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Hawaii professor is named a Mayo Clinic 'medical hero'


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POSTED: Friday, August 14, 2009

A University of Hawaii medical professor who was the only physician to question the ethics of a U.S. Public Health Service study on “;Untreated Syphilis in the Negro Male”; when he was 34 years old is being honored today by the Mayo Clinic in Rochester, Minn.

Dr. Irwin Schatz is one of four “;medical heroes”; receiving a Distinguished Alumni Award from the Mayo Clinic board of trustees. He has chaired the Department of Medicine and led the residency program at the John A. Burns School of Medicine for more than 20 years.

A 1961 Mayo School of Medicine graduate, Schatz was a young cardiologist in Detroit when he read a study “;of indigent black men, essentially sharecroppers, that started in the 1930s.”;

               

     

 

Dr. Schatz's letter

        Dr. Irwin Schatz's letter June 11, 1965, questioning the ethics of a U.S. Public Health Service syphilis research project was just two paragraphs.
       

But his concerns about the “;Tuskegee Study of Untreated Syphilis in the Negro Male,”; conducted between 1932 and 1972 in Tuskegee, Ala., had wide-ranging repercussions on research and clinical studies.

       

An Associated Press reporter disclo'sed the Tuskegee study on July 28, 1972.

       

Files containing records of the study at the U.S. Centers for Disease Control in Atlanta were barred from the press until the Wall Street Journal demanded access under the Freedom of Information Act.

       

Staff reporter Jim Montgomery found Schatz's letter in the files and wrote an article Nov. 2, 1972, entitled, “;Controversial Study of Untreated Syphilis Victims Added Little to Medical Knowledge, Files Indicate.”;

       

Montgomery wrote: “;The lone professional voice protesting the study was raised in June 1965 by Dr. Irwin J. Schatz, then on the staff at Henry Ford Hospital in Detroit.”;

       

Schatz read a paper on the study in the Archives of Internal Medicine and said in a letter to the authors:

       

“;I am utterly astounded by the fact that physicians allow patients with potentially fatal disease to remain untreated when effective therapy is available. I assume you feel that the information which is extracted from observation of this untreated group is worth their sacrifice. If this is the case, then I suggest that the United States Public Health Service and those physicians associated with it in this study need to reevaluate their moral judgments in this regard.”;

       

Schatz, on the staff of the University of Michigan hospital at Ann Arbor when Montgomery's article was published, said he never got a reply.

       

Montgomery said the CDC files confirmed that with a note stapled to his letter saying: “;This is the first letter of this type we have received. I do not plan to answer this letter. Anne R. Yoba, M.D.”;

       

Yoba, co-author of the report that infuriated Schatz, said she couldn't recall the letter or why she didn't answer it, Montgomery said.

       

 

       

Reports of the infamous Tuskegee Syphilis Study in Tuskegee, Ala., say it initially involved 600 African Americans—399 with syphilis. It was conducted without the patients' informed consent.

There was no definitive treatment at that time for syphilis, but when penicillin was shown to cure most forms of the disease, “;they elected not to treat these poor guys,”; Schatz recalled yesterday in a telephone interview from Rochester. “;They just followed them and made periodic reports.”;

He saw a report in the Archives of Internal Medicine in 1964 describing 30 years of following the patients with no treatment to cure their illness, he said. “;I couldn't believe my eyes. I reread it several times. I wanted to make sure I interpreted it correctly. I was so incensed. I couldn't believe doctors did this.”;

He was so upset he wrote a letter to the senior author of the paper at the Public Health Service (the precursor of the National Institutes of Health) saying he could not believe ethical standards permitted such a study. “;I never heard a word about it from them,”; he said.

Then six or seven years later, a Wall Street Journal reporter rifling through U.S. Centers for Disease files ran across his letter and wrote an article that triggered a raft of media reports and a public outcry.

A class-action lawsuit was filed in 1973 for the study participants and families, resulting in a $10 million out-of-court settlement, lifetime medical benefits and burial services.

The Tuskegee University called the study “;one of the most horrendous examples of research carried out in disregard of basic ethical principles of conduct.”;

It changed the way research was done in the United States, including the need for informed consent from research subjects and protection of patients in clinical trials.

“;Whatever I've done I'm proud of, but I think the sensibility of the country was ready for this change,”; Schatz said.

In a letter nominating Schatz for the Mayo award, Dr. David Peterson, program director for clinical research at the Vanderbilt University Medical Center, said his complaint about the study was courageous.

He “;was a young physician at the time, and criticizing an investigation which was overseen by some of the leading figures in the American Public Health Service was an action that was, to say the very least, potentially harmful to his career.”;