Tuesday, January 28, 2014

Luther Terry Remembered as Surgeon General Who Released 1964 Smoking Report, But There's More to His Legacy

As tobacco control advocates commemorate the 50th anniversary of the release of the 1964 Surgeon General's report on smoking by Dr. Luther Terry, we are praising Dr. Terry for his groundbreaking and pivotal work that many view as having started the tobacco control movement. Dr. Terry served as Surgeon General of the United States Public Health Service from 1961 to 1965.

In fact, the American Cancer Society (ACS) has established a series of awards given in Dr. Terry's honor and memory. According to the ACS: "The Luther L. Terry Awards are presented triennially and in conjunction with the World Conference on Tobacco OR Health. These awards recognize outstanding worldwide achievement in the field of tobacco control. Awards are presented in six categories: Outstanding Individual Leadership, Outstanding Organization, Outstanding Research Contribution, Exemplary Leadership by a Government Ministry, Distinguished Career, and Outstanding Community Service. Named for the late United States Surgeon General Luther L. Terry, M.D., whose groundbreaking work established the foundation for public health scrutiny of the dangers of tobacco use, the Awards honor outstanding leadership and accomplishment, are synonymous with excellence, and signify that the recipients are among the very best in the world at what they do."

The Rest of the Story

Sadly, there is more to the story of Dr. Luther Terry's reign as Surgeon General and more to the legacy of his having served this critical role as leader of the Public Health Service.

Between 1961 and 1965 - during the entire time that Dr. Terry was heading the Public Health Service as Surgeon General - the Service was conducting an unethical and racist study in which it denied antibiotic treatment to African American men with advanced syphilis in order to observe the debilitating and fatal long-term sequelae of this essentially 100% treatable infection.

At the time the experiment was initiated in 1932, the treatment for syphilis involved toxic drugs. However, by the 1940's, penicillin was readily available as a treatment for this infection. Nevertheless, the study continued and penicillin was not made available to these black men. Nor were they informed about the availability of the medicine or even of what disease they actually had.

Shockingly, no one stopped the experiment. That includes Luther Terry. The rest of the story is that Dr. Terry, who presided over the Tuskegee Experiment from 1961 to 1965, failed to stop the study, even though penicillin had been available for the past 20 years.

And Dr. Terry failed to stop the study in 1965, even after the 1964 World Health Organization's Helsinki Declaration clearly articulated the ethical imperative of informed consent for human medical experimentation.

Along with the Surgeon General's who served before him, Dr. Terry shares in the culpability for the 128 deaths and 19 cases of congenital syphilis that were caused by the government's irresponsibility and racism. While it is not pretty, these are the facts and we cannot simply ignore this atrocity and pretend that it is not part of Dr. Terry's legacy.

Personally, I cannot condone the idea of establishing an award in Dr. Terry's name, and I would hope that the American Cancer Society would rename its award so as not to commemorate the legacy of a physician who - during his tenure as a government leader - directed one of the worst, most unethical, and most racist medical and public health atrocities of our time.

We certainly should not forget Dr. Terry's amazing work in bringing the issue of the health effects of smoking to public light. But at the same time, we must not forget his responsibility in the atrocity that is the Tuskegee study.

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