mistakes), to apologies, and to plans for action. I really have no idea how African American (and other minorities) trust levels have been affected by this apology.

Today was the inauguration of first African American President Barack Obama. I think that this may be helpful in regaining the trust of the Tuskegee families and the African American population because they are finally being represented by a member of their own community. It's about time!

Multidrug-Resistant Tuberculosis

In the CDC podcast posted on October 10th, 2008, Dr. Oeltmann talks about the increase and dangers of MDR TB due to a common factor: the misuse of antibiotics used to treat regular TB. It's extremely important for someone to follow their medication regimen if they are treating TB. If they sporadically take a drug for TB, the drug can't do its job completely, and then TB survives within the body and ultimately develops a resistance to the drug.

We should be very concerned about MDR TB because it is resistant to at least two of the best drugs used to treat TB. What a dilemma! There have been 45 reported cases of MDR TB in the US--which may seem small, but it seems like it can spread pretty easily according to Dr. Oeltmann. For example, he said that most of the Thai refugees who tested positive for MDR TB were socially linked within their refugee camps in California; this was the main cause of the outbreak in camps. And since MDR TB is resistant to our strongest drugs, who's to say that those 45 cases can't jump to 100, to 1000, etc.? It's a scary thought. Obviously, I am concerned about MDR TB because it is a potentially fatal disease, because vaccines aren't useful and aren't even recommended in this case, and because it's not just any problem across the ocean to be ignored. In fact, TB is a global epidemic.

I think MDR TB has changed the whole process of treating and managing other diseases not only in incoming refugees but in our society as well. Instead of giving patients their drugs for treatment and setting them off on their own, health officials are now creating programs (or something like that) to ensure that their patients come in to take their medicine as recommended. If this keeps up, hopefully the threat of MDR TB--including countless other diseases--will be the least of our worries.