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Irwin Schatz, 83, Rare Critic of Tuskegee Study, Is Dead

“These researchers had deliberately withheld treatment for this group of poor, uneducated, black sharecroppers in order to document what eventually might happen to them. I became incensed. How could physicians, who were trained first and foremost to do no harm, deliberately withhold curative treatment so they could understand the natural history of syphilis?”

A doctor draws blood from one of the Tuskegee test subjects.,wikimedia

Nobody knows how many people read the December 1964 issue of the journal Archives of Internal Medicine, but apparently only one, Dr. Irwin Schatz, was so appalled by one of its articles, about a syphilis experiment using uneducated black men in Tuskegee, Ala., that he wrote the study’s author to protest.

“I couldn’t believe what I had read,” Dr. Schatz, who died on April 1, wrote in an email in 2013 to Civil Beat, an online newsletter in Hawaii, where he had moved to teach. “But the message was unmistakable.”

“These researchers had deliberately withheld treatment for this group of poor, uneducated, black sharecroppers,” he added, “in order to document what eventually might happen to them. I became incensed. How could physicians, who were trained first and foremost to do no harm, deliberately withhold curative treatment so they could understand the natural history of syphilis?”

In 1964, Dr. Schatz was just four years out of medical school and working as a cardiologist at Henry Ford Hospital in Detroit. No one ever responded to Dr. Schatz’s letter, written in 1965, but its discovery in 1972 helped frame a national debate over patients’ rights that generated new standards for research involving human subjects.

Photo

 

Dr. John C. Cutler of the Public Health Service during its syphilis experiment in Tuskegee, Ala., which went on for 40 years. Credit Coto Report

Dr. Schatz (pronounced SHOTZ) died of metastatic melanoma at his home in Honolulu, his wife, Barbara, said. He was 83.

The Tuskegee clinical study had been conducted by the United States Public Health Service since 1932 to reach underserved black rural populations. But it was not widely known outside the scientific community.

In 1972, on the basis of information from Peter Buxtun, a health service interviewer turned whistle-blower, the study was revealed by The Washington Star. Dr. Schatz’s letter was found by The Wall Street Journal in response to a Freedom of Information Act request.

Of the 600 men enrolled in the study, about two-thirds had already contracted syphilis. All were told that they had “bad blood,” but none were given penicillin, even after it became a proven treatment for the disease in the 1940s.

The study raised questions not only about denial of treatment but also about racial discrimination and morality in the aftermath of medical experiments by the Nazis during World War II.

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Dr. Schatz sent his letter, comprising three sentences, to the study’s senior author, Dr. Donald H. Rockwell. He wrote: “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 the United States Public Health Service and those physicians associated with it in this study need to re-evaluate their moral judgments in this regard.”

The letter was passed to a co-author, Dr. Anne R. Yobs of the Centers for Disease Control, who wrote in a memo to her bosses: “This is the first letter of this type we have received. I do not plan to answer this letter.”

In 2009, the Mayo Clinic recognized Dr. Schatz with a Distinguished Alumni Award. A nominating letter praised his courage because “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.”

Irwin Jacob Schatz was born in St. Boniface, Manitoba, on Oct. 16, 1931, the son of Jacob Schatz and the former Reva Rechtman. His parents ran a kosher-style restaurant in Winnipeg.

He earned undergraduate and medical degrees from the University of Manitoba and a fellowship from the Mayo Clinic. Besides his wife, the former Barbara Jane Binder, his survivors include his sons, Jacob, Edward, Stephen and Brian, who is a United States senator from Hawaii; nine grandchildren; and a sister, Bea Berger.

Dr. Schatz joined the faculty of the University of Hawaii in 1975 and was the chairman of medicine and a professor at the John A. Burns School of Medicine there.

In 2013, Brian Schatz told the Pomona College magazine in California that his father was reluctant to play the hero for criticizing the Tuskegee study. “His style is that you just do the right thing and move on, then you do the right thing again and just move on,” Senator Schatz said.

Dr. Schatz explained that he had written the letter as a young doctor “not knowing what else to do,” and that when he received no response he did not pursue his complaint any further. With hindsight, however, he hinted that perhaps he should have persisted.

“I suspect it would not have made a difference, because they really didn’t think they were doing anything wrong,” Professor Susan M. Reverby of Wellesley College, the author of “Examining Tuskegee: The Infamous Syphilis Study and Its Legacy,” said in an interview. However, she added, “in looking at my interview notes, he said, ‘I wish I had followed it through.’ ”