Comment by bobthepanda | Hacker News Reader

Comment by bobthepanda | Hacker News Reader

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That's not really why the study was conducted on African Americans.

> The conception which lay behind the U.S. Public Health Service Syphilis Study at Tuskegee in 1932, in which 100% of its participants were poor, rural African-American men with very limited access to health information, reflects the racial attitudes in the U.S. at that time. The clinicians who led the study assumed that African-Americans were particularly susceptible to venereal diseases because of their race, and they assumed that the study's participants were not interested in receiving medical treatment.[4][45]

> Taliaferro Clark said, "The rather low intelligence of the Negro population, depressed economic conditions, and the common promiscuous sex relations not only contribute to the spread of syphilis but the prevailing indifference with regards to treatment."[45] In reality, the promise of medical treatment, usually reserved only for emergencies among the rural black population of Macon County, Alabama, was what secured subjects' cooperation in the study.[4]

I mean the other racist part was the fact that penicillin, which is still a standard treatment of syphilis today, was developed while the study was ongoing and yet there were still three more decades that it ran.

>> Taliaferro Clark said, "The rather low intelligence of the Negro population, depressed economic conditions, and the common promiscuous sex relations not only contribute to the spread of syphilis but the prevailing indifference with regards to treatment."...

This is a fairly sickening mindset. I hope I am never not sickened by it.

Strange. I have no problem reading it as a literal description with no bigotry or racism implied.

If it were about J.R.R. Tolkien's orcs, then I might agree. When basic observation disproves ¾ of your "literal description" about a racially-defined population… those "facts" probably didn't originate from honest mistakes.

It's possible to be racist while using objective language: there's an entire Wikipedia article on scientific racism.

I’d go so far as to characterize HN as a hotbed for scientific racism. It’s an inevitable consequence of the guideline to “assume good faith”.

What was the basic observation that disproves it?

It was a statement about a specific group of people in a specific situation. I assume most of it was based in contemporary reality.

You could probably say the same thing about other places today and be correct.

I think the part that you're missing is that it wasn't a statement about blacks in general, but a particular community of incredibly poor people with zero education. syphilis was in fact rampant in that community, and I imagine that with zero access to healthcare or even detection, they were fairly fatalistic about it. People were more likely to have it than not have it by a huge margin.

You're asking me to provide a recorded observation, as evidence that the people recording "facts" didn't make observations. My theory (as stated) doesn't expect that evidence to exist! If this were debate club, that would be a foul.

Fortunately for my ELO rating, they did make observations that contradicted their bigotry. Per the great-grandparent:

>> In reality, the promise of medical treatment, usually reserved only for emergencies among the rural black population of Macon County, Alabama, was what secured subjects' cooperation in the study.

(Racists always do this. Such comorbidities are part of why we have a special name for this special category of "being wrong".)

>You're asking me to provide a recorded observation, as evidence that the people recording "facts" didn't make observations. My theory doesn't expect that evidence to exist!

I Don't understand either if your statements. You said the characterization of Marcon County was obviously wrong, but say there's no possible evidence way they could have known this.

>reality, the promise of medical treatment, usually reserved only for emergencies among the rural black population of Macon County, Alabama, was what secured subjects' cooperation in the study

What are you trying to say here? Is this bad? They gave medical care to people who wouldn't have it otherwise.

Getting Medical Care is a reason people of all Races enroll in clinical trials and it's still true today

Normally you need to confirm a stereotype with data, not verify it after the fact.

The treatment funding ran out during the study period, so this stopped being a benefit but the study continued anyways.

They had a positive belief. Conventionally, people come to positive beliefs after observing evidence*. I'm accusing them of not doing this. They absolutely could have known better; they simply chose not to look.

*: Exception: beliefs about Other Groups of People, which are conventionally formed by looking at Our Group of People, then inventing ways that Other Groups of People are different and/or worse.

Here is a study that gives a completely encyclopedic coverage of the context, data, and knowledge of the time. [1] If you're at all interested in this topic, I'd strongly encourage checking it out. It is the most extensively informative paper, on any topic, that I have ever seen, by far. I have no idea how many years the author spent collecting the data he presents there but it was clearly a labor of love.

For some relevant points: in Georgia, they carried out widescale syphilis testing, on the scale of hundreds of thousands in 1945. Counties adjacent to Tuskegee reached 89% test coverage, with the outcome being an infection rate of 30% in black individuals and 3% in white individuals. Of course people wouldn't have known the exact numbers back when the Tuskegee study started in 1932, but with such ridiculously high rates of infection, they'd have had a generally accurate idea. It's also accurate that the majority of those who were infected had not proactively sought out medical treatment. That knowledge is part of what led Georgia to mandate the blood tests and pair it alongside recommendations of treatment for those infected. How do you think you would have framed these data at the time with a wide open Overton Window, no notions of political correctness, and so on?

To be clear, as always, I am not defending the Tuskegee experiment, the people who did it, their views, or anything of the sort. They did awful things, obviously. But what I am trying to show is that if we were in their shoes, in the same situation, in the same context, it would have been all too easy to fall into the exact same trappings. It's only by really understanding the past that we might ever try to hope to avoid repeating it. When we simply demonize the past, the only lesson to be learned is don't be a demon. And certainly none of us think ourselves demons, so surely such things could never happen again. But with that mindset, they most assuredly will!

[1] - https://jamanetwork.com/journals/jamainternalmedicine/fullar...

> To be clear, as always, I am not defending the Tuskegee experiment, the people who did it, their views, or anything of the sort.

But it looks to me as though you are tirelessly excusing the researchers and spending many hours starting from the conclusion that there was nothing racist about what went on at Tuskegee and then reasoning backwards.

All humans are capable of racist actions, but some uphold the moral duty to fight against that tendency more conscientiously than others.

Having logical, or indeed even sympathetic, reasons for doing bad things does not excuse doing bad things. This is the entire point, and how history should be studied, because it emphasizes the underlying lessons to be learned. In this thread every attempt to paint the researchers as evil racists is relatively easy to factually rebuke. And it's because they weren't. They easily could have been you or I. And this is why it's so important to study history and actually try to genuinely understand the perspective of bad individuals.

Basically the entirety of evils in human history is people saying 'Okay, I know I'm doing bad things. But I'm a good person and I have very good, exceptional, reasons for doing these bad things. And once this is over we'll have a much better world for everybody, so it's okay in this instance.' And a lot of the times, the logic and rhetoric used is appealing. This is why it's so absolutely important to understand it, study it, and endeavor to never fall into such rationalization ever again. Because after all is said and done, this grand utopia we envision at the end will likely never come to pass, or anything even like it - whether or not we succeed, yet all of these evils done in the name of the pursuit of such absolutely do come to pass.

I think I see the confusion. We're saying that "racist" is a useful description of a type of human thought / behaviour. You seem to think it's a demonising invocation of Godwin's Law that's incompatible with empathy.

One level more meta, though: if, as a society, we treat racist behaviour as inexcusable, that makes it less likely to occur. Treating racists as "reasonable, but mistaken" is actually in the neo-Nazi playbook. (I understand the impulse, though: I used to do it myself, until I realised that I was making up historical "facts" in order to justify the attitudes of racists. I really don't want to believe that some people are bad people… but racism is a choice, a habit; not a mere mistake about the facts. Ignoring that legitimises it.)

The issue is you're not "making up" anything. One group had a syphilis rate of 30%, about an order of magnitude higher than everybody else. Race, to me, is simply another group, and should be treated as such. So imagine if it turned out that blondes had had a syphilis rate an order of magnitude higher than everybody else. Would it have fundamentally changed things? I don't think so. And indeed at such point we would likely have all sorts of colorful quotes about blondes. Is that hairism, or now somehow not a grave offense because it's a different group?

> The issue is you're not "making up" anything.

Reread what you're ardently defending, please. https://news.ycombinator.com/item?id=40974970

Your abstract point is (mostly) valid, but you keep trying to tie it back to "and therefore that isn't racist". I described it as ¾ disproved by basic observation. You're defending the other ¼, then acting like that justifies the original claims.

I'll assume good faith, and ask: are you aware that you're doing racist propaganda? (I have literally heard these exact arguments, third sentence onwards, from self-professed White Supremacists.)

Please elaborate and tell me what exactly you think I'm defending or not, as opposed to just linking to somebody quoting some Wiki editor. Because otherwise I have no idea what you're saying.

And I couldn't care less who agrees or disagrees with my views. When formulating a view I always engage in the same pattern - look to the falsifiable facts and data on any given issue and come to the conclusion that I think is the most logically and factually well supported. Wherever that leads is what I tend to believe. Others say they do the same of course, but I can't help but notice so few seem people comparably obsessed with reading (or providing) sources on information (and the scarce time it is provided, it often tends to be from the TellMeMyOpinionIsRight.com type sources), which makes me doubt the overall sincerity of most on this.

> Please elaborate

Done. https://news.ycombinator.com/item?id=40981302

> And I couldn't care less who agrees or disagrees with my views.

Then you aren't introspective enough for this:

> It's only by really understanding the past that we might ever try to hope to avoid repeating it.

to be anything more than an aspiration. (Or, less charitably, an excuse to make racism apologetics seem socially-acceptable.)

I'm not sure that answers my question, but whatever - I'll play along. The statement you quoted was written by a Wiki poster, and is most likely false. It is a fact that the overwhelming majority of people infected with syphilis did not pursue medical treatment (at least in Georgia). The clinicians for the Tuskegee study had an extremely difficult time even convincing the farmers to allow themselves to be examined when doctors were proactively approaching them. They ultimately required the assistance of an intermediary civilian (trusted by the farmers) to convince them. To suggest that the farmers were largely indifferent (if not averse) to medical treatment is fully justified, and absent some significant evidence to the contrary should be seen as true.

The thing you continue to conspicuously ignore is that it is the behaviors of the clinicians that were wrong, and behaviors are what I think everybody should focus on. Whatever the clinicians thought, said, felt, or whatever else is irrelevant. The race of them, the race of the subjects, and everything else - irrelevant. All that matters is their behavior, which are unjustifiable. Even if every single imaginable bias, prejudice, and everything else were 100% true, it would not make what they did right. And so the real value in the story is looking to put yourselves in their shoes hypothetically, so that you never find yourself in those shoes in reality.

> The statement you quoted was written by a Wiki poster, and is most likely false.

I was being dense. Thanks for pointing that out.

> It is a fact that […]

You're telling a story with the facts, and the conclusions you draw from that story are not necessarily facts. The medical establishment of a particular area often acts as though they are medicine, medical treatment, and that people distrusting them means they distrust medicine – when really, all it might mean is (say) that a group of people willing to run the Tuskegee Syphilis Study give off bad vibes.

> Even if every single imaginable bias, prejudice, and everything else were 100% true, it would not make what they did right.

Yes. Their claimed reasons transparently do not justify their actions; so either they had a weird moral system, or those were post-hoc justifications of a decision they'd already made. However, their stated reasons do reveal that they were racist, and racists often come up with post-hoc justifications for racially-motivated atrocities.

I agree with your last paragraph, in that racism isn't the only moral failure mode that humans exhibit – not the only trap we need to watch out for, lest we stumble –; but I think you're making a mistake in assuming that behaviour is either racist or something else. We can analyse it in many ways, and learn many lessons. (There's an extent to which we're really studying ourselves when we do that… but I digress.) There is no "the real value in the story".

> Their claimed reasons transparently do not justify their actions

This part I disagree with. They do. And that's the point - that bad actions, even if justifiable, do not suddenly become acceptable actions. You can have all the justifications in the world and, even if true, the second you start engaging in bad behavior - you are wrong. The entire point of studying history is see all of these people making justifications. And in many cases those justifications are compelling, logical, and reasonable - yet that does not then make the actions acceptable nonetheless.

OK, I see what is going on. I believe they were likely correct and basing their opinion directly from observational data. Syphilis was rampant and education was extremely low.

You think they were wrong, and assume observational data would refute it.

In this case, observational data did refute it.

>> [list of stereotypes] contribute to […] the prevailing indifference with regards to treatment.

>> the promise of medical treatment […] secured subjects' cooperation in the study

However, you're right: I was actually using the heuristic "racists are full of shit". This heuristic is pretty useful, because it means you can do useful things with your life instead of analysing and refuting bullshit racist argument #453054624.

Characterizing "rather low intelligence of the Negro population" (not educational attainment, but "intelligence") as "likely correct" is shocking. But it's also not an uncommon perspective on HN. Lots of "The Bell Curve" truthers here.

I think educational attainment and intelligence are correlated, and understand the quote to be in relation to a specific group, time, and place (and not race as a category).

Individuals arent statistics, but environmental circumstances have profound impact on cognitive development and intelligence measures.

In looking up more information on this topic in general. I came upon this [1] paper on the Tuskegee Study. It's an absolutely encyclopedic work that covers the historical context, parallel programs, and much more with an absurd level of detail and sources galore. So for instance I also thought that no subjects in Tuskegee received penicillin. It turns out this is incorrect and by 1952 27.5% had! [2]

Another really interesting datum is that Georgia in 1945 started carrying out widespread syphilis testing, on the scale of hundreds of thousands of people, reaching 89% testing coverage in one local jurisdiction (which is where I assume Tuskegee was located). The interesting thing is that 30% of black individuals and 3% of white individuals tested positive for syphilis. People wouldn't have known the exact numbers back when this the Tuskegee study started (in 1932), but with such ridiculously high rates of infection, they'd have had a general idea.

How do you think that would shape your views of a people when the Overton Window was wide open? Do you honestly think you'd still have been standing on a moral pedestal? This is why I think it's important to try to do more than just demonize the people involved. Because demonizing them isn't hard. They deserve it, and worse. But at the same time when we demonize them, it's so easy to miss the lessons to be learned because, after all, we aren't demons so surely we couldn't go down the same path again. Yet we almost certainly will if the only lesson we take away is 'don't be evil', because what we see as evil after the fact is not what people, good normal and "moral" people, perceive to be evil in the present. That's history in a nutshell after all.

[1] - https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[2] - https://sci-hub.ru/https://www.sciencedirect.com/science/art... (gotta love 70 year old papers being paywalled...)

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