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In 2010, we learned that the same research group had deliberately infected hundreds of Guatemalans with syphilis and gonorrhea in the 1940s, with the goal of developing better methods for preventing these infections. Despite 15 journal articles detailing the results, no physician published a letter criticizing the Tuskegee study. Informed consent was never sought; instead, Public Health Service researchers deceived the men into believing they were receiving expert medical care. The study is an especially powerful parable because readers can identify the key players in the narrative and recognize them as exemplars of people they encounter in daily life\u2014these flesh-and-blood characters convey the principles of research ethics more vividly than a dry account in a textbook of bioethics. The study spurred reforms leading to fundamental changes in the infrastructure of research ethics. The reason people fail to take steps to halt behavior that in retrospect everyone judges reprehensible is complex. Lack of imagination, rationalization, and institutional constraints are formidable obstacles. The central lessons from the study are the need to pause and think, reflect, and examine one\u2019s conscience; the courage to speak; and above all the willpower to act. History, although about the past, is our best defense against future errors and transgressions.<\/jats:p>","DOI":"10.1164\/rccm.202201-0136so","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T20:00:32Z","timestamp":1651521632000},"page":"1145-1158","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":85,"title":["Fiftieth Anniversary of Uncovering the Tuskegee Syphilis Study: The Story and Timeless Lessons"],"prefix":"10.1093","volume":"205","author":[{"given":"Martin J.","family":"Tobin","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital, Hines, Illinois; and"},{"name":"Stritch School of Medicine, Loyola University of Chicago, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,15]]},"reference":[{"key":"2026022021003496000_bib1","first-page":"1993","volume-title":"Bad blood: the Tuskegee syphilis experiment","author":"Jones","year":"1981"},{"key":"2026022021003496000_bib2","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.2105\/AJPH.2006.100131","article-title":"Awareness of the Tuskegee syphilis study and the US presidential apology and their influence on minority participation in biomedical research","volume":"98","author":"Katz","year":"2008","journal-title":"Am J Public Health"},{"key":"2026022021003496000_bib3","first-page":"103","article-title":"John A. 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