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SusanReverby_TheTuskegeeStudy_2021E-_丑陋的历史：美国的梅毒实验_
In the 1930s, the United States was ravaged by syphilis . 1930 年代,美国境内梅毒肆虐。
This sexually transmitted infection afflicted nearly 1 in 10 Americans, producing painful sores and rashes that persisted for roughly two years. 透过性行为传播, 近十分之一的美国人被感染, 感染后会产生持续约两年的 疼痛的溃疡和疹子。
After these initial symptoms , late-stage syphilis was known to cause organ damage, heart and brain disorders , and even blindness. 在这些初期症状之后, 梅毒后期还会造成器官损伤、 心脏及脑部疾病,甚至失明。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式) ravaged:v.毁坏;损坏;严重损害;(ravage的过去分词和过去式) syphilis:n.[性病]梅毒; sexually:adv.性,性欲 transmitted:v.传送;输送;发射;播送;传播;传染;(transmit的过去分词和过去式) infection:n.感染;传染;(身体某部位的)感染;传染病; afflicted:v.折磨;使痛苦;(afflict的过去式和过去分词) painful:adj.痛苦的;疼痛的;令人不快的; sores:n.疡;褥疮;痍(sore的复数); rashes:n.发疹,[皮肤]疹(rash复数形式); persisted:v.持续(persist的过去分词);坚持不懈; roughly:adv.粗糙地;概略地; initial:adj.最初的; n.(名字的)首字母; v.用姓名的首字母作标记(或签名)于; symptoms:n.症状;征候;征兆;(symptom的复数) organ:n.[生物]器官;机构;风琴;管风琴;嗓音; disorders:n.无秩序,混乱; v.[电子]扰乱(disorder的单三形式);
It was incredibly difficult to slow the disease’s spread. 当时很难减缓梅毒的传播。
Experts cautioned against unprotected sex, but the infection could also be passed during childbirth . 专家警告性行为要做好保护, 但产妇也可能把感染传给孩子。
Worse still, existing treatments like mercury and bismuth were considered unreliable at best and potentially harmful at worst. 更糟的是,既有的治疗方法, 如比使用汞和铋, 不只是不可靠而已, 最糟的状况则可能造成伤害。
incredibly:adv.难以置信地;非常地; unprotected:adj.无保护的;未设防的;v.无保护;(unprotect的过去式和过去分词); childbirth:n.分娩; treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数) mercury:n.[化]汞,水银;[天]水星;温度表;精神,元气; bismuth:n.[化学]铋; unreliable:adj.不可靠的;靠不住的; potentially:adv.可能地,潜在地;
Today these heavy metals are classified as toxic , but at the time, doctors were still uncovering their dangerous side effects. 现今,这些重金属 被归类为有毒物质, 但在当时,医生都还在探究 它们的危险副作用。
Amidst the uncertainty , health care professionals had two key questions. 在这不确定性中, 医护专業人员有两个关键问题。
Did late-stage syphilis warrant the risks of existing treatments? 晚期梅毒就是冒险使用 既有治疗方式的正当理由吗？
And, did the infected individual’s race change how the disease progressed? 以及,疾病在体内的发展 是否因种族而异？
classified:adj.机密的; v.将…分类; (classify的过去分词和过去式) toxic:adj.有毒的;中毒的; uncovering:adj.露出的; v.发现(uncover的现在分词); n.露出; Amidst:prep.在…当中; uncertainty:n.不确定,不可靠; health care:n.卫生保健; professionals:n.[管理]专业人员(professional的复数); warrant:n.依据;许可证;执行令;授权令;v.使有必要;使正当;使恰当; infected:adj.带菌的; v.传染; (infect的过去分词和过去式) disease:n.病,[医]疾病;弊病;vt.传染;使…有病;
Many physicians were convinced syphilis affected the neurological systems of white patients and the cardiovascular systems of Black patients. 许多医生相信, 以及黑人的心血管系统。
There was little evidence for this theory, but the U.S. Public Health Service was determined to investigate further. 这个理论的证据很少, 但美国的公共卫生局 决心要进一步调查。
In 1932 they launched a massive experiment in Tuskegee , Alabama . 一九三二年,他们在阿拉巴马州 塔斯基吉启动了一项大型实验。
physicians:n.[内科]内科医生(physician的复数); convinced:adj.坚信; v.使确信; (convince的过去分词和过去式) neurological:adj.神经病学的,神经学上的; patients:n.接受治疗者,病人;(patient的复数) cardiovascular:adj.[解剖]心血管的; evidence:n.证据,证明;迹象;明显;v.证明; Health Service:n.公共医疗保健服务; determined:adj.决定了的:v.决定;(determine的过去分词和过去式) investigate:v.调查;研究;审查; launched:v.发射;发起;开展;开始;(launch的过去式和过去分词) massive:adj.大量的;巨大的,厚重的;魁伟的; Tuskegee:n.塔斯基吉(美国一城市名); Alabama:n.阿拉巴马州(美国州名);
The town had already possessed a small hospital, and the area was home to a large population of potential participants . 该镇已经有一间小医院, 且这个地区的居民中 有许多都有可能成为受试者。
The PHS collaborated with local doctors and nurses to recruit roughly 400 Black men presumed to have noncontagious late-stage syphilis, as well as 200 non-syphilitic Black men for their control group. 公共卫生局和当地 医生及护理师合作, 招募了约四百名被认为是无传染力的 晚期梅毒的黑种病人, 另以两百名未感染梅毒的 黑人作为控制组。
possessed:adj.着了魔;v.有;拥有;具有(特质);控制;(possess的过去分词和过去式) participants:n.参与者(participant的复数形式); collaborated:v.合作;协作;通敌;勾结敌人;(collaborate的过去分词和过去式) recruit:n.新兵; v.吸收(新成员); (通过招募)组成; presumed:adj.假定的;推测的;v.假定(presume的过去分词和过去式); noncontagious:n.非传染性的; as well as:也;和…一样;不但…而且;
But their recruitment plan centered on a lie. 但他们的招募计画 却是建构在谎言上。
While the researchers planned to observe how syphilis would progress with minimal treatment, participants were told they would receive free drugs and care for their condition. 研究者的规划是要观察在最少 治疗的情况下梅毒会如何发展, 但却告知受试者,他们能得到 治疗该疾病的免费药品和照护。
recruitment:n.补充;征募新兵; observe:v.观察;看到;庆祝;监视; minimal:adj.最低的;最小限度的;
At first, researchers gave the men existing treatments, but these were soon replaced with placebos . 一开始,研究者用既有的方式 来治疗予受试者, 但很快就用安慰剂来取代。
Under the false pretense of providing a special remedy , researchers performed painful and invasive spinal taps to investigate the disease’s neurological consequences . 假藉提供特殊疗法的名义, 研究者开始进行痛苦 且侵入性的脊椎穿刺, 来研究梅毒对神经系统有什么影响。
placebos:n.安慰剂(placebo的复数); pretense:n.借口;虚假;炫耀;自吹(等于pretence); remedy:vt.补救;治疗;纠正;n.补救;治疗;赔偿; performed:v.表演;执行;履行;演出;工作,运转(好/不好)(perform的过去分词和过去式) invasive:adj.侵略性的;攻击性的; spinal:adj.脊髓的;脊柱的;针的;脊骨的;尖刺的;n.脊椎麻醉; consequences:n.后果,结果;影响(consequence的复数);
When patients died, the PHS would swoop in to study the body by funding funerals in exchange for autopsies . 当病人死亡时,公共卫生局 立刻前来研究尸体, 以资助葬礼的方式来交换解剖。
In their published studies, they listed the men as volunteers to obscure the circumstances under which they’d been recruited . 在刊载出来的研究中, 这些人被列为自愿者, 以掩饰招募他们时的实际情况。
Outside Alabama, syphilis treatment was advancing. 在阿拉巴马以外的地方, 梅毒的治疗正在进步。
swoop:v.俯冲;突然袭击;突然行动;n.突然袭击;俯冲;突击搜查; funding:n.基金;资金;提供资金;v.为…提供资金;拨款给;(fund的现在分词) funerals:n.葬礼;丧礼;出殡;(funeral的复数) in exchange for:作为…的交换; autopsies:n.验尸(autopsy的复数形式); volunteers:n.志愿者; v.自愿做; (volunteer的第三人称单数和复数) obscure:n.朦胧; adj.无名的; v.使模糊; circumstances:n.情况;环境;情形;(circumstance的复数) recruited:v.招聘,雇佣;招募;(recruit的过去分词和过去式)
A decade after the study began, clinical trials confirmed that penicillin effectively cured the disease in its early stages. 此研究开始后十年, 临床实验证实了在梅毒前期, 盘尼西林的治疗很有效。
But in Tuskegee, researchers were determined to keep pursuing what they considered vital research. 但在塔斯基吉, 研究者坚决要继续进行 他们认为十分重要的研究。
They had yet to confirm their theories about racial difference, and they believed they would never have another opportunity to observe the long-term effects of untreated syphilis. 他们关于种族差异的理论 尚未得到证实, 且他们相信他们不会再有其他机会 可以观察到梅毒若未治疗, 会有什么长期影响。
clinical:adj.临床的;诊所的; penicillin:n.盘尼西林(青霉素); pursuing:v.追求;致力于;贯彻;跟踪;追赶;(pursue的现在分词) vital:adj.至关重要的;生死攸关的;有活力的; racial:adj.种族的;人种的; long-term:adj.长期的;从长远来看; untreated:adj.未经处理的;未经治疗的;
The study’s leadership decided to withhold knowledge of new treatments from their subjects. 研究的领导阶层决定向受试者 隐瞒新治疗方式的资讯。
During World War II, researchers convinced the local draft board to exempt men from their study, preventing them from enlisting and potentially accessing penicillin. 第二次世界大战期间, 研究者说服当地的兵役委员会 豁免参与研究的受试者, 避免他们入伍时 有机会取得盘尼西林。
withhold:v.保留;隐瞒;抑制;忍住;克制; draft:n.草案; v.起草; adj.供役使的; exempt:vt.免除;豁免;adj.被免除的;被豁免的;n.免税者;被免除义务者; enlisting:v.征募;支持(enlist的ing形式);n.征募;支持;
The study even continued through the 1950s when penicillin was shown to help manage late-stage syphilis. 1950 年间,已证实盘尼西林 有助于治疗晚期梅毒, 该研究却仍然持续进行。
By today’s bioethical standards , withholding treatment in a research study without a patient’s informed consent is morally abhorrent . 以现今的生物伦理标准来看, 在研究中,在没有病人 知情同意的情况下不让病人接受治疗, 在道德上十分令人深恶痛绝。
But for a large part of the 20th century, this practice was not uncommon . 但在二十世纪的大半, 这种做法并不罕见。
In the 1940s, US led studies in Guatemala infected numerous prisoners, sex workers, soldiers, and mental health patients with sexually transmitted infections to study potential treatments. 1940 年代,美国 在瓜地马拉进行研究, 刻意让许多囚犯、性工作者、士兵, 及患有精神疾病者受到性病感染, 以便研究可能的治疗方式。
standards:n.标准,水平,规格(standard的复数) withholding:v.拒绝给;不给;(withhold的现在分词) informed:adj.见多识广的; v.通知; (inform的过去分词和过去式) consent:vi.同意;赞成;答应;n.同意;(意见等的)一致;赞成; morally:adv.道德上;有道德地;确实地; abhorrent:adj.可恶的;厌恶的;格格不入的; uncommon:adj.不寻常的;罕有的;adv.非常地; Guatemala:n.危地马拉(拉丁美洲国家);危地马拉人; numerous:adj.许多的,很多的; mental:adj.精神的;脑力的;疯的;n.精神病患者; infections:n.传染病;口腔病害(infection复数形式);
And other studies throughout the 50s and 60s saw doctors secretly infecting patients with viral hepatitis or even cancer cells. 在五零和六零年代的其他研究中, 也可以发现有医生偷偷让病人 感染病毒性肝炎或甚至癌症。
Eventually , researchers began objecting to these unjust experiments. 最终,研究者开始反对 这些不公义的实验。
In the late 1960s, an STI contact tracer named Peter Buxtun convinced the PHS to consider ending the study. 1960 年代末,进行 性病接触者追踪的彼得布克斯顿 说服了公共卫生局终止研究。
throughout:adv.自始至终,到处;全部;prep.贯穿,遍及; infecting:v.传染;使携带病菌;使感染;(infect的现在分词) viral:adj.滤过性毒菌引起的;滤过性毒菌的; hepatitis:n.肝炎; cancer:n.癌症;恶性肿瘤; Eventually:adv.最后,终于; unjust:adj.不公平的,不公正的;非正义的; contact:n.接触,联系;v.使接触,联系; tracer:n.[核]示踪物;追踪者;描图者;(铁笔等)绘图工具;
But after leadership decided against it, Buxtun sent his concerns to the press. 领导阶层决定不接受之后, 布克斯顿把他的担忧告诉媒体。
In July of 1972, an exposé of the Tuskegee study made headlines across the country. 一九七二年七月,
Following public outcry , a federal investigation, and a lawsuit , the study was finally shut down in 1972— 40 years after it began and 30 after a treatment for syphilis had been found. 在大众强烈抗议、联邦调查, 以及法律诉讼之后, 该研究终于在一九七二年终止—— 梅毒的治疗方式 被发现的三十年之后。
concerns:n.关注; v.使关心(concern的三单形式); outcry:n.强烈抗议;大声疾呼;尖叫;倒彩; federal:adj.联邦的;同盟的;联邦政府的;联邦制的;adv.联邦政府地; lawsuit:n.诉讼;[法]官司;诉讼案件; finally:adv.终于;最终;(用于列举)最后;彻底地;
No evidence of any racial difference was discovered. 没有找到任何证据证明梅毒 会因种族而有不同的表现。
When the study ended, only 74 of the original 600 men were alive. 研究终止时,原本的六百位受试者 只剩下七十四位还活着。
40 of their wives and 19 of their children had contracted syphilis, presumably from their husbands and fathers. 他们的家人中有四十位妻子 和十九位孩子染上梅毒, 推测都是被他们的丈夫和父亲感染。
In the wake of this tragedy , and concerns about similar experiments, 在这场悲剧之后, 出于担心会有类似的实验,
original:n.原件;原作;原物;原型;adj.原始的;最初的;独创的;新颖的; contracted:adj.契约的; v.使收缩; presumably:adv.大概;推测起来;可假定; In the wake of:紧紧跟随;随着…而来;作为…的结果;仿效; tragedy:n.悲惨的事;不幸;灾难;悲剧作品;
Congress passed new regulations for ethical research and informed consent. 国会通过了关于研究伦理 及知情同意的新规定。
But systemic racism continues to permeate medical care and research throughout the US. 但在全美各地,制度性种族主义仍然持续弥漫在 医疗照护和研究领域中。
To truly address these issues , the need for structural change, better access to care, and transparency in research remains urgent . 若要真正处理这些议题, 急需的是结构性的改变、 让医疗照护资源更容易取得, 以及研究的透明化。
Congress:n.国会;代表大会;会议;社交; regulations:n.章程;规则;法规;管理,控制;(regulation的复数) ethical:adj.伦理的;道德的;凭处方出售的;n.处方药; systemic:adj.系统的;全身的;体系的; racism:n.种族主义,种族歧视;人种偏见; permeate:vt.渗透,透过;弥漫;vi.弥漫;透入;散布; issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) structural:adj.结构的;建筑的; transparency:n.透明,透明度;幻灯片;有图案的玻璃; urgent:adj.紧急的;急迫的;