{"id":10419,"date":"2021-05-11T01:41:09","date_gmt":"2021-05-10T22:41:09","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=10419"},"modified":"2021-05-29T00:49:05","modified_gmt":"2021-05-28T21:49:05","slug":"unutulan-bir-film-gercek-bir-hikaye-tuskegee-deneyi","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/unutulan-bir-film-gercek-bir-hikaye-tuskegee-deneyi\/","title":{"rendered":"Unutulan Bir Film, Ger\u00e7ek Bir Hikaye: Tuskegee Deneyi"},"content":{"rendered":"\n

1997 y\u0131l\u0131nda ABD Ba\u015fkan\u0131 \u015fu s\u00f6zleriyle \u00f6z\u00fcr dilemi\u015fti:<\/p>\n\n\n\n

\u201cYery\u00fcz\u00fcndeki hi\u00e7bir g\u00fc\u00e7 size kaybedilen hayatlar\u0131 ve \u0131zd\u0131rap y\u0131llar\u0131n\u0131 geri veremez. Yap\u0131lan geri al\u0131namaz. Ama sessizli\u011fi sona erdirebiliriz. Ba\u015f\u0131m\u0131z\u0131 ba\u015fka y\u00f6ne \u00e7evirmeyi b\u0131rakabiliriz. Birle\u015fik Devletler h\u00fck\u00fcmetinin yapt\u0131\u011f\u0131 utan\u00e7 vericiydi ve \u00fczg\u00fcn\u00fcm. \u00d6z\u00fcr dilerim ve bu \u00f6z\u00fcr \u00e7ok gecikti\u011fi i\u00e7in \u00fczg\u00fcn\u00fcm.\u201d  -Bill Clinton<\/p><\/blockquote>\n\n\n\n

Bu konu\u015fmadan 2 ay \u00f6nce \u201cMiss Evers\u2019 Boys\u201d filmi tamamlanm\u0131\u015ft\u0131. Ger\u00e7ekler herkes taraf\u0131ndan biliniyordu ki zaten hi\u00e7 saklanmam\u0131\u015ft\u0131. Ya da en az\u0131ndan denekler haricinde kimseden saklanmam\u0131\u015ft\u0131.<\/p>\n\n\n\n

\"\"
(Miss Evers\u2019 Boys film kapa\u011f\u0131 \u2013 Wikipedia)<\/figcaption><\/figure><\/div>\n\n\n\n

Deney 1932 tarihinde Public Health Service (Halk Sa\u011fl\u0131\u011f\u0131 Hizmetleri) taraf\u0131ndan Tuskegee\/ Amerika\u2019da ba\u015flat\u0131ld\u0131. Bu \u015fehirde Afro \u2013 Amerikanlar ya\u015f\u0131yordu ve deney buradaki erkek frengi hastalar\u0131n\u0131 ara\u015ft\u0131rmay\u0131 hedefliyordu.  Fakat ortada bir problem  vard\u0131. Bu insanlar\u0131n ikna edilmeleri gerekiyordu. \u0130\u015fte filmin ba\u015frol\u00fc hem\u015fire Eunice Evers burada kilit noktay\u0131 oynuyordu. Halkla ileti\u015fimi o sa\u011flad\u0131.<\/p>\n\n\n\n

Bedava sa\u011fl\u0131k hizmetleri vaat edildi, yemek verildi. Cenaze i\u015flemleri i\u00e7in para teklif edildi. Fakat hastal\u0131\u011f\u0131n ismi hi\u00e7 ge\u00e7medi. Frenginin k\u00f6t\u00fc \u015f\u00f6hreti y\u00fcz\u00fcnden k\u00f6t\u00fc kanlar\u0131<\/strong> oldu\u011fu s\u00f6ylendi. Yap\u0131lan testlerle seroloji pozitif hasta grubu ve kontrol grubu olu\u015fturuldu. Aylar s\u00fcren g\u00f6zlemin ard\u0131ndan Salvarsan ile tedaviye ba\u015fland\u0131. Ancak bir s\u00fcre sonra kaynak k\u0131s\u0131tlamas\u0131na gidildi.<\/p>\n\n\n\n

Tedavi i\u00e7in fon kaybedildi\u011finde doktorlar\u0131n iki se\u00e7ene\u011fi vard\u0131. Birincisi ara\u015ft\u0131rmay\u0131 sonland\u0131rmakt\u0131. \u0130kincisi ise tedavi edilmeyen denekleri incelemekti.<\/p>\n\n\n\n

Filmi izledi\u011finizde ilk fark edece\u011finiz detay beyaz \u2013 siyah e\u015fitli\u011finin o d\u00f6nemde sa\u011flanmad\u0131\u011f\u0131 olacakt\u0131r. Hem sosyal hem t\u0131bbi farkl\u0131l\u0131k d\u00fc\u015f\u00fcncesi yayg\u0131nd\u0131. Beyazlarda daha \u00e7ok n\u00f6rosifiliz g\u00f6r\u00fcl\u00fcrken siyahlarda kardiyovask\u00fcler sistem etkileniyordu. Filmdeki doktora g\u00f6re, e\u011fer bu \u00e7al\u0131\u015fmay\u0131 tamamlarsa beyaz – siyah e\u015fitli\u011fini kan\u0131tlayabilirdi. Bu ama\u00e7la deneye devam etti.<\/p>\n\n\n\n

Ger\u00e7ek hayatta deneyin alt\u0131ndaki niyet bilimsel veriler miydi? Bu \u0131rksal bir m\u00fccadele miydi? Deneklerin ba\u015f\u0131na gelenler fedakarl\u0131k m\u0131yd\u0131? Her ne olursa olsun filmde veya ger\u00e7ekte g\u00f6sterilen tutuma paternalizm <\/strong>denir. Doktorlar hastalar ad\u0131na karar alm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Ba\u015ftan sona uygunsuz yap\u0131lan deneyde etik d\u0131\u015f\u0131 olaylar burada bitmez. Penisilin tedavi olarak kabul edildi\u011fi zaman bile ila\u00e7 hastalara verilmez. Hastalara penisilin almamalar\u0131 tembihlenir. Alerjik reaksiyonla korkutulurlar. Deneklerin listeleri civar merkezlere g\u00f6nderilir. B\u00f6ylece farkl\u0131 yerlerde de tedavileri yasaklan\u0131r. Hastalar\u0131n kaderine karar verilmi\u015ftir. Hepsi otopsi masas\u0131ndan ge\u00e7ene kadar deney s\u00fcrecektir.<\/p>\n\n\n\n

Olan biten hakk\u0131nda makaleler yaz\u0131l\u0131r. Deney saklanmaya \u00e7al\u0131\u015f\u0131lmaz tam tersine \u201ctarih yaz\u0131laca\u011f\u0131na\u201d inan\u00e7 vard\u0131r. 1968\u2019de \u00e7ekincelerin dile getirilmesiyle proje incelenmeye ba\u015flan\u0131r. \u00c7al\u0131\u015fma, CDC (Hastal\u0131k Kontrol ve Korunma Merkezleri)  taraf\u0131ndan yeniden onaylasa da 1972\u2019de bitirilir. Kat\u0131l\u0131mc\u0131lar ad\u0131na dava a\u00e7\u0131l\u0131r ve duru\u015fmalar d\u00fczenlenir. Olan olmu\u015ftur. 399 ki\u015filik hasta grubundan 28\u2019i frengiden, 100\u2019\u00fc ili\u015fkili komplikasyonlardan \u00f6lm\u00fc\u015ft\u00fcr. Hastalar\u0131n e\u015flerinden en az 40\u2019\u0131 enfekte olmu\u015ftur. 19 \u00e7ocuk bu hastal\u0131kla do\u011fmu\u015ftur.<\/p>\n\n\n\n

Olay\u0131n sonucunda devlete kar\u015f\u0131 g\u00fcvensizlik belirir. Dahas\u0131, ortaya \u00e7\u0131kar ki tek frengi deneyi bu de\u011fildir. 1946 – 1948 y\u0131llar\u0131 aras\u0131nda Guatemala Frengi Deneyi yap\u0131lm\u0131\u015ft\u0131r. Bu deneyde t\u0131ptaki birinci ilke \u00e7i\u011fnenir. Primum non nocere<\/strong> yani \u201c\u00f6nce, zarar verme\u201d. Frenginin kas\u0131tl\u0131 olarak bula\u015ft\u0131r\u0131lmas\u0131 sa\u011flanm\u0131\u015ft\u0131r. \u0130ki \u00e7al\u0131\u015fma aras\u0131ndaki ortakl\u0131k yine savunmas\u0131z bir grubun suistimalidir. Bu sefer askerler, mahkumlar ve ak\u0131l hastalar\u0131 kullan\u0131lm\u0131\u015ft\u0131r. Ayd\u0131nlat\u0131lan bu ikinci insanl\u0131k su\u00e7unun ard\u0131ndan 2010\u2019da Barack Obama \u00f6z\u00fcr dilemi\u015ftir.<\/p>\n\n\n\n

B\u00fcy\u00fck \u00c7i\u00e7ek<\/strong><\/p>\n\n\n\n

Hastal\u0131\u011f\u0131n k\u00f6keni ara\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda en eski iddia 1.600.000 y\u0131ldan \u00f6nceye aittir. Afrikal\u0131 bir Homo erectus <\/em>kal\u0131nt\u0131s\u0131nda frengiye i\u015faret etti\u011fi d\u00fc\u015f\u00fcn\u00fclen kemik de\u011fi\u015fiklikleri saptanm\u0131\u015ft\u0131r. Bunun yan\u0131nda y\u0131ldan ba\u011f\u0131ms\u0131z olarak insanl\u0131k tarihinin derinden etkilendi\u011fi tart\u0131\u015f\u0131lmazd\u0131r.<\/p>\n\n\n\n

\"\"
(Treponema pallidum<\/em> \u2013 Flickr)<\/figcaption><\/figure><\/div>\n\n\n\n

Frengi hastal\u0131\u011f\u0131n\u0131n etkeni Treponema pallidum<\/em> bakterisidir. Konjenital olarak anneden bebe\u011fe ge\u00e7ebilir, cinsel yolla bula\u015fabilir. Bunun d\u0131\u015f\u0131nda farkl\u0131 bula\u015f yollar\u0131 olan Treponema hastal\u0131klar\u0131 da vard\u0131r. T\u00fck\u00fcr\u00fck gibi daha kolay yollar ile aktar\u0131l\u0131rlar. Buna ra\u011fmen yine de \u015fansl\u0131 oldu\u011fumuzu s\u00f6yleyebiliriz. \u00c7\u00fcnk\u00fc bahsedilen gram negatif d\u0131\u015f ortama dayan\u0131ks\u0131zd\u0131r. Ayr\u0131ca penisiline hala duyarl\u0131 olmas\u0131 lehimizedir.  Nadiren  Jarisch\u2013Herxheimer reaksiyonu g\u00f6r\u00fclebilir.  Alternatif tedavi se\u00e7enekleri mevcuttur. En iyi \u00e7\u00f6z\u00fcm ise riskleri azaltmakt\u0131r. \u00d6rne\u011fin prezervatif kullan\u0131m\u0131 bula\u015f riskini azalt\u0131r.<\/p>\n\n\n\n

\u201cB\u00fcy\u00fck taklit\u00e7inin\u201d evreleri vard\u0131r. Bir\u00e7ok hastal\u0131\u011f\u0131 taklit etmesi sebebiyle bu isim kullan\u0131lm\u0131\u015ft\u0131r. Primer evre olan ilkinde \u015fankr<\/strong> lezyonu olu\u015fur. \u0130\u00e7inde enfeksiyoz spiroketler bulunur. Lezyonun \u00e7i\u00e7ekten b\u00fcy\u00fck olmas\u0131 nedeniyle \u201cB\u00fcy\u00fck \u00c7i\u00e7ek\u201d denmi\u015ftir.<\/p>\n\n\n\n

Devam\u0131nda ikincil sifiliz geli\u015fir. Condyloma lata<\/strong> olarak bilinen si\u011fil benzeri lezyonlar olu\u015fabilir. D\u00f6k\u00fcnt\u00fclerin hepsi bula\u015f\u0131c\u0131d\u0131r. Latent sfilizde ise semptom olmaks\u0131z\u0131n seroloji pozitiftir. Son olarak \u00fc\u00e7\u00fcnc\u00fcl sifiliz a\u015famas\u0131 vard\u0131r. Benign sifiliz, ge\u00e7 n\u00f6rosifiliz ve kardiyovask\u00fcler sifiliz olarak \u00fc\u00e7e ayr\u0131l\u0131r.<\/p>\n\n\n\n

Her evrede ortaya \u00e7\u0131kabilen n\u00f6rosifiliz, televizyonda romantize edilerek aktar\u0131l\u0131r. Halbuki davran\u0131\u015f de\u011fi\u015fikli\u011fi ile s\u0131n\u0131rl\u0131 kalmaz. Sinir sistemini \u00e7ok ciddi etkiler. Yine televizyonda  dramatize edilen bir konu daha vard\u0131r. S\u00f6z konusu enfeksiyon oldu\u011funda doktorlar kendinde test yaparlar. \u015ea\u015f\u0131rt\u0131c\u0131 olsa da ger\u00e7ek hayattaki \u00f6rnekler muhtemelen daha fazlad\u0131r. Hatta b\u00fcy\u00fck \u00e7i\u00e7ek i\u00e7in de bu olay ya\u015fanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

 18. Y\u00fczy\u0131lda John Hunter hastas\u0131ndan elde etti\u011fi \u00f6rne\u011fi kendisine bula\u015ft\u0131r\u0131r. Amac\u0131 bel so\u011fuklu\u011fu ile sifilizin ayn\u0131 patojenden kaynakland\u0131\u011f\u0131n\u0131 ispatlamakt\u0131r. Fakat bilmedi\u011fi \u015fey, ne\u015fterine iki ayr\u0131 patojenin de bula\u015ft\u0131\u011f\u0131d\u0131r. Hipotezini kan\u0131tlad\u0131\u011f\u0131n\u0131 d\u00fc\u015f\u00fcn\u00fcr. Maalesef frengi sebebiyle hayat\u0131n\u0131 kaybeder. Yar\u0131m y\u00fczy\u0131l bu deneyin sonucuna inan\u0131lsa da patojenlerin farkl\u0131 oldu\u011fu anla\u015f\u0131l\u0131r.<\/p>\n\n\n\n

G\u00f6rd\u00fc\u011f\u00fcn\u00fcz gibi b\u00fcy\u00fck \u00e7i\u00e7ek hikayesi insanl\u0131k tarihine farkl\u0131 dersler vermi\u015ftir. Baz\u0131 \u015feyler unutulsa da bu hikaye anlat\u0131lmaya devam edilmelidir.<\/strong><\/p>\n\n\n\n

Kaynak\u00e7a:<\/p>\n\n\n\n

  1. Wikipedia. \u201cMedical paternalism\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.m.wikipedia.org\/wiki\/Medical_paternalism<\/a> <\/li>
  2. Wikipedia. \u201cGuatemala syphilis experiments\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.m.wikipedia.org\/wiki\/Guatemala_syphilis_experiments<\/a><\/li>
  3. Centers for Disease Control and Prevention. \u201cThe Tuskegee Timeline\u201d  Eri\u015fim 28 \u015eubat, 2021 https:\/\/www.cdc.gov\/tuskegee\/timeline.htm<\/a><\/li>
  4. Wikipedia. \u201cTuskegee Syphilis Study\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.m.wikipedia.org\/wiki\/Tuskegee_Syphilis_Study<\/a><\/li>
  5. Wikipedia. \u201cMiss Evers\u2019 Boys\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.wikipedia.org\/wiki\/Miss_Evers’_Boys<\/a><\/li>
  6. Sherman, Irwin. D\u00fcnyam\u0131z\u0131 De\u011fi\u015ftiren On \u0130ki Hastal\u0131k. \u0130stanbul: T\u00fcrkiye \u0130\u015f Bankas\u0131 K\u00fclt\u00fcr Yay\u0131nlar\u0131, 2019<\/li>
  7. Centers for Disease Control and Prevention. \u201cPresidential Apology\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/www.cdc.gov\/tuskegee\/clintonp.htm<\/a><\/li>
  8. Wikipedia. \u201cSyphilis\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.wikipedia.org\/wiki\/Syphilis<\/a><\/li>
  9. Wikipedia. \u201cPrimum non nocere\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.m.wikipedia.org\/wiki\/Primum_non_nocere<\/a><\/li>
  10. Flickr. \u201c\u201dTreponema pallidum\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/bit.ly\/37ZKheg<\/a><\/li>
  11. Wikipedia. \u201cJohn Hunter (surgeon)\u201d Eri\u015fim 28 \u015eubat, 2021 https:\/\/en.wikipedia.org\/wiki\/John_Hunter_(surgeon)<\/a><\/li>
  12. Wikipedia. \u201cMiss Evers\u2019 Boys cover art\u201d Eri\u015fim 28 \u015eubat, 2021  https:\/\/en.wikipedia.org\/wiki\/File:Miss_Evers%27_Boys_cover_art.jpg<\/a><\/li>
  13. CNN International. \u201cUS apologizes for infecting Guatemalans with STDs in the 1940s\u201d  Eri\u015fim 28 \u015eubat, 2021  http:\/\/www.cnn.com\/2010\/WORLD\/americas\/10\/01\/us.guatemala.apology\/index.html<\/a><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

    1997 y\u0131l\u0131nda ABD Ba\u015fkan\u0131 \u015fu s\u00f6zleriyle \u00f6z\u00fcr dilemi\u015fti: \u201cYery\u00fcz\u00fcndeki hi\u00e7bir g\u00fc\u00e7 size kaybedilen hayatlar\u0131 ve \u0131zd\u0131rap y\u0131llar\u0131n\u0131 geri veremez. Yap\u0131lan<\/p>\n","protected":false},"author":344,"featured_media":10421,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[763,95,187,2043,70,73,74,894,893,2036,2037,1682,426,2041,1832,255,705,1045,543,2045,990,92,758,926,1654,2042,283,2039,2034,2035,265,616,2038,1044,2040,559,84,1683,66,704,34,2044],"acf":[],"views":2081,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/10419"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/344"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=10419"}],"version-history":[{"count":6,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/10419\/revisions"}],"predecessor-version":[{"id":10557,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/10419\/revisions\/10557"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/10421"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=10419"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=10419"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=10419"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}