54 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

SEEKING JUSTICE FOR VICTIMS OF THE 

GUATEMALAN SEXUALLY TRANSMITTED DISEASE 

EXPERIMENTS 1946–1948 
 

SUSAN S. LEE & AURORA J. GRUTMAN* 

 

Abstract 

 

Between 1946 and 1948, researchers sponsored by the United States government 

intentionally exposed more than 1,300 Guatemalan men and women to sexually 

transmitted diseases without their informed consent. Many of the surviving victims and 

their descendants suffer from the effects of untreated syphilis, gonorrhea, and similar 

illnesses. But the general public did not become aware of these non-consensual human 

experiments for more than sixty years. After a researcher uncovered the experiments, the 

United States government apologized to the Guatemalan victims, but the victims received 

no compensation for their injuries. So far, the efforts of the victims to receive legal 

redress for their injuries have been unsuccessful. 

 

This Article has two aims—one descriptive and the other conceptual. First, it seeks to 

bring awareness to the history and legacy of the Guatemalan sexually transmitted disease 

experiments. Second, it argues that litigation—even if unsuccessful—can play a role in 

amplifying the victims’ voices in a way that acknowledges their pain and helps to repair 

harm that was done. Even if the United States government is immune from formal legal 

liability, the government and the corporate interests that benefitted from the Guatemalan 

experiments, have a moral obligation to compensate the victims. The lens of reproductive 

justice makes clear this obligation. By critically investigating the Guatemalan sexually 

transmitted disease experiments and their legacy, one can better understand how gender, 

race, socioeconomic class, geopolitical power, and even geography informed the initial 

decision to conduct non-consensual human experimentation in that country and why the 

victims have been unable to obtain formal legal recognition for their suffering. 

 

 

 

 
* Susan S. Lee will begin her career as Judge Advocate Officer in the United States Air Force in 2020. She is 

a graduate of North Carolina State University (BA 2015) and the Elisabeth Haub School of Law at Pace 

University (JD 2019). Aurora Grutman is an independent researcher based in New York City. Affiliations are 

listed for informational purposes only. The views expressed in this article are those of the individual authors 

alone and do not represent the views of any employer or affiliated institution. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         55 

 

 

 

INTRODUCTION 

 

Between 1946 and 1948, researchers approved and funded by the United States 

government intentionally exposed over 1,300 people in Guatemala to sexually 

transmitted diseases without their informed consent.1 The subjects of these unethical 

experiments were mostly prisoners, mental patients, sex workers, and members of the 

Guatemalan military. The United States researchers infected these patients with syphilis, 

gonorrhea, and chancroid without explaining to the patients what would happen to them, 

and in many cases, without offering treatment for the resulting diseases.2 These sexually 

transmitted disease experiments came to light only in 2003, when a professor at 

Wellesley College presented the startling discovery she had made while conducting 

research on the infamous Tuskegee syphilis experiments.3 Professor Susan Reverby 

found copious records of the previously secret Guatemalan experiments among the 

papers of Dr. John Charles Cutler, one of principal investigators at the Tuskegee 

Institute.4 The Tuskegee experiments, which began in 1932, involved the intentional 

withholding of medical treatment for nearly thirty years—without the informed consent 

of the participants—from approximately 400 black, mostly poor men who were infected 

with syphilis.5 Professor Reverby presented her findings to the American Association for  

 

 
1 See Kayte Spector-Bagdady & Paul A. Lombardo, “Something of an Adventure:” Postwar NIH Research 

Ethos and the Guatemala STD Experiments, 41 J.L. MED. & ETHICS 697, 697 (2013). 

 
2 See Susan M. Reverby, Restorative Justice and Restorative History for the Sexually Transmitted Disease 

Inoculation Experiments in Guatemala, 106 AM. J. PUB. HEALTH 1163, 1163 (2016). 

 
3 See SUSAN M. REVERBY, EXAMINING TUSKEGEE: THE INFAMOUS SYPHILIS STUDY AND ITS LEGACY (2009). 

Although some public health advocates began in the 1980s to advocate for the use of the less “serious” label 

of “sexually transmitted infections” to refer to a variety of infections, many leading medical groups consider 

the difference in the phrases to be semantic only. See, e.g., H. Hunter Handsfield, Sexually Transmitted 

Diseases, Infections, and Disorders: What’s In a Name?, 42 SEXUALLY TRANSMITTED DISEASES 169, 169 

(2015) (“Today, STD and STI should be considered synonymous and interchangeable . . . Those who prefer 

either term should use it freely, with neither defensiveness nor pride in either one.”). 

 
4 See Reverby, supra note 2, at 1163. 

 
5 See CTRS. FOR DISEASE CONTROL AND PREVENTION, Timeline, U.S. Public Health Service Syphilis Study at 

Tuskegee, https://www.cdc.gov/tuskegee/timeline.htm [https://perma.cc/NY9L-MV39] [hereinafter Timeline]. 

In 1997, President Bill Clinton issued a public apology for the involvement of the United States government 

in these “morally wrong” experiments. CTRS. FOR DISEASE CONTROL AND PREVENTION, Presidential Apology, 

U.S. Public Health Service Syphilis Study at Tuskegee, https://www.cdc.gov/tuskegee/clintonp.htm 

[https://perma.cc/9S67-F296] [hereinafter Presidential Apology] (quoting President Clinton as saying, “The 

American people are sorry—for the loss, for the years of hurt. You did nothing wrong, but you were 

grievously wronged. I apologize and I am sorry that this apology has been so long in coming”). 



56 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

the History of Medicine in 2003, and in 2010, President Obama issued a public apology 

to the President of Guatemala.6  

 

This Article begins by exploring the background and significance of the Guatemalan 

sexually transmitted disease experiments. Part I places the research project in the context 

of the United States’ relationship with Central American countries, and with Guatemala 

in particular, after World War II and during the beginning of the Cold War.7 This Part 

goes on to describe the nature of the non-consensual human experimentation conducted 

by the United States government in Guatemala, with the approval and cooperation of the 

host country.8 During this period, the United States government was conducting other 

non-consensual human medical experiments both domestically and abroad.9 

 

Part II of this Article considers the ongoing efforts by victims of the Guatemalan 

sexually transmitted disease experiments (and their descendants) to access the United 

States legal system. Victims have brought two major lawsuits in United States courts, 

seeking financial compensation for physical harm that has been transmitted over several 

generations.10 A third case, a human rights claim, remains stalled before the Inter-

American Commission of Human Rights Organization of American States.11 But so far, 

justice remains elusive. Sovereign immunity and forum selection have presented 

challenges to those seeking restitution.  

 

Part III of the Article frames the Guatemalan sexually transmitted disease 

experiments in the broader context of race and gender. It argues that the gross violations 

of Guatemalans’ human rights remained out of the public record so long precisely 

because most of the subjects were of non-white, Latin American descent and since the  

 

 
6 See Sushma Subramanian, Worse Than Tuskegee, SLATE (Feb. 26, 2017), http://www.slate.com/articles/ 

health_and_science/cover_story/2017/02/guatemala_syphilis_experiments_worse_than_tuskegee.html 

[https://perma.cc/2G7B-4A4N] (providing a timeline graphic detailing the chronology of the Guatemalan 

experiments). 

 
7 See infra Part I.A. 

 
8 See infra Part I.B. 

 
9 See infra Part I.C. 

 
10 See infra Part II.A.–II.B. 

 
11 See infra Part II.C. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         57 

 

 

 

study involved a great number of women as vectors and victims of diseases.12 The 

experimenters treated Guatemalan women as having “expendable” bodies (likely already 

diseased) that could be sacrificed for the allegedly greater “good” of finding a cure for a 

venereal disease common among male Unites States military personnel.13 Even when 

Guatemalan women were not directly the subject of the non-consensual experimentation, 

many were the wives or partners of men who were infected with sexually transmitted 

diseases during the experiments. Thus, the experiments should be understood as 

involving not only the subjects themselves, but also the intimate partners of those who 

were the subjects of the study.14 Further complicating any analysis of the Guatemalan 

experiments are questions about gender, geography, race, and socioeconomics.15 

 

Part IV of the Article suggests reproductive justice as a helpful lens for evaluating the 

impact and legacy of the Guatemalan sexually transmitted disease experiments.16 The 

reproductive justice framework, with its focus on public resources, emphasizes that a 

crucial first step in accessing resources is ensuring that disadvantaged peoples’ voices are 

heard. The legal system is a proper venue for the victims of the Guatemalan experiments 

and their descendants to share their stories and have their suffering acknowledged by not 

only governments and private actors, but also by the public.17 In shedding light on the 

Guatemalan sexually transmitted disease experiments, this Article seeks to amplify the 

victims’ quest for justice and acknowledgment. 

 

I. United States Involvement in Guatemala, the Sexually Transmitted Disease 

Experiments, and Other Non-consensual Medical Research 

 

A.   United States Political Involvement in Guatemala 

 

In 1944, toward the end of World War II, Guatemala experienced a political 

revolution that led to the democratic election of a civilian president who was friendly to 

 
12 See infra Part III. 

 
13 See id. 

 
14 See id. 

 
15 See id. 

 
16 See infra Part IV. 

 
17 See Reverby, supra note 2, at 1164. 



58 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

the United States.18 Initially, the United States had not focused much of its foreign 

diplomacy efforts on Central America, but this changed as Cold War tensions grew 

quickly. George Kennan’s “Long Telegram” warned that “peaceful coexistence” between 

capitalist nations and socialist nations would be impossible, and he predicted that the 

Soviet Union would venture to bring otherwise unstable countries within Soviet 

influence.19 In March 1947, President Truman announced to Congress what became 

known as the Truman Doctrine, which mandated the United States to “support free 

peoples who are resisting attempted subjugation by armed minorities or by outside 

pressures.”20 

 

For these reasons, it is not surprising to learn that the United States Central 

Intelligence Agency kept a close watch over Guatemalan politics and began to monitor 

the country for communist influences. The United States’ involvement in Guatemala in 

the 1940s was, in many ways, a precursor to later official pronouncements that the United 

States would act to protect countries in the Western Hemisphere from Soviet influence.21 

Close ties with Guatemala were key to keeping that country free and democratic. The 

scientific experimentation supported and funded by the governments of both the United 

States and Guatemala strengthened these ties by enabling the formation of contacts 

between United States researchers and Guatemalan leaders of hospitals, prisons, and the 

military.22 Through these contacts, the United States gained firsthand information about 

the functions and operations of these Guatemalan institutions, and the institutions may 

have come to rely in turn on the expertise provided by United States contacts. 

 

B.   Non-consensual Medical Experimentation by the United States 

Government and United States Companies 

 

Out of the atrocities of World War II and the subsequent Nuremberg Trials, there 

developed a clear international norm against non-consensual experimentation on human 

 
18 See NICK CULLATHER, SECRET HISTORY: THE CIA’S CLASSIFIED ACCOUNT OF ITS OPERATIONS IN 

GUATEMALA, 1952–1954 10–14 (1st ed. 1999). 

 
19 See, e.g., Michael F. Duggan, The Open Hand: Moderate Realism and the Rule of Law, 61 HOW. L.J. 271, 

285 (2018) (describing Kennan’s “Long Telegram”). 

 
20 See, e.g., Michal R. Belknap, The Warren Court and the Vietnam War: The Limits of Legal Liberalism, 33 

GA. L. REV. 65, 77 n.65 (1998) (describing the Truman Doctrine). 

 
21 See John Foster Dulles, Intervention of International Communism in Guatemala, in GUATEMALA IN 

REBELLION: UNFINISHED HISTORY 78 (Jonathan L. Fried et al. eds., 1983). 

 
22 See id. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         59 

 

 

 

subjects.23 As early as 1767, the common law had recognized a doctor’s liability for 

treating a patient without the patient’s consent, except in cases of emergency.24 In the 

Enlightenment Era of the eighteenth century, there emerged an increased emphasis on 

patient autonomy.25 A Norwegian physician was found liable in 1880 for failing to obtain 

a patient’s consent before he intentionally used a surgical instrument contaminated with 

leprosy on her in order to better understand the disease’s transmission.26 In 1931, 

Germany made binding a set of directives issued in 1900 that prohibited experimentation 

on nonconsenting patients.27 So, although it may be true that “acceptance and application 

[of an individual’s right to determine what shall be done with his or her body] . . . 

diffused slowly within the medical profession,”28 United States government officials and 

medical professionals undoubtedly were aware of their ethical obligations and the 

negative attention that would accompany any non-consensual human experimentation.29 

 
23 See, e.g., Military Tribunals No. 1, in 2 TRIALS OF WAR CRIMINALS BEFORE THE NUREMBERG MILITARY 

TRIBUNALS UNDER CONTROL COUNCIL LAW NO. 10 80–86 (1949) (setting forth ethical principles for human 

experimentation, including required “voluntary consent of the individual upon whom the experiment is to be 

performed,” in response to physicians who had conducted experiments on nonconsenting individuals in 

concentration camps during World War II). 

 
24 See John I. Gallin, A Historical Perspective on Clinical Research, in PRINCIPLES AND PRACTICE OF 

CLINICAL RESEARCH 1, 6 (John I. Gallin & Frederick P. Ognibene eds., 3d ed. 2012) (discussing 1767 English 

case of Slater v. Baker & Stapleton). 

 
25 Martin S. Pernick, The Patient’s Role in Medical Decisionmaking: A Social History of Informed Consent in 

Medical Therapy, in MAKING HEALTH CARE DECISIONS: THE ETHICAL AND LEGAL IMPLICATIONS OF INFORMED 

CONSENT IN THE PATIENT-PRACTITIONER RELATIONSHIP VOL. 3, APP’X E 1, 5–6 (describing the President’s 

Commission for the Study of Ethical Problems in Medical and Biomedical and Behavioral Research 1982 

and explaining Benjamin Rush’s theory that patient autonomy led to enhanced personal well-being and public 

health). 

 
26 See Siang Yong Tan & Connor Graham, Armaeuer Hansen (1841-1912): Discoverer of the Cause of 

Leprosy, 49 SING. MED. J. 520, 521 (2008) (discussing Dr. Hansen’s unauthorized experimentation). 

 
27 See generally FRANCES R. FRANKENBURG, HUMAN MEDICAL EXPERIMENTATION: FROM SMALLPOX 

VACCINES TO SECRET GOVERNMENT PROGRAMS 54, 79–80 (2017) (discussing Prussian directives issued in 

1900 in response to public outcry over doctor’s intentional and non-consensual infection of prostitutes with 

syphilis and subsequent codification in 1931 of these directives in response to tuberculosis experiment carried 

out on children); Laurel Hattix, Comment, Expanding Notions of Self-Determination: Int’l Customs of 

Informed Consent in Medical Experimentation Pre-1945, 19 CHI. J. INT’L L. 145, 162–80 (2018) (surveying 

the development of consent as a foundational ethic for the medical profession). 

 
28 AMY GUTMANN & JAMES WAGNER, PRESIDENTIAL COMM’N FOR THE STUDY OF BIOETHICAL ISSUES, 

“ETHICALLY IMPOSSIBLE”: STD RESEARCH IN GUATEMALA FROM 1946 TO 1948 97 (2011). 

 
29 See infra note 83 and accompanying text. 



60 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

Notwithstanding these norms, the United States government and United States 

companies have been the primary architects of several non-consensual human 

experiments in the United States and abroad. The Tuskegee experiments are perhaps the 

most infamous, but they are not the only examples.30 By way of illustration, when the 

Spanish-American War ended in 1900, a team of United States doctors led by Walter 

Reed intentionally infected human subjects in Cuba with yellow fever in order to study 

the disease’s pathogenic mechanisms.31 Not all of the subjects may have fully appreciated 

the risks of their participation in the program, especially because “volunteers” received 

substantial payments for agreeing to be injected with the virus.32 United States 

researchers also conducted a failed gonorrhea experiment at a federal prison in Terre 

Haute, Indiana, in 1943, the purpose of which was to study the effectiveness of post-

exposure treatments for gonorrhea.33 Prisoners were paid for their participation and told 

that their involvement in the study would be considered by the parole board.34 Scientists 

dabbed the tips of the prisoners’ penises with gonorrheal bacteria.35 These attempts did 

not produce consistent infections, however, and in any event, the human subjects of the 

study received some medical treatment.36 Ultimately the experiment was discontinued.37 

 
30 See supra notes 3–5 and accompanying text (providing overview of Tuskegee experiments). 

 
31 See, e.g., Akil Mehral, Politics of Participation: Walter Reed’s Yellow-Fever Experiments, 11 AMA J. 

ETHICS 326 (2009), https://journalofethics.ama-assn.org/article/politics-participation-walter-reeds-yellow-

fever-experiments/2009-04 [https://perma.cc/S6FU-AR9L]. 

 
32 Id. 

 
33 The Executive Officer of the United States Army Medical Corps urged “that the National Research Council 

undertake an investigation in search of an effective prophylaxis and improved treatment for gonorrheal 

infections, using selected human volunteers.” Letter from John A. Rogers, Exec. Officer of the U.S. Army 

Med. Corps, to Lewis H. Weed, Chairman of Div. of Med. Sci. of the Nat’l Res. Coun. (Dec. 4, 1942), cited 

in GUTMANN & WAGNER, supra note 28, at 14 n.65. 

 
34 See Letter from James V. Bennett to Joseph E. Moore (Feb. 26, 1943) (on file with PCSBI HSPI Archives, 

NARA-II_0000188), cited in GUTMANN & WAGNER, supra note 28, at 18 nn.113, 115 [hereinafter Bennett-

Moore Letter]. 

 
35 See GUTMANN & WAGNER, supra note 28, at 13. 

 
36 See Subcomm. on Venereal Diseases, Meeting Minutes 21 (Nov. 11, 1943) (on file with PCSBI HSPI 

Archives, NAS_0002782), cited in GUTMANN & WAGNER, supra note 28, at 21 n.149; Reports to a 

Conference Held Under the Auspices of the Subcomm. on Venereal Diseases on the Chemical Prophylaxis of 

Venereal Disease (Feb. 9, 1944) (on file with PCSBI HSPI Archives, NAS_0003114-17), cited in GUTMANN 

& WAGNER, supra note 28, at 21 n.149. 

 
37 See GUTMANN & WAGNER, supra note 28, at 21–22. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         61 

 

 

 

A draft report about the Terre Haute experiments explained that “[e]fforts were made to 

produce experimental gonorrhea in these volunteers by almost every conceivable 

expedient except by the intraurethral inoculation of pus taken directly from the cervix or 

urethra of infected females or by the natural method of infection—sexual intercourse.”38 

The United States Office of Scientific Research and Development approved the 

experiment and the United States Attorney General had opined that it met applicable 

legal requirements.39  

 

More recently, in 2009, a United States court allowed a lawsuit to proceed against the 

drug company Pfizer on account of its failure to obtain the informed consent for the use 

of an experimental oral antibiotic on Nigerian children in 2006.40 The case later settled 

out of court.41 In 2009, the Bill and Melinda Gates Foundation financed an India-based 

trial of a vaccination against the human papilloma virus.42 The human subjects were girls 

ages ten to fourteen; a large number had parents who were illiterate and unable to 

consent.43 After seven girls died, the Indian Parliament launched an investigation and 

 
38 Memorandum from E. Cowles Andrus, Chief, Division of Med., Office of Sci. Research and Dev. Comm. 

on Med. Research to Chester S. Keefer (Feb. 25, 1946) (on file with PCSBI HSPI Archives, NARA-

II_0000419), quoted in GUTMANN & WAGNER, supra note 28, at 22. 

 
39 See GUTMANN & WAGNER, supra note 28, at 17–18 (describing discussion between U.S. Assistant Solicitor 

General Oscar Cox and Attorney General Francis Biddle that experiments were legal). But see Bennett-

Moore Letter, supra note 34, at 18 nn.113, 115 (expressing concerns about legality of experiments). 

 
40 Abdullahi v. Pfizer, Inc., 562 F.3d 163, 169 (2d Cir. 2009) (allowing plaintiffs’ claim under Alien Tort 

Statute to go forward). 

 
41 See Donald G. McNeil, Jr., Nigerians Receive First Payments for Child Who Died in 1996 Meningitis Drug 

Trial, N.Y. TIMES (Aug. 11, 2011), https://nyti.ms/2kTwn5P [https://perma.cc/LS8E-5X5P] (describing the 

creation of a $35 million settlement fund and payment of $175,000 to each of four families from that fund). 

 
42 See, e.g., Mark Barnes et al., The Evolving Regulatory Landscape for Clinical Trials in India, 73 FOOD & 

DRUG L.J. 601, 602 (describing the Gates Foundation’s sponsorship of Indian HPV vaccine trials); see also 

Press Release, Bill and Melinda Gates Found., Decade of Vaccines (2010) (on file with the Bill and Melinda 

Gates Foundation), https://www.gatesfoundation.org/Media-Center/Press-Releases/2010/01/Bill-and-

Melinda-Gates-Pledge-$10-Billion-in-Call-for-Decade-of-Vaccines [https://perma.cc/CZJ9-EULB] 

(describing $10 million campaign to increase global vaccine access). 

 
43 See PARLIAMENT OF INDIA RAJYA SABHA DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON 

HEALTH AND FAMILY WELFARE, SEVENTY SECOND REPORT: ALLEGED IRREGULARITIES IN THE CONDUCT OF 

STUDIES USING HUMAN PAPILLOMA VIRUS (HPV) VACCINE BY PATH IN INDIA (DEPARTMENT OF HEALTH 

RESEARCH, MINISTRY OF HEALTH AND FAMILY WELFARE) 1, 11 (2013), http://164.100.47.5/newcommittee/ 

reports/EnglishCommittees/Committee%20on%20Health%20and%20Family%20Welfare/72.pdf 

[https://perma.cc/JJP5-ZNGG]. 



62 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

found that the study had violated informed consent procedures, among other standards.44 

In 2010, the Gates Foundation provided grants for African trials for malaria and 

meningitis vaccines.45 That work, too, was dogged by claims of uninformed consent, 

although the claims were not substantiated as in India.46 Medical experimentation—

whether by the United States government or by United States companies—with the 

specter of uninformed consent lurking in the background has been and remains an issue 

fraught with ethical concerns. 

 

C.   The Guatemalan Sexually Transmitted Disease Experiments 

 

Dr. John Charles Cutler was one of the investigators of the failed Terre Haute 

gonorrhea experiments.47 Cutler and his colleagues had been frustrated by the results and 

sought to improve the study’s methodology.48 In the 1940s, at the height of World War II, 

there was concern that sexually transmitted diseases presented a threat to United States 

military readiness.49 For example, beginning in 1941, roughly coinciding with the 

entrance of the United States into war, rates of gonorrhea infection in the United States 

gradually increased and did not start declining until 1947.50 Infections could leave 

 
44 See id. at 12–13; see also Sharmeen Ahmed, Accountability of International NGOs: Human Rights 

Violations in Healthcare Provision in Developing Countries and the Effectiveness of Current Measures, 22 

ANN. SURV. INT’L & COMP. L. 33, 37–50 (2017) (discussing history and implementation of two of the Gates 

Foundation’s vaccination campaigns). 

 
45 See, e.g., First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children, 365 NEW 

ENG. J. MED. 1863 (2011). 

 
46 See, e.g., Ahmed, supra note 44, at 50 (“While claims of human rights abuses resulting from these trials 

across Africa may be unsupported, the trials had the same potential for abuse as in India because of the weak 

legal regime governing trials in these countries.”). 

 
47 See GUTMANN & WAGNER, supra note 28, at 12–23 (“The experiments in Terre Haute . . . provided a 

scientific impetus for the experiments in Guatemala; the inability to develop a reliable method for gonorrheal 

infection in Terre Haute left the researchers unable to address their primary research goal, more effective 

prophylaxis, and wondering about alternative infection strategies.”). 

 
48 See J. F. Mahoney et al., Experimental Gonococcic Urethritis in Human Volunteers, 30 AM. J. SYPHILIS, 

GONORRHEA & VENEREAL DISEASE 1, 32 (1946), cited in GUTMANN & WAGNER, supra note 28, at 22 n.165 

(reporting that, in their own words, the researchers evaluated their methods as incapable “of producing 

disease with a consistency considered to be adequate for a study of experimental prophylaxis.”). 

 
49 See id. at 22; GUTMANN & WAGNER, supra note 28, at 11. 

 
50 See, e.g., Rebecca Kreston, Sex, War & Revolution: The Epidemiology of Gonorrhea in the USA, 

DISCOVER MAG. (Sept. 24, 2012) (citing C.E. Cornelius, Seasonality of Gonorrhea in the United States, 86 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         63 

 

 

 

patients unable to work or permanently disabled, and even cause death.51 The United 

States military was the first to test antibiotics as a possible way to prevent gonorrhea and 

to use penicillin to treat the disease.52 Given the quantifiable cost of sexually transmitted 

diseases affecting military personnel, it is no wonder that the government sought to 

understand the diseases better and to find more effective treatments for them. Because 

there were so many more men than women enrolled in the United States Armed Forces 

during World War II, with men exclusively serving in combat roles, it seems reasonable 

to say that the research experiments were designed to find cures for these sexually 

transmitted diseases as they manifested in men.53 

 

After the Terre Haute experiments, United States researchers sought a place where it 

would be possible to do what they could not in the Indiana prison: spread the disease by 

human vectors (through sexual contact) or by direct injection.54 The place the researchers 

chose was Guatemala.55 Although there is no concrete proof, it may be that in selecting 

the location for the experiments, the researchers took into account Guatemala’s 

geographic separation from the United States, the fact that most of its citizens did not 

speak English, and that most Guatemalans are indigenous or have a Spanish or mixed-

heritage background. The researchers did not consistently inform the Guatemalans, if at 

all, that they were exposed to sexually transmitted diseases, and gave less than half of the 

 
HSMHA HEALTH REP. 157 (1971)), http://blogs.discovermagazine.com/bodyhorrors/2012/09/24/ 

epidemiology-of-gonorrhea-usa/#.XciYWDJKhQI [https://perma.cc/6QF6-LTRH]. 

 
51 See Mark S. Rasnake et al., History of U.S. Military Contributions of the Study of Sexually Transmitted 

Diseases, 170 MIL. MED. 61, 61 (2005) (citing JH Greenberg, Venereal Disease in the Armed Forces, 6 MED. 

ASPECTS HUM. SEXUALITY 165 (1972)) (describing the military’s “lost person-days, disabilities, and even 

deaths before penicillin became available in the middle 1940s”). 

 
52 See id. at 62. 

 
53 During World War II, of approximately sixteen million members of the Armed Forces, only about 350,000 

were women. See History.com Editors, American Women in World War II, HISTORY (Aug. 21, 2018), 

https://www.history.com/topics/world-war-ii/american-women-in-world-war-ii-1 [https://perma.cc/Y2VM-

T73F] (providing a figure for women’s military service during that time); RESEARCH A VETERAN GUIDE: HOW 

TO LOCATE SOMEONE WHO FOUGHT IN WORLD WAR II, https://www.nationalww2museum.org/war/research-

veteran [https://perma.cc/KW4V-ZD7C] (stating that more than sixteen million men and women served in the 

Armed Forces during World War II). 

 
54 See supra notes 33–36 and accompanying text (describing methods the Terre Haute experiments). 

 
55 See infra notes 70–80 and accompanying text (summarizing principal aims and methods of Dr. Cutler’s 

human experimentation in Guatemala). 



64 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

subjects any documented medical treatment.56 Consequently, the Guatemalan 

experiments departed even further from acceptable medical ethics than did the Terre 

Haute experiments. 

 

Dr. John Charles Cutler and other researchers encountered a politically friendly 

climate in Guatemala in August 1946.57 Dr. Cutler quickly laid the groundwork for live 

human experimentations.58 The Pan American Sanitary Bureau, now known as the Pan 

American Health Bureau, sponsored Dr. Cutler’s research with a grant from the United 

States National Institutes of Health, which itself was funded by the United States Public 

Health Service, and the Public Health Service’s Venereal Disease Division.59 Several 

members of Dr. Cutler’s research staff were also affiliated with or employed by the 

Public Health Service (which later became part of the Centers for Disease Control) and 

the National Institutes of Health.60 The Committee on Medical Research of the United 

States Office of Scientific Research and Development, established by President Franklin 

Roosevelt, approved the Guatemalan experiments.61 Members of the approving 

committee included employees of Johns Hopkins University, Harvard University, and 

Columbia University, as well as the Director of the National Institutes of Health and 

representatives of the United States Navy and the United States Army.62 

 

The Guatemalan government both financially and practically supported Dr. Cutler’s 

sexually transmitted disease research by providing access to Guatemalan prisoners and to 

medical facilities.63 The Guatemalan Ministry of Public Health approved Dr. Cutler’s 

studies and officials of the National Orphanage of Guatemala, the Central Penitentiary in 

Guatemala City, the Guatemala National Army of the Revolution, and the Guatemala 

National Army of the Revolution Military Hospital all provided Dr. Cutler with access 

 
56 See GUTMANN & WAGNER, supra note 28, at 6; see also infra note 92 and accompanying text. 

 
57 See GUTMANN & WAGNER, supra note 28, at 28–29. 

 
58 See id. at 31–32. 

 
59 See id. at 4–6, 122. 

 
60 See id. at 6, 112–15 (“Table 2: Individuals Involved in the STD Experiments in Guatemala”). 

 
61 See id. at 12, 120 (“Organizational Chart of the Office of Scientific Research and Development”). 

 
62 See id. 

 
63 See GUTMANN & WAGNER, supra note 28, at 32–33. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         65 

 

 

 

and support.64 Notably, however, after the sexually transmitted diseases became 

widespread public information65 and President Obama apologized for the United States 

government’s involvement,66 the government of Guatemala did not acknowledge its own 

role in supporting the experiments; instead, the Guatemalan government denounced the 

experiments as racist and discriminatory on the part of the United States.67 

 

In the 1940s, research on sexually transmitted diseases was a top priority for the 

United States military. One government official estimated that each year there were 

“approximately 350,000 fresh infections with gonorrhea [in the Armed Forces], [which] 

will account for 7,000,000 lost man days per year, the equivalent of putting out of action 

for a full year the entire strength of two full armored divisions or of ten aircraft 

carriers.”68 At the time, syphilis in particular could be treated with penicillin, but Dr. 

Cutler and the sponsors of the Guatemalan experiments were seeking prophylactic cures, 

or post-exposure treatment that would prevent the development of sexually transmitted 

diseases.69 

 

Through his work with Guatemalan subjects, Dr. Cutler intended to do what the Terre 

Haute experiments could not: make infected sex workers available for intercourse with 

test subjects.70 At the time, sex work was legal in Guatemala, as long as sex workers were 

over the age of eighteen and were checked twice a week by a government clinic for 

sexually transmitted diseases.71 Some of the sex workers Dr. Cutler engaged received $25 

 
64 See id. at 112–15 (“Table 2: Individuals Involved in the STD Experiments in Guatemala”). 

 
65 See REVERBY, supra note 3, and accompanying text (discussing publication of Reverby’s findings). 

 
66 See Subramanian, supra note 6, and accompanying text (reporting apology by President Obama). 

 
67 See generally Comisión Presidencial para el Esclarecimiento de los Experimentos Practicados con 

Humanos en Guatemala, Recomendaciones del Gobierno de Guatemala de los Experimentos Practicados con 

Humanos en Guatemala, CITY PROJECT BLOG (11 de Julio 2012), http://www.cityprojectca.org/blog/ 

archives/14922 [https://perma.cc/5RYG-U6PJ]. 

 
68 GUTMANN & WAGNER, supra note 28, at 12 (quoting correspondence of Dr. Joseph Earle Moore, chairman 

of the National Research Council’s Subcommittee on Venereal Diseases). 

 
69 See Letter from J. F. Mahoney, Chairman, Nat’l Research Council Subcomm. on Venereal Diseases, to A. 

N. Richards, Chairman, Nat’l Research Council Comm. on Med. Research (Feb. 1, 1943), cited in GUTMANN 

& WAGNER, supra note 28, at 12. 

 
70 See GUTMANN & WAGNER, supra note 28, at 28–29. 

 
71 See id. at 28, 45 (describing the legal status and regulation of sex work in Guatemala at the time). 



66 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

to have their cervixes swabbed with gonorrheal pus obtained from a previously infected 

male.72 There is no documentation to suggest that these women knew that they were 

being infected with sexually transmitted diseases or that they consented to participation in 

the experiment.73 The sex workers were then instructed to have intercourse with specified 

prisoners.74 

 

In Guatemala, Dr. Cutler became frustrated by the relatively slow spread of sexually 

transmitted diseases among the prisoners via sex workers.75 Dr. Cutler therefore shifted 

his focus to psychiatric patients and intentionally infected them with syphilis by artificial 

means.76 This was done by having health workers either inject a needle containing 

syphilis into a man’s foreskin or deposit syphilitic material onto an open sore they had 

created by scratching or abrading the penis.77 Dr. Cutler also injected syphilis directly 

into the cerebral spinal fluid of other psychiatric patients.78 Dr. Cutler personally 

documented several cases in which psychiatric patients clearly objected to participating 

in the experiments (by fleeing the room or by resisting physical examination), yet he 

continued with his activities.79 The sores that developed on psychiatric patients were 

documented by several disturbing photographs that are now included in the National 

Archives’ collection of Dr. Cutler’s papers.80 

 
72 See Clinical Notes of John C. Cutler, Experiment No. 2 Gonorrhea Prophylaxis (Mar. 15, 1947) (on file 

with the National Archives), https://nara-media-001.s3.amazonaws.com/arcmedia/research/ health/cdc-cutler-

records/folder-31-gonorrheal-experiment.pdf [https://perma.cc/YT7T-5R7K]. 

 
73 See GUTMANN & WAGNER, supra note 28, 45–46. 

 
74 See id. 

 
75 Letter from John C. Cutler, Senior Assistant Surgeon and Dir., Guatemalan STD Studies, U.S. Pub. Health 

Serv., to John F. Mahoney, Head, Pub. Health Venereal Disease Research Lab. (June 22, 1947) (on file with 

the National Archives), https://nara-media-001.s3.amazonaws.com/ arcmedia/research/health/cdc-cutler-

records/folder-11-cutler-1947-correspondence.pdf [https://perma.cc/RF3N-CNHP]. 

 
76 See GUTMANN & WAGNER, supra note 28, at 56–61 (describing experimentation on psychiatric patients). 

 
77 See id. at 61–66 (describing injection method and “scarification and abrasion” method). 

 
78 See id. at 66–68. 

 
79 See id. at 61. 

 
80 NAT’L ARCHIVES, PRISON AND INSANE ASYLUM PHOTOGRAPHS TO ACCOMPANY FINAL REPORT IN THE 

RECORDS OF DR. JOHN C. CUTLER (May 17, 2017), https://www.archives.gov/research/health/cdc-cutler-

records [https://perma.cc/5ZG5-KE6V] [hereinafter PHOTOGRAPHS]. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         67 

 

 

 

Dr. Cutler left Guatemala in December 1948 when funding for the project 

concluded,81 although a small staff remained to continue taking blood samples through 

the early 1950s.82 Dr. Cutler never published final reports or public papers about his 

experiments in Guatemala, and it seems that he went to significant lengths to keep his 

work a secret. An article in the New York Times, published in May 1947, opined that 

injecting humans with syphilis bacteria, as had been done in animal experiments, would 

be “ethically impossible.”83 Less than a decade after leaving Guatemala, Dr. Cutler wrote 

in a draft report that “it was deemed advisable, from the point of view of public and 

personnel relations, to work so that as few people as possible know the experimental 

procedure.”84 Regardless of whether Dr. Cutler or those involved in the Guatemalan 

experiments knew of the specific New York Times article, fear of negative publicity may 

have caused those involved to keep quiet about their work.85 In the 1960s, Dr. Cutler took 

on the role of lead investigator in the ongoing Tuskegee syphilis experiments and later 

became the Acting Dean of the Graduate School of Public Health at the University of 

 
81 See Kayte Spector-Bagdady & Paul A. Lombardo, U.S. Public Health Service STD Experiments in 

Guatemala (1946-1948) and Their Aftermath, 41 ETHICS & HUM. RES. 29, 31 (2019) (describing how some 

United States health workers stayed in Guatemala after Cutler’s departure, continuing to collect specimens 

from the intentionally infected Guatemalan patients). 

 
82 See GUTMANN & WAGNER, supra note 28, at 6 (stating diagnostic testing continued through 1953); id. at 

70–71, 81–83 (stating that Genevieve Stout, a researcher with the United States-sponsored Pan American 

Sanitary Bureau, remained in Guatemala until 1951 to continue work similar to Dr. Cutler’s). 

 
83 Walter Kaempffert, Notes on Science: Syphilis Prevention, N.Y. TIMES (Apr. 27, 1947), https:// 

timesmachine.nytimes.com/timesmachine/1947/04/27/87741906/html?pageNumber=115 [https://perma.cc/ 

FMM2-SL3J] (describing successful syphilis tests on rabbits but noting that “[t]o settle the human issue 

quickly, it would be necessary to shoot living syphilis germs into human bodies . . . Since this is ethically 

impossible, it may take years to gather the information needed.”); see also GUTMAN & WAGNER, supra note 

28, at 57 (referring to an article in which the New York Times science editor described the injection of live 

syphilis germs into humans as “ethically impossible”). 

 
84 John C. Cutler, [Draft] Final Syphilis Report (Feb. 24, 1955) (unpublished manuscript) (on file with PCSBI 

HSPI Archives), cited in GUTMANN & WAGNER, supra note 28, at 74 n.580. 

 
85 See GUTMANN & WAGNER, supra note 28, at 103. 



68 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

Pittsburgh.86 He died in 2003 without public knowledge of his involvement in the 

Guatemalan sexually transmitted disease experiments.87 

 

After Professor Reverby discovered the trove of Dr. Cutler’s archived papers,88 

President Obama asked Amy Gutmann, the Chair of the Presidential Commission for the 

Study of Bioethics (and President of the University of Pennsylvania) to “oversee a 

thorough fact-finding investigation into the specifics of the U.S. Public Health Service 

Sexually Transmitted Diseases Inoculation Study,” including Dr. Cutler’s work in 

Guatemala.89 The Presidential Commission concluded that 1,308 people from three 

principal populations—prisoners, soldiers, and psychiatric patients—had been 

intentionally exposed to a sexually transmitted disease, whether syphilis, gonorrhea, or 

chancroid.90 This number does not seem to include the professional sex workers who 

were used in the experiments in order to transmit the disease.91 Of those 1,308 exposed to 

a sexually transmitted disease, only about half of them—678 people—received any kind 

of documented treatment.92 Separate and apart from the 1,308 people intentionally 

infected, an additional 5,128 people—soldiers, prisoners, psychiatric patients, children, 

leprosy patients, and United States Air Force personnel—were the subjects of diagnostic 

 
86 See Stephen Smith, Wellesley Professor Unearths a Horror: Syphilis Experiments in Guatemala, 

BOSTON.COM (Oct. 2, 2010), http://archive.boston.com/news/local/massachusetts/articles/2010/10/ 

02/wellesley_professor_unearths_a_horror_syphilis_experiments_in_guatemala/ [https://perma.cc/CSS5-

K2RT] (recounting historian Susan Reverby’s discovery of Dr. Cutler’s involvement in the Guatemalan 

experiments); Jan Ackerman, Obituary, John Charles Cutler / Pioneer in Preventing Sexual Diseases, PITT. 

POST-GAZETTE (Feb. 12, 2003), https://www.bitss.org/wp-content/uploads/2014/06/obituary-john-charles-

cutler1.pdf [https://perma.cc/2CYE-QHQK] (providing details about Dr. Cutler’s career). 

 
87 See Ackerman, supra note 86; see also Smith, supra note 86 (quoting Susan Reverby as saying, “[t]wo 

years after the [Guatmalan] experiment began, it was ended. The final report was secreted away in Cutler’s 

papers”). Until the discoveries by Dr. Reverby, the staff of Centers for Disease Control and Prevention 

apparently was not aware of the contents of Dr. Cutler’s papers nor the Guatemalan experiments. See id. 

 
88 See REVERBY, supra note 3, and accompanying text. 

 
89 Letter from Barack Obama, President, United States, to Amy Gutmann, Chair, Presidential Comm’n for the 

Study of Bioethical Issues (Nov. 24, 2010), reprinted in GUTMANN & WAGNER, supra note 28, at vi. 

 
90 See GUTMANN & WAGNER, supra note 28, at 6. 

 
91 See id. (seemingly treating female sex workers as outside the count of research subjects, even though they 

were intentionally infected with syphilis in order to transmit the disease). 

 
92 See id. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         69 

 

 

 

testing, including blood draws.93 Many of those who were infected in the 1940s 

transmitted the disease to their partners or children.94 Over 840 living victims or their 

descendants have self-identified.95 Many suffer the long-term consequences of untreated 

sexually transmitted diseases, such as burning during urination, pain or aching in the 

bones, infertility, and blindness.96 Most of these survivors or their descendants live in 

“extreme poverty,” in poor and rural areas without easy access to any medical care.97 The 

next Part of the Article explores how the United States legal system has failed to provide 

adequate remedies for victims of the Guatemalan sexually transmitted disease 

experiments, and then goes on to examine whether race, nationality, economic inequality, 

and physical geography may make justice elusive in this case. 

 

II. Legal Attempts to Redress Harm Suffered by Guatemalan Victims of Non-

consensual Human Experimentation  

 

Despite President Obama’s public apology in 2010 to Guatemalan President Alvaro 

Colom and the people affected by the non-consensual experimentation conducted by the 

United States government in Guatemala, and despite the finding by the United States 

Presidential Commission for the Study of Bioethical Issues that the Guatemalan 

experiments were morally wrong,98 little to no effort has been put forth to gain justice for 

the victims of these horrid experiments.99 The victims of the Guatemalan experiments and 

 
93 See id.; see also Presidential Commission for the Study of Bioethical Issues, Guatemala Subject Data 

Spreadsheet (on file with the Georgetown Bioethics Archive), https://bioethicsarchive.georgetown.edu/ 

pcsbi/node/650.html [https://perma.cc/2KE4-PTHG]. 

 
94 See Subramanian, supra note 6. 

 
95 See id. 

 
96 See id. (describing symptoms experienced by former subjects of Dr. Cutler or descendants of subjects who 

suffer from the consequences of untreated sexually transmitted diseases). 

 
97 Id. 

 
98 See, e.g., US Apologizes for Infecting Guatemalans with STDs in the 1940s, CNN.COM (Oct. 1, 2010), 

http://www.cnn.com/2010/WORLD/americas/10/01/us.guatemala.apology/index.html [https://perma.cc/ 

7ANT-LJNV] (quoting Guatemalan President Alvaro Colom saying that President Obama had called him 

“offering profound apologies and asking pardon for the deeds of the 1940s”); GUTMANN & WAGNER, supra 

note 28, at v (“[T]he Commission has concluded that the Guatemala experiments involved gross violations of 

ethics as judged against both the standards of today and the researchers’ own understanding of applicable 

contemporaneous practices.”). 

 
99 See Michael A. Rodriguez & Robert Garcia, First, Do No Harm: The US Sexually Transmitted Disease 



70 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

their families have yet to be compensated for their injuries, so they took matters into their 

own hands by turning to the courts in 2011.100 

 

A.   Garcia v. Sebelius: United States Rejects First Guatemalan Class Action 

Lawsuit  

 

On March 14, 2011, a plaintiff class comprised of surviving victims or legal heirs of 

victims of the Guatemalan sexually transmitted disease experiments sued eight named 

sitting federal officials and the then-acting Director of the Pan-American Health 

Organization, the successor to the Pan-American Sanitary Bureau, for injuries originating 

from a non-consensual medical experimentation program conducted in Guatemala from 

1946–1953.101 In the United States District Court for the District of Columbia, the 

plaintiffs asserted four claims for relief: first, violation of the Alien Tort Statute (ATS) 102 

for medical experimentation on non-consenting human subjects; second, violations under 

the ATS for cruel, inhuman, or degrading treatment; third, violations of their Fifth 

Amendment rights to substantive due process; and fourth, violations of their Eighth 

Amendment rights against cruel and unusual punishment.103 Although the plaintiffs 

acknowledged that none of the named defendants had any personal responsibility for or 

 
Experiments in Guatemala, 103 AM. J. PUB. HEALTH 2122, 2122 (2013). 

 
100 See supra Part I. 

 
101 Garcia v. Sebelius, 867 F. Supp. 2d 125 (D.D.C. 2012), vacated in part, 919 F. Supp. 2d 43 (D.D.C. 

2013), dismissed (June 5, 2013). Eight of the nine federal defendants were current federal government 

officials under the then-current Obama administration: (1) Kathleen Sebelius, Secretary of the United States 

Department of Health & Human Services (HHS); (2) Howard Koh, Assistant Secretary of HHS; (3) Vice 

Admiral Regina Benjamin, Surgeon General of the United States Public Health Service; (4) Thomas Frieden, 

Director of the United States Centers for Disease Control and Prevention (CDC); (5) Rima Khabbaz, Director 

of the Office of Infectious Diseases at the CDC; (6) Kevin Fenton, Director of the National Center for 

HIV/AIDS, Viral Hepatitis, STDs, and Tuberculosis Prevention at the CDC; (7) Gail Bolan, Director of the 

Division of STD Prevention at the CDC; and (8) Harold Varmus, Director of the National Cancer Institute at 

HHS. Garcia, 867 F. Supp. 2d at 131. Mirta Roses Periago, Director of the Pan-American Health 

Organization, formerly the Pan-American Sanitary Bureau, was the ninth defendant. Id. The plaintiffs also 

named a variety of “David Doe” defendants, to be determined. Id. 

 
102 28 U.S.C. § 1350 (2006). 

 
103 Plaintiffs’ First Amended Complaint ¶¶ 133–40, Garcia v. Sebelius, 867 F. Supp. 2d 125 (D.D.C. 2012) 

(alleging medical experimentation on non-consensual human subjects); id. at ¶¶ 141–47 (alleging cruel, 

inhuman or degrading treatment); id. at ¶¶ 148–56 (alleging a violation of Fifth Amendment rights); id. at ¶¶ 

148–56 (alleging a violation of Eighth Amendment rights). The plaintiffs filed their suit before the 

Presidential Commission for the Study of Bioethics had issued its report; the court permitted the plaintiffs to 

amend their complaint after the report’s issuance. Garcia, 867 F. Supp. 2d at 131. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         71 

 

 

 

involvement in the Guatemalan experiments, they were liable under a successor liability 

theory for the acts of those who preceded them in office.104 

 

The court granted the federal government’s motion to substitute itself in the place of 

the eight named federal officials under the Westfall Act.105 This law provides that the 

federal government shall be substituted in the place of federal employees when the 

employees “were acting within the scope of their federal office or employment at the time 

of the incidents out of which the plaintiffs’ claims arose.”106 Because none of the named 

federal defendants had been in office at the time of the experiments and because federal 

employees have absolute immunity from tort claims arising from actions taken within the 

employee’s scope of employment,107 the District Court then granted the federal 

government’s motions to dismiss plaintiffs’ ATS claims.108 Once the United States has 

been substituted as a party in the place of a federal employee acting within the scope of 

office or employment, the Federal Tort Claims Act—not the ATS—governs the suit.109  

 

 
104 Plaintiffs’ First Amended Complaint ¶ 45, Garcia v. Sebelius, 867 F. Supp. 2d 125 (D.D.C. 2012) 

(claiming defendants were “liable under principles of successor liability for the acts of their predecessor 

office-holders”). 

 
105 Garcia, 867 F. Supp. 2d at 134–36. The government relied on Osborn v. Haley, 549 U.S. 225 (2007), in 

which the Supreme Court ruled that a “Westfall Act certification is proper [even] when a federal officer 

charged with misconduct asserts, and the Government determines, that the incident or episode in suit never 

occurred.” Id. at 247. The Osborn Court reasoned that “it would make scant sense to read the Act as leaving 

an employee charged with an intentional tort to fend for himself when he denies wrongdoing and asserts he 

‘engaged only in proper behavior occurring wholly within the scope of his office or employment.’” Id. at 248 

(internal citation omitted). 

 
106 Garcia, 867 F. Supp. 2d at 134. 

 
107 28 U.S.C. § 2679(b)(1) (2006). 

 
108 Garcia, 867 F. Supp. 2d at 136. The ATS provides that, “The district courts shall have original jurisdiction 

of any civil action by an alien for a tort only, committed in violation of the law of nations or a treaty of the 

United States.” 28 U.S.C. § 1350 (2006). Thus, a successful litigant must prove three separate elements: that 

the plaintiff is an “alien,” that a “tort” has been committed against the plaintiff by the defendant, and that 

such tort was “committed in violation of the law of nations or a treaty of the United States.” 13D CHARLES 

ALAN WRIGHT ET AL., FEDERAL PRACTICE AND PROCEDURE § 3585 (3d ed. 2009); see also Dennis M. Coyne, 

Note, International Pharmaceutical Mistrials: Existing Law for the Protection of Human Subjects and a 

Proposal for Reform, 29 B.U. INT’L L.J. 427, 431–32 (2011) (providing an overview of satisfaction of claims 

under ATS). 

 
109 28 U.S.C. § 1346 (2013). 



72 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

The Federal Tort Claims Act (FTCA) generally permits private parties to bring tort 

actions against the federal government for actions taken by persons acting on its behalf, 

but a number of exceptions apply.110 One of those exceptions is the “foreign country 

exception,” which, in effect, bars claims arising in foreign countries.111 Although the 

plaintiffs tried to argue that treating their claims as barred would “work an injustice in 

this case,”112 the court granted the federal government’s motion to dismiss because the 

activities that form the basis for the suit took place in Guatemala.113 When the District 

Court dismissed this lawsuit brought by the victims of the Guatemalan sexually 

transmitted disease experiments, it effectively ended their quest to hold the United States 

government responsible for the actions taken by employees and agencies under its 

supervision and influence.  

 

In dicta, Judge Reggie B. Walton called the Guatemalan experiments “a deeply 

troubling chapter in our Nation’s history,” but he also stated that the court could not 

provide the plaintiffs with any redress.114 Judge Walton recognized the real harm suffered 

by the victims but doubted that the court system could provide a remedy.115 He instead 

suggested that the plaintiffs would be better served by directing their “pleas . . . to the 

 
110 28 U.S.C. §§ 1291, 1346, 1402, 2401, 2402, 2411, 2412, 2671–2680. 

 
111 See Sosa v. Alvarez-Machain, 542 U.S. 692, 701, 712 (2004) (“[T]he FTCA’s foreign country exception 

bars all claims based on any injury suffered in a foreign country, regardless of where the tortious act or 

omission occurred.”). 

 
112 Garcia, 867 F. Supp. 2d at 137. 

 
113 In evaluating the federal government’s motion to dismiss the plaintiffs’ claims, the court noted that the 

Supreme Court’s 1971 decision in Bivens v. Six Unknown Named Agents of Federal Bureau of Narcotics, 403 

U.S. 388 (1971), requires that a claim arising out of the actions of any individual federal defendant may 

succeed only when that defendant was “personally involved in the illegal conduct.” Id. (citing Simpkins v. 

District of Columbia, 108 F.3d 366, 369 (D.C. Cir. 1997)). Because the plaintiffs in this case asserted a 

successor liability theory, they had conceded that the named federal defendants had no personal involvement 

in the Guatemalan studies. Garcia, 867 F. Supp. 2d at 138. Therefore, the court dismissed the plaintiffs’ 

constitutional claims. Id. The court also granted the motion to dismiss filed by Mirta Roses Periago⎯the 

ninth named defendant (and only named defendant who was not a federal employee)⎯but on different 

grounds. Id. at 140–44. As the current Director of the Pan-American Health Organization, the successor to 

the Pan-American Sanitation Bureau, Roses Periago asserted immunity under the International Organizations 

Immunities Act of 1945, 22 U.S.C. § 288a(b) (2006). Id. The court agreed with Roses and dismissed the case 

against her. Id. 

 
114 Garcia, 867 F. Supp. 2d at 144. 

 
115 Id. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         73 

 

 

 

political branches of the government who, if they choose, have the ability to grant some 

modicum of relief to those affected by the Guatemala study.”116 

 

Some modicum of relief did, in fact, arrive while the Garcia matter was pending.117 

The United States Department of Health and Human Services announced its $1.8 billion 

investment to aid the treatment and prevention of HIV and other sexually transmitted 

diseases in Guatemala, accompanied by promises to strengthen ethical training on human 

research protections.118 Similarly, in 2012, the Centers for Disease Control and 

Prevention stated it would increase funding to Guatemala by $775,000 over three years to 

help monitor and control the spread of sexually transmitted diseases.119 

 

These funds, plus President Obama’s apology, most certainly will help some 

survivors. But the financial investments are not nearly enough to address the tangible 

harm inflicted on more than 5,000 people by non-consensual human experimentation, 

including intentional exposure to sexually transmitted diseases that were left untreated in 

many cases.120 Judge Walton’s exhortation to the plaintiffs to exert influence on other 

branches of government may be technically sound, but such exertion is not likely to 

occur, given that many of the victims are poor people in rural areas of Guatemala, have 

never traveled outside their native country, and do not speak English, and all of whom 

have been ignored by the United States government for over sixty years.121 

 

B.   Estate of Alvarez v. Johns Hopkins University: The Emerging Hope for 

Justice  

 

Shortly after the dismissal of their case in the United States District Court for the 

District of Columbia, the Garcia plaintiffs joined a separate lawsuit brought in the United 

 
116 Id.; see also Richard Monastersky, Court Dismisses Suit Over Unethical US Experiments, NATURE: NEWS 

BLOG (June 15, 2012, 19:45 GMT), http://blogs.nature.com/news/2012/06/court-dismisses-suit-over-

unethical-us-experiments.html [https://perma.cc/6SS2-DZBY]. 

 
117 See Mariano Castillo, U.S. Rejects Guatemalans’ STD Lawsuit, Offers Aid, CNN (Jan. 10, 2012), https:// 

www.cnn.com/2012/01/10/world/americas/us-guatemala-std-experiments/index.html [https://perma.cc/T5ZE-

FQQC]. 

 
118 See id. 

 
119 See id. 

 
120 See supra notes 95–97 and accompanying text. 

 
121 See supra note 116 and accompanying text (reporting Judge Walton’s advice to the plaintiffs). 



74 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

States District Court for the District of Maryland.122 That group of plaintiffs asserted 

multiple claims against the Rockefeller Foundation, Bristol-Myers Squibb Company, and 

a variety of institutions affiliated with Johns Hopkins University, including its hospital, 

medical school, and school of public health.123 The theory of liability applied to the 

Rockefeller Foundation and Johns Hopkins was that their agents or employees “designed, 

developed, participated in, approved, encouraged, directed, and aided and abetted non-

consensual, non-therapeutic, human subject experiments in Guatemala.”124 The theory of 

liability applied to the Bristol-Meyers Squibb company was that its employees 

participated in “critical meetings” that designed the Guatemalan experiments as a 

“continuation and progression of their existing research into penicillin, to test various 

forms of penicillin that they had manufactured and their efficacy on a large population of 

controlled human subjects,” and that its agents or employees actively concealed the 

“unethical, immoral, and tortious nature” of the experiments in Guatemala.”125 

 
122 Estate of Alvarez v. Johns Hopkins Univ., 205 F. Supp. 3d 681 (D. Md. 2016). 

 
123 Plaintiffs’ Second Amended Complaint, Estate of Alvarez v. Johns Hopkins Univ., 205 F. Supp. 3d 681 

(D. Md. 2016). The plaintiffs had an initial complaint that was removed to federal court. Alvarez, 205 F. 

Supp. 3d at 685 (providing procedural history of the case). The plaintiffs then filed an eleven-count amended 

complaint to include additional claims. Id. The court dismissed most of the claims but allowed the claims 

under the ATS and the claims for punitive damages to go forward. Id. The plaintiffs then filed the Second 

Amended Complaint asserting claims under Guatemalan law and Maryland law and seeking to hold liable the 

named defendant organizations. Id. 

 
124 Plaintiffs’ Second Amended Complaint ¶ 1, Estate of Alvarez v. Johns Hopkins Univ., 205 F. Supp. 3d 

681 (D. Md. 2016). Recall, for example, that Dr. Lewis H. Weed of Johns Hopkins University served as the 

Vice-Chairman of the Office of Scientific Research and Development’s Committee on Medical Research, the 

entity that approved the Guatemalan experiments. See supra note 33 and accompanying text. Five additional 

senior physicians “served on the Syphilis Study Section, an advisory panel to the United States Public Health 

Service that authorized and oversaw the Guatemalan experiments.” Estate of Alvarez v. Johns Hopkins Univ., 

275 F. Supp. 3d 670, 680 (D. Md. 2017). Dr. Hugo Muench of the Rockefeller Foundation’s International 

Health Division was part of the Subcommittee on Venereal Diseases of the National Research Council and 

thus contributed to the design of the Guatemalan experiments. See GUTMANN & WAGNER, supra note 28, at 

15 n.72, 121. In addition to Dr. Weed, four additional doctors affiliated with Johns Hopkins were “involved” 

in the Guatemalan experiments: Dr. J. Earle Moore, Dr. Lowell Reed, Dr. Thomas Turner, and Dr. Harry 

Eagle. See Alvarez, 275 F. Supp. 3d at 680. The Third Amended Complaint established that the Rockefeller 

Foundation had “funded and carried out several public health projects throughout Central and Latin 

America,” and Rockefeller employees or board members, including Dr. Thomas Parran, Dr. Frederick Soper, 

and Dr. George Strode “were involved in” the Guatemalan experiments. Id. at 681. For instance, Dr. Parran 

was a member of the Public Health Service and employed as the United States Surgeon General from the 

1930s to 1949. Id. Dr. Soper was the Director of the Pan-American Sanitary Board and assigned as the 

“Responsible Investigator” during the Guatemalan experiments. Id. 

 
125 Plaintiffs’ Second Amended Complaint ¶¶ 6–7, Estate of Alvarez v. Johns Hopkins Univ., 205 F. Supp. 3d 

681 (D. Md. 2016). 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         75 

 

 

 

The Alvarez plaintiffs asserted multiple claims for harms caused by the Guatemalan 

sexually transmitted disease experiments’ use of non-consensual human subjects as well 

as crimes against humanity.126 The plaintiffs requested compensatory and punitive 

damages.127 The court dismissed the plaintiffs’ Second Amended Complaint for failure to 

present adequate factual allegations, failure to plead a claim under the ATS, and failure to 

present allegations on which any of the named defendants could be found liable.128 The 

court did, however, grant the plaintiffs leave to file a Third Amended Complaint and 

provided extensive guidance on what foundational allegations the plaintiffs would need 

to include in order to survive a motion to dismiss.129 Approximately three months later, 

the Alvarez plaintiffs did file a Third Amended Complaint.130 The defendants moved to 

dismiss all claims asserted against them.131 

 

In an opinion more than forty pages long, Judge Marvin J. Garbis addressed every 

aspect of the defendants’ motion to dismiss the plaintiffs’ Third Amended Complaint, 

 
126 Id. 

 
127 Alvarez, 205 F. Supp. 3d at 685 (summarizing twenty counts raised in the Plaintiffs’ Second Amended 

Complaint). 

 
128 Id. (reciting shortcomings of Plaintiffs’ Second Amendment Complaint). 

 
129 Id. at 688–94. 

 
130 Id. at 679. 

 
131 Id. As directed by the court in its dismissal of the Second Amended Complaint to “provide adequate 

foundational allegations for at least one Plaintiff” in six different categories, the Third Amended Complaint 

divided the 842 plaintiffs into six categories. Alvarez, 205 F. Supp. 3d at 679–80. The first category was 

“direct plaintiffs,” namely, Guatemalans who were unknowingly infected with syphilis as part of the 

experiments without their consent. Id. The second category was “spouses,” namely, Guatemalans who did not 

have syphilis before he or she married or had sexual contact with a direct plaintiff, and who was infected with 

syphilis through sexual contact with the direct plaintiff. Id. at 680. The third category was “children,” 

namely, the sons and daughters of a direct plaintiff or of the spouse of a direct plaintiff. Id. The fourth 

category was “grandchildren,” namely, the grandchildren or great-grandchildren of a direct plaintiff. Id. The 

fifth category was “wrongful death plaintiffs” who were either the parent, spouse, or child of a deceased 

plaintiff who died as a result of syphilis acquired as a result of the Guatemalan experiments. Id. The sixth 

category was “estate plaintiffs,” namely, the estates of Guatemalans who died as a result of syphilis acquired 

from the Guatemalan experiments, but who did not have other status in other categories; the claims of all 

“estate plaintiffs” were brought by their heirs, next of kin, or personal representatives. Alvarez, 205 F. Supp. 

3d at 680. Within each category, the Alvarez plaintiffs specified the type of sexually transmitted disease they 

each have, their experience as subjects of the experiments, when they first noticed the symptoms of syphilis, 

when they received a syphilis diagnosis, when they knew the cause of their disease, and the dates of the 

deaths of relevant decedents. Id. 



76 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

granting the motion in part and denying it in part.132 The court permitted the plaintiffs’ 

claims to proceed under the ATS, finding that the Third Amended Complaint was not 

time-barred.133 The Third Amended Complaint also alleged facts adequate to support a 

theory of corporate liability for the acts of defendants’ agents or employees,134 that the 

 
132 Alvarez, 275 F. Supp. 3d. at 711. 

 
133 The defendants argued that claims under the ATS were time-barred by a ten-year statute of limitations that 

ran from the date of the experiments. Id. at 683–87. The court disagreed, finding that “an ATS claim [did] not 

accrue and the limitations period [did] not commence when a plaintiff, through no fault of his or her own, 

[was] unaware of an injury’s existence or factual cause.” Id. at 685. In order to appreciate Judge Garbis’ 

careful opinion, consider his detailed discussion of the statute of limitations issue. The court stated that the 

relevant inquiry was whether a person in a plaintiff’s position would have been able to discover a critical fact. 

Id. The court found that the Alvarez plaintiffs adequately alleged a “plausible contention that they could not 

have discovered the cause of their injuries if they had exercised due diligence.” Id. at 686. The Alvarez 

plaintiffs had alluded to the fact that the Guatemalan experiment researchers targeted the test subjects of the 

experiments because they were poor and uneducated, likely unable to know what was happening to them. Id. 

In the court’s view, even when plaintiffs had consulted with a doctor about their condition, it is plausible that 

they would not have been able to trace the origin of their infections to the Guatemalan experiments. Alvarez, 

275 F. Supp. 3d at 686. Second, the spouses of nonconsenting human subjects of the experiments would not 

have known the “critical fact” that the experiments were the cause of their spouses’ syphilis. Id. Therefore, 

the court reasoned, “the limitations period did not commence until they discovered the cause of their 

injuries”—i.e., the infection of syphilis by the researchers. Id. 

 
134 For the corporate liability argument, the Alvarez plaintiffs alleged that the defendants could be held 

vicariously liable for the acts taken by the primary perpetrators, or that the defendants aided and abetted or 

conspired with the primary perpetrators in experimenting on non-consenting human subjects. 275 F. Supp. 3d 

at 687. The court had to determine the correct standard for corporate liability under the ATS and whether the 

individuals involved in the Guatemalan experiments were acting within the scope of their employment or 

were agents of the defendants between 1946 and the early 1950s. Looking to the Ninth Circuit’s analysis on 

the standard for corporate liability under the ATS, the court looked to federal common law and domestic tort 

law for guidance on the correct standard. Id. at 689. Federal courts have considered “general agency 

principles, elements of control, and knowledge by a corporation’s executives or managers” when dealing with 

ATS claims against corporate defendants. Id. at 690. 

 

Following this guidance, the court relied on Doe v. Exxon Mobil Corp., 654 F.3d 11 (D.C. Cir. 2011), 

vacated, 527 F. App’x 7 (D.C. Cir. 2013), a federal case in which the United States District Court for the 

District of Columbia held that the plaintiffs had sufficiently stated a claim of aiding and abetting a violation 

of the law of nations under the ATS. In this case, the plaintiffs alleged that the corporate defendants’ 

facilities, supplies, and vehicles were used to commit human rights abuses; that the corporate executives had 

received reports that their employees were committing human rights violations on their property; and that the 

corporate executives planned and approved the catalyst for the human rights violations. Id.; Alvarez, 275 F. 

Supp. 3d at 691. In the Alvarez case, Judge Garbis reasoned that the complaint adequately alleged a plausible 

contention that the defendants’ doctors and officers were “decisionmakers who engaged in a multi-year 

practice of wrongdoing.” 275 F. Supp. 3d at 693. In particular, the actions of the primary perpetrators were 

“known, directed, and encouraged” by high-ranking individuals with decision-making authority in Johns 

Hopkins, the Rockefeller Foundation, and Bristol-Myers Squibb. Id. at 692. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         77 

 

 

 

defendants aided and abetted violations of international law (and conspired to do so), and 

to extend possible standing under the ATS to children and descendants of victims of the 

Guatemalan sexually transmitted disease experiments—even if not conceived at the time 

of the experiments—if the injuries to the children and descendants were foreseeable and 

expected.135 The court dismissed the Alvarez plaintiffs’ Guatemalan law claims on the 

grounds that Guatemala’s 1933 Civil Code did not provide for vicarious liability for 

employers in scenarios like the one presented in this case.136 

 

The day after the court’s decision, the press reported that a judge had ruled that the 

claims of the Guatemalan plaintiffs could go forward.137 As the Alvarez suit continued to 

progress, the Supreme Court of the United States issued a significant decision under the 

ATS. In Jesner v. Arab Bank, PLC, the Court ruled that the ATS does not subject foreign 

corporations to suits brought in United States courts for alleged human rights 

violations.138 Even though the defendants in the Alvarez case—the Rockefeller 

Foundation, Bristol-Myers Squibb Company, and the variety of institutions affiliated with 

Johns Hopkins University—acknowledged that Jesner’s holding was limited to foreign 

corporations, the defendants nevertheless moved for a Judgment on the Pleadings, 

arguing that the ATS does not permit claims against a corporation.139 That motion was 

denied.140 

 

One month later, the defendants moved to have certified for appeal that decision of 

the United States District Court of the District of Maryland.141 The Fourth Circuit granted 

 
135 Alvarez, 275 F. Supp. 3d at 705–06. 

 
136 Id. at 709. 

 
137 See Colin Campbell, Judge Allows $1 Billion ‘Guatemala Experiment’ Suit Against Hopkins and Others to 

Move Forward, BALTIMORE SUN (Aug. 31, 2017), https://www.baltimoresun.com/health/ bs-md-hopkins-

guatemala-suit-20170831-story.html [https://perma.cc/STS3-XNM5]. 

 
138 Jesner v. Arab Bank, PLC, 138 S. Ct. 1386, 1403 (2018) (“[A]bsent further action from Congress it would 

be inappropriate for courts to extend ATS liability to foreign corporations.”). 

 
139 Estate of Alvarez v. Johns Hopkins Univ., 373 F. Supp. 3d 639, 646 (2019). 

 
140 Id.; see also Rafael Azul, US Federal Judge Allows Lawsuit Over Illegal Experimentation On Guatemalan 

Subjects, WORLD SOCIALIST WEB SITE (Jan 21, 2019), https://www.wsws.org/en/articles/ 2019/01/21/guat-

j21.html?view=print [https://perma.cc/K5KV-QPZ2]. 

 
141 See Estate of Alvarez v. Johns Hopkins Univ., No. CV TDC-15-0950, 2019 WL 1779339 (D. Md., Apr. 

23, 2019) (describing defendants’ interlocutory appeal). The corporate defendants are represented by major 

law firms including DLA Piper US LLP, Hogan Lovells US LLP, King and Spalding LLP, and Patterson 



78 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

that motion, in light of a conflict between the United States Courts of Appeals on the 

question of whether the ATS allows for corporate liability.142 If the Fourth Circuit 

reverses the District Court’s decision, the case will almost certainly be dismissed. In the 

meantime, the Alvarez case continues to proceed toward trial.143 The Alvarez plaintiffs 

continue to hope for redress for their injuries. 

 

C.   Petition on Behalf of Oficina de Derechos Humanos del Arzobispado de 

Guatemala v. Guatemala and the United States of America 

 

In December 2015, the Office of Human Rights for the Archdiocese of Guatemala, 

acting on behalf of the victims of the Guatemalan sexually transmitted disease 

experiments, filed a petition with the Inter-American Commission on Human Rights 

(IACHR), a body within the Organization of American States.144 The UC Irvine School 

of Law International Human Rights Clinic and the City Project of Los Angeles serve as 

counsel for the petitioner, which is one of Guatemala’s leading non-governmental human 

 
Belknap Webb and Tyler LLP. Id. (listing DLA Piper US LLP and Hogan Lovells US LLP, Baltimore, MD, 

as among the counsel for The Johns Hopkins University, The Johns Hopkins University School of Medicine, 

The Johns Hopkins Hospital, The Johns Hopkins Bloomberg School of Public Health, and The Johns 

Hopkins Health Systems Corporation; DLA Piper US LLP and Patterson Belknap Webb and Tyler LLP, New 

York, NY, among the counsel for The Rockefeller Foundation; and DLA Piper US LLP and King and 

Spalding LLP among the counsel for the Bristol-Myers Squibb Company). 

 
142 Id. 

 
143 The most recent filing in the case is a request by the defendants for the imposition of sanctions on all 

plaintiffs’ counsel for alleged abuse of the litigation process, namely, presenting “manufactured evidence, 

false sworn statements, and unsupportable allegations that even a cursory investigation would have shown,” 

and exhibiting “bad faith and vexatious conduct.” Alvarez v. Johns Hopkins Univ., No. CV TDC-15-950, 

2019 WL 4038562 at *1, *9 (D. Md. Aug. 27, 2019) (summarizing substantive content of the Defendants’ 

Motion for Discovery and Sanctions). If the allegations in that motion are true, then the named plaintiffs in 

the case may not, in fact, have had any connection to the Guatemalan sexually transmitted disease 

experiments. See id. at *2. In August 2019, Chief United States Magistrate Judge Beth P. Gesner denied the 

defendants’ motion, finding that the defendants had not met the requisite burden of proof. Id. Yet even if the 

behavior of plaintiffs’ counsel as alleged in the defendants’ motion did not rise to the level of meriting 

sanctions, the glimpse the motion provides into the pre-trial discovery process suggests that this will be a 

highly disputed case. 

 
144 Petition, Oficina de Derechos Humanos del Arzobispado de Guat. v. Guat. and the U.S., Inter-Am. 

Comm’n H.R. (2015), https://www.law.uci.edu/academics/real-life-learning/clinics/IHRC-GuatemalaPetition. 

pdf [https://perma.cc/D6V5-RE8F] [hereinafter Petition]; see also Press Release, The City Project, Overdue 

Justice for Guatemalan Victims of Venereal Disease Experiments (Dec. 14, 2015), http://www.law.uci.edu/ 

news/press-releases/IHRC-GuatemalaHumanRights-121415.pdf [https:/perma.cc/TV63-YD7A] [hereinafter 

Press Release, Overdue Justice]. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         79 

 

 

 

rights organizations.145 The petition seeks a declaration that the non-consensual human 

experimentation conducted by Dr. Cutler and others violated customary international law 

and a variety of international agreements.146 Specifically, the petition urges findings of 

“violations of the rights to life, health, freedom from torture and crimes against humanity 

under the American Declaration of the Rights and Duty of Man147 and the American 

Convention on Human Rights.”148 Both the United States and Guatemala are signatories 

to the American Declaration; Guatemala (but not the United States) is a signatory to the 

American Convention.149 The purpose of the petition is to establish “truth and justice for 

the Guatemalan victims’ families of these experiments through comprehensive and 

dignified reparations.”150 The petition reveals the agonizing suffering of the direct victims 

of the Guatemala experiments, as well as the devastating physical consequences and 

psychological effects on their children and grandchildren, some of whom have suffered 

from blindness, paralysis, and still-births.151 

 

 
145 Id. The authors have attempted on multiple occasions (most recently in March 2019) to contact counsel for 

an update on the case. To date, the authors have not received any response to their inquiries. See, e.g., E-mail 

from Bridget Crawford to Catherine Sweetser (May 31, 2017) (on file with author). 

 
146 Id. 

 
147 The petition alleges that the United States and Guatemala violated the Declaration’s Article I (right to life, 

liberty, and personal security), Article VI (right to a family and to protection thereof), and Article XI (right to 

preservation of health and to well-being). Id. 

 
148 The petition alleges that Guatemala violated the American Convention’s Articles 1 (right to “free and full 

exercise of . . . rights and freedoms, without any discrimination for reasons of race, color, sex, language, 

religion, political or other opinion, national or social origin, economic status, birth, or any other social 

condition”); 4 (“Every person has the right to have his life respected.”); 5 (“Every person has the right to 

have his physical, mental, and moral integrity respected.”); 11 (“Everyone has the right to have his honor 

respected and his dignity recognized.”); and 17 (“The family is the natural and fundamental group unit of 

society and is entitled to protection by society and the state.”). Organization of American States, American 

Convention on Human Rights arts. 1, 4, 5, 11, Nov. 22, 1969, O.A.S.T.S. No. 36, 1144 U.N.T.S. 123. 

 
149 See American Declaration of the Rights and Duties of Man, Inter-Am. Comm’n H.R., O.A.S. Off. Rec. 

OEA/Ser. LV/I.4 Rev. (1965), https://www.cidh.oas.org/Basicos/English/Basic2.american%20 

Declaration.htm [https://perma.cc/Z3ZD-XZ3G]; Organization of American States, American Convention on 

Human Rights, supra note 148 (showing that Guatemala ratified the Convention in 1978 and the United 

States signed the Convention in 1977, but it has not been ratified by the United States Congress). 

 
150 Press Release, Overdue Justice, supra note 144. 

 
151 Id. 



80 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

The petition filed with the IACHR includes facts similar to those contained in the 

pleadings in Garcia and Alvarez.152 The human rights petition focuses on both countries 

knowingly endorsing and conducting non-consensual medical experimentation on 

humans from the most vulnerable populations in Guatemala, on account of the victims’ 

poverty and lack of education.153 The petition attempts to emphasize the victims’ personal 

stories. It tells the story of Celso Ramirez Reyes, for example, who served in 

Guatemala’s “Guardia de Honor” from 1948 to 1950; he was injected with sexually 

transmitted diseases by United States scientists over a six-month period.154 As a 

consequence, Mr. Reyes experienced sores, poor vision, gonorrhea, and extreme 

lethargy.155 His untreated disease caused his daughter to be born with poor vision; she 

went completely blind at age fifteen.156 Mr. Reyes’ granddaughter suffers from canker 

sores on her head and related hair loss.157 The petition also tells the stories of multiple 

untreated mothers whose children were born blind or paralyzed, or both; mothers who 

had still-births; and mothers who gave birth to dangerously low-weight and premature 

babies.158 The widespread prevalence of symptoms associated with syphilis and 

gonorrhea among the descendants of the victims of the study reveal the magnitude of 

ongoing suffering caused by Dr. Cutler’s experiments.159 

 

Because filings in the IACHR are not public, it is difficult to discern the status of this 

case. It is not clear whether the petition has been admitted by the Commission and, if so, 

whether the Commission is preparing a report. Given that the Garcia v. Sebelius court has 

left the victims without a remedy against the United States government, this petition 

before the IACHR may be the only way to hold the governments of the United States and 

Guatemala accountable in the international community.160  

 
152 See supra Parts II.A. and II.B. 

 
153 Petition, supra note 144, at 3. 

 
154 Id. at 11; Garcia, 867 F. Supp. 2d at 125. 

 
155 Petition, supra note 144, at 11. 

 
156 Id. 

  
157 Id. 

 
158 Id. at 10. 

  
159 Id. at 11. 

 
160 See supra Part II.A. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         81 

 

 

 

III. Identity, Law, and Politics in the Guatemalan Sexually Transmitted Disease 

Experiments  

 

The primary purpose of the United States government’s non-consensual human 

experiments in Tuskegee,161 Terre Haute,162 and Guatemala163 was to better understand 

sexually transmitted diseases because of the underlying threat those diseases posed to the 

American public generally and the country’s military readiness in particular.164 One 

might think, then, that researchers would choose to conduct their experiments on United 

States military personnel. Instead, researchers in Guatemala intentionally infected both 

men and women in a country that was geographically distant from the United States, 

where the laws allowed women to be used as human vectors for the disease, where the 

government was cooperative, and where the human research subjects were racially and 

linguistically different from most Americans. Combined, these factors contributed to the 

decades-long secrecy about the activities of United States researchers in Guatemala in the 

1940s. 

 

A. Gender Matters: Women as Subjects and Principals in Non-consensual 

Experimentation 

 

1. Women as Subjects 

 

The Tuskegee experiments—initially called “The Tuskegee Study of Untreated 

Syphilis in the Male Negro”165—famously followed the progression of untreated syphilis 

in black men,166 without regard for the impact of any transmitted syphilis on the men’s  

 
161 See supra note 3 and accompanying text (linking to materials explaining the Tuskegee experiments). 

 
162 See supra notes 33–40 and accompanying text (describing experiments in federal prison in Terre Haute, 

Indiana). 

 
163 See supra Part I.B. (discussing Guatemalan sexually transmitted disease experiments). 

 
164 See GUTMANN & WAGNER, supra note 28, at 12–13 (describing creation by President Franklin D. 

Roosevelt of the federal Office of Scientific Research and Development as providing “STD researchers an 

unprecedented opportunity to mobilize federal funds to mitigate these threats” to military readiness). 

 
165 R.A. Vonderlehr et al., Untreated Syphilis in the Male Negro: A Comparative Study of Treated and 

Untreated Cases, 107 JAMA 856 (1936). This was the first published study to come out of the Tuskegee 

experiments. 

 
166 See Timeline, supra note 5 and accompanying text (providing overview of Tuskegee experiments). 



82 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

sexual partners.167 The fact that the experiment had a direct effect on the men’s sexual 

partners, most of whom were women, has not been part of most accounts of the atrocities 

of that study.168 Similarly, governmental researchers conducted the Terre Haute 

experiments in an all-male prison, where 241 prisoners participated as “volunteers” who 

agreed to be exposed to the gonorrhea bacteria; the men received $100 in cash and a 

promise that the parole board would likely take their participation in the study into 

account when they were eligible for parole.169 No account of the Terre Haute study 

includes the number or names of the local women, some of whom were sex workers, 

from whom the researchers took vaginal swabs in order to study a variety of strains of 

gonorrhea they may have had.170 Nor is there any account of any impact the gonorrhea 

studies had on the partners of the male participants in the study who perhaps did not 

respond to medication and then transmitted infections to their sexual partners after their 

release from prison.171 Women are largely absent from the narrative, except as unnamed 

and uncounted sources of additional specimens. 

 

In its report on the Guatemalan sexually transmitted disease experiments, the 

Presidential Commission for the Study of Bioethics reported that there were 5,540 human 

subjects, but did not further break down the subjects by gender.172 It is not possible to 

know for certain whether men or women comprised the majority of the study’s subjects. 

They were classified as commercial sex workers (fourteen, all female), soldiers (1,017, 

 
167 For a powerful discussion of the impact of the Tuskegee studies on women, who were not the direct 

subjects of the experiments, see DELESO A. ALFORD, TUSKEGEE’S FORGOTTEN WOMEN: THE UNTOLD SIDE OF 

THE U.S. PUBLIC HEALTH SERVICE SYPHILIS STUDY (2020). See also TUSKEGEE’S FORGOTTEN WOMEN, 

https://www.abc-clio.com/ABC-CLIOCorporate/product.aspx?pc=A5354C [https://perma.cc/BM5E-XYKF] 

(promoting Alford’s book as acknowledging “the importance of women’s voices, and especially black 

women’s voices, in history” and drawing attention to the historic inattention paid to the impact of the 

Tuskegee studies on women). 

 
168 See Deleso A. Alford, Examining the Stick of Accreditation for Medical Schools Through a Reproductive 

Justice Lens: A Transformative Remedy for Teaching the Tuskegee Study, 26 J.C.R. & ECON. DEV. 153, 154 

(2011) (“[The] omission of Black women in the legal, medical, and historical narratives of the Tuskegee 

Study illustrates the marginalization of Black women in medical research and education.”). 

 
169 GUTMANN & WAGNER, supra note 28, at 18 (describing incentives for Terre Haute prisoners to participate 

in the study). 

 
170 See, e.g., id. at 21 (mentioning samples taken from local sex workers). 

 
171 See, e.g., id. at 21–23 (failing to discuss the impact of untreated disease on post-prison transmission by 

prisoner participants in the Terre Haute study). 

 
172 Id. at 188 (“Table 4: Subject and Population Specific Data”). 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         83 

 

 

 

all male), prisoners (976, all male), orphans and school children (1,384, sex unspecified), 

patients seeking treatment for specific blood-related illnesses (fifty-one, sex unspecified), 

psychiatric patients (716, sex unspecified), United States soldiers in Guatemala (twenty-

three, all male), and other “unspecified” subjects (sex not reported).173 The records of Dr. 

Cutler which were maintained by the National Archives include a list of “Female Insane 

Asylum Patients” (with names redacted).174 The “Prison and Insane Asylum Photographs 

to Accompany Final Report” include images of female subjects.175 Thus, unlike in the 

Tuskegee or Terre Haute experiments, it is certain that women were included in the 

Guatemalan study as formal human subjects. They also were used as key disease 

“vectors”—instruments of sorts—in the study. Commercial sex workers were paid to 

have sexual intercourse with prisoners (during one phase of the study) and soldiers 

(during another phase of the study).176 The researchers did not inform the soldiers that 

they were part of a research study; the scientists supplied the soldiers with alcohol and 

sex workers infected with sexually transmitted diseases.177 

 

2. Women as Researchers 

 

In terms of the researchers involved in the Tuskegee, Terre Haute, and Guatemalan 

experiments, it is well documented that the projects’ medical personnel overlapped to a 

large extent.178 One detail from the report of the Presidential Commission for the Study of 

Bioethics is that of the twenty-six named individuals who were directly “involved” in the 

 
173 Id. 

 
174 FOLDER 18 - LIST OF FEMALE INSANE ASYLUM PATIENTS, https://nara-media-001.s3.amazonaws.com/ 

arcmedia/research/health/cdc-cutler-records/folder-18-female-patients.pdf [https://perma.cc/923H-XMHU]. 

 
175 PHOTOGRAPHS, supra note 80. 

 
176 See supra notes 70–74; see also GUTMANN & WAGNER, supra note 28, at 48 (describing how commercial 

sex workers were instructed to have intercourse with men multiple times a day or within short time periods, 

and reporting on one specific instance in which a commercial sex worker engaged in intercourse with eight 

different soldiers during a single seventy-one-minute time period). 

 
177 See Subramanian, supra note 6 (“Army men were often lubricated with alcohol, too, before being set up 

with the prostitutes . . . The soldiers were never informed that this was part of a medical experiment, 

obliterating any possibility that consent was obtained and making the experiments ethically unsound.”). 

 
178 See supra note 4 and accompanying text (reporting Dr. Cutler’s participation in Tuskegee experiments and 

Guatemalan experiments); GUTMANN & WAGNER, supra note 28, at 13–14 (noting participation of Dr. Cutler 

and others in Terre Haute experiments and noting many of the same personnel participated in the Guatemalan 

experiments). 



84 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

Guatemalan experiments, three were women.179 The three women were employed by the 

United States Public Health Service as either serologists or bacteriologists.180 In the case 

of the Guatemalan experiments, women were both part of the group of scientists 

implementing non-consensual experimentation and among the subjects studied. To be 

sure, the experiments were designed and approved by male military and scientific 

leaders.181 But it would be inaccurate to characterize the Guatemalan experiments in 

simplistic gender terms—i.e., male scientists doing harm to both male and female human 

subjects. Instead, both male and female scientists actively participated in this non-

consensual research. Thus, the history is not a simple story of men-as-perpetrators and 

women-as-victims. Rather, the Guatemalan sexually transmitted disease experiments 

invite consideration of the way that female scientists (representing three out of the 

twenty-six individuals named in the report of the Presidential Commission) participated 

in dehumanizing harm inflicted on other women. 

 

In evaluating the harmful effects of the Guatemalan experiments, it is important to 

recognize that the victims of the study go well beyond the human subjects themselves, as 

Deleso Alford has done in her study of the impact of the Tuskegee experiments on the 

female partners of the men who were infected with syphilis.182 In Guatemala, both 

women and men were infected with sexually transmitted diseases, and any infected 

human subject also risked exposing his or her sexual partners to the disease and 

transmitting disease to future generations.183 The circle of people harmed by the 

Guatemalan sexually transmitted disease experiments extends well beyond the subjects 

themselves. 

 

 

 

 

 
179 GUTMANN & WAGNER, supra note 28, at 112–15 (“Table 2: Individuals Involved in the STD Experiments 

in Guatemala”). 

 
180 Id. (listing among participants bacteriologist Virginia Lee Harding, serologist Genevieve Stout, and 

bacteriologist Alice Walker). 

 
181 See supra Part I.B. 

 
182 See Alford, supra note 168 (discussing importance of women’s role in the Tuskegee experiments, even 

though they were not technically the subject of the study). 

 
183 See, e.g., Meghan O’Connor et al., Syphilis in Pregnancy, 53 J. MIDWIFERY & WOMEN’S HEALTH e17, e19 

(2011) (reporting that women infected with syphilis can transmit the disease to a gestating fetus or to the 

infant through the birth canal at childbirth). 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         85 

 

 

 

B. Law Matters: Legally Permitted Commercial Sex Work in Guatemala  

 

The selection of Guatemala as the site for Dr. Cutler’s experiments after the 

conclusion of the Terre Haute experiments was no coincidence. The formal law of 

Guatemala permitted researchers to do what they could not in the United States—use 

intentionally infected commercial sex workers to spread sexually transmitted diseases to 

uninformed human subjects.184 Indeed, in correspondence with Dr. John F. Mahony of 

the National Research Council’s Subcommittee on Venereal Diseases, Dr. Cutler reported 

that he and his colleagues working in Guatemala believed that they “should do all 

possible to keep knowledge of our project restricted,” because it was becoming the 

subject of gossip and rumors.185 Mahoney replied that in the United States, the scientists 

on the National Research Council were “doing [the] utmost . . . to restrict our own 

conversations and those of others bearing upon the matter,” because Mahoney had 

become “aware of considerable conversation and discussion . . . being carried out in 

rather high places, much of which has not helped the work greatly.”186 The non-

consensual human experiments were facilitated by favorable laws. 

 

C. Politics Matter: Government Cooperation Facilitated by Financial Aid 

 

Another factor that likely informed the selection of Guatemala as the location for the 

sexually transmitted disease experiments was the predisposition of that country’s 

leadership to be friendly to the United States, for reasons that no doubt included the vast 

amounts of financial aid the United States was supplying to Guatemala.187 Not through 

physical colonization, but through political and financial interventions, the United States 

was able to develop a certain degree of dominance over Guatemala. The colonial-like 

relationship essentially meant that Dr. Cutler and his team were free to conduct their 

experiments without the Guatemalan government’s intervention—and indeed with the 

government’s active cooperation. 

 

 

 
184 See supra notes 70–74 and accompanying text. 

 
185 GUTMANN & WAGNER, supra note 28, at 78 (quoting letter of John C. Cutler to John Mahoney on June 22, 

1947). 

 
186 Id. (quoting letter of John Mahoney to John C. Cutler on June 30, 1947). 

 
187 See supra Part I.A.; see also Eric Helleiner, Central Bankers as Good Neighbours: US Money Doctors in 

Latin America During the 1940s, 16 FIN. HIST. REV. 5 (2009) (describing financial interventions of the 

United States in Latin America during this period). 



86 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

D. Geography Matters: Doing Harm Far Away 

 

News of the experiments was able to be contained because of Guatemala’s physical 

distance from the United States. In an era when long-distance travel and communications 

were uncommon, it was highly unlikely that any person from the United States would 

simply “happen” upon the Guatemalan experiments. The physical distance of the 

experiments from the continental United States facilitated these unethical experiments. 

 

E. Race Matters: Othering Human Subjects 

 

The colonialist mindset also helps illuminate race as a factor in the Guatemalan 

experiments. Dr. Cutler himself was highly race-conscious. He conducted serology on 

children he explicitly labeled as “Ladino” (441 children) and “Indian” (277 children).188 

Dr. Cutler’s final report speculated that Guatemala’s population was “85% Indian . . . 

[M]any of our patients had the classic, pure Indian features indicating little or no mixture 

[with other races].”189 A colleague of Dr. Cutler, Dr. Joseph Spoto, advised that 

researchers did not have to explain the experiments to any “Indians” in the prisons, 

because “they are only confused by explanations and knowing what is happening.”190 

Like many of his contemporaries, Dr. Cutler suspected that the symptoms and progress of 

a disease depended on the race of the infected person, but his own research failed to 

provide that Guatemalan “Indians” were immune to syphilis.191 At no point did the 

researchers consider how poverty, lack of geographic or social mobility, or gender might 

impact the spread or manifestation of the diseases with which they intentionally infected 

human beings. The researchers were eager to determine whether their subjects were (or 

were not) “Indians,” but otherwise did not appear to take into account the subjects’ 

personal characteristics or actual lives. The fact that the human subjects did not speak 

much or any English also meant that they would not be able to communicate easily with 

the American press, a fact that has otherwise escaped mention in other critiques of the 

Guatemalan sexually transmitted disease experiments.192 

 
188 GUTMANN & WAGNER, supra note 28, at 118 (“Table 4: Subject and Population Specific Data”). 

 
189 JOHN C. CUTLER, FINAL SYPHILIS REPORT (1955) (on file with PCSBI HSPI Archives). 

 
190 Letter from John C. Cutler to Richard Arnold (Apr. 10, 1947) (on file with the National Archives) 

(recounting advice of Dr. Spoto). 

 
191 GUTMANN & WAGNER, supra note 28, at 74. 

 
192 See, e.g., Rodriguez & Garcia, supra note 99 (lacking any mention of linguistic difference between 

researchers and human subjects). 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         87 

 

 

 

IV. Medical Experimentation, Reproductive Justice, and Restorative Justice 

 

Through a reproductive justice framework, it is possible to better understand the 

magnitude of harms suffered by the victims of the non-consensual human 

experimentation in Guatemala. Reproductive justice, as opposed to reproductive rights, is 

a movement grounded in the experience of women of color and the product of their 

organizing on their own behalf.193 Reproductive justice “is about shifting resources—in 

addition to extending rights—to those who lack the information and means to achieve 

self-determination in reproduction.”194 By intentionally infecting people with sexually 

transmitted diseases and then not treating them, the United States government-sponsored 

researchers denied their subjects self-determination. That is, if an individual were never 

informed that she (or her partner) had been infected with syphilis, she would not have 

been able to make a fully informed decision about whether to become pregnant and risk 

the possibility of giving birth to a child with severe congenital abnormalities. The 

reproductive choices were similarly limited for a woman who knew that she had syphilis 

but had no means of obtaining adequate medical treatment. Through litigation, the 

survivors and families of the non-consensual human research subjects are attempting to 

achieve not only compensation for pain and suffering, but redress for denied reproductive 

justice. 

 

The next question is whether justice remains elusive if the litigation fails. The answer 

is that the litigation, even if unsuccessful, plays a role in a restorative justice project. 

Restorative justice—in contrast with a retributivist justice195—seeks to repair harm that 

has been done.196 Carrie Menkel-Meadow has explained, “there are four Rs of restorative 

justice: repair, restore, reconcile, and reintegrate the offenders and victims to each other 

and to their shared community.”197 Practically speaking, litigation in United States courts 

is one venue for the victims of the Guatemalan sexually transmitted disease experiments 

to share what happened. But litigation, whether successful or not, is not enough. The 

 
193 See, e.g., JAEL SILLIMAN ET AL., UNDIVIDED RIGHTS, WOMEN OF COLOR ORGANIZE FOR REPRODUCTIVE 

JUSTICE 35–236 (2004). 

 
194 Sarah London, Reproductive Justice: Developing a Lawyering Model, 13 BERKELEY J. AFR.-AM. L. & 

POL’Y 71, 72 (2011). 

 
195 See, e.g., Alana Saulnier & Diane Sivasubramaniam, Restorative Justice: Underlying Mechanisms and 

Future Directions, 18 NEW CRIM. L. REV. 510, 512 (2015). 

 
196 Carrie Menkel-Meadow, Restorative Justice: What Is It and Does It Work?, 3 ANN. REV. L. & SOC. SCI. 

161, 162 (2007). 

 
197 Id. 



88 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

United States government should hold public hearings and invite the victims and their 

descendants to testify as to what happened and what effects the experiments have had on 

them. Historians and ethics experts should be called to explain what is known about the 

Guatemalan experiments and how the research should be understood by reference to the 

scientific and ethical norms in the 1940s. Bringing greater public awareness to the non-

consensual experiments in Guatemala is a necessary first step.  

 

After victims have been able to share what happened to them, the restorative justice 

project continues to the next step: “[T]he perpetrator must both acknowledge that 

experience and atone for it.”198 Upon learning about the Guatemalan sexually transmitted 

disease experiments, United States government officials publicly apologized for the 

“reprehensible research” that took place “under the guise of public health.”199 The 

Director of the National Institutes of Health said that he found it “very difficult as a 

physician-researcher today [to imagine] that the participants in [these experiments] could 

have considered them ethical.”200 During the Garcia litigation, the United States 

government announced some funding for research and monitoring, but did not offer 

direct payments to the Guatemalan victims or their families.201 In the case of the 

Tuskegee Syphilis Experiments, government officials entered into an informal $10 

million settlement to provide lifetime medical benefits for the Tuskegee human subjects, 

their spouses, surviving spouses, and descendants.202 The United States government, the 

Guatemalan government, and the corporate interests that profited from the sexually 

transmitted disease experiments should contribute to a fund that will provide the same for 

the Guatemalan victims. 

 

One of the goals of the pending litigation brought by the Guatemalan victims is to 

hold financially accountable the organizations or companies whose agents or officers 

 
198 Abigail Perkiss, Public Accountability and the Tuskegee Syphilis Experiments: A Restorative Justice 

Approach, 10 BERKELEY J. AFR.-AM. L & POL’Y 70, 86 (2008). 

 
199 See Scott Hensley, U.S. Apologizes for Syphilis Experiments in Guatemala, NPR (Oct. 1, 2010), 

https://www.npr.org/sections/health-shots/2010/10/01/130266301/u-s-apologizes-for-medical-research-that-

infected-guatemalans-with-syphilis [https://perma.cc/ZG6S-UAVM] (quoting a statement of Secretary of 

State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius now unavailable on 

official government websites). 

 
200 Id. (quoting a statement of NIH Director Dr. Francis Collins). 

 
201 See supra Part II.A. 

 
202 See Timeline, supra note 5. 



 

39.2 COLUMBIA JOURNAL OF GENDER AND LAW                         89 

 

 

 

were directly responsible for the Guatemalan experiments.203 Victory in litigation 

undoubtedly would increase the financial resources available for those denied self-

determination in reproductive matters. When a woman’s child is born with congenital 

injuries, she suffers again if she lacks financial or practical resources to address the 

child’s special needs.204 If the ligitation is unsuccessful, the United States government, 

Guatemalan government, and the corporate interests that benefited from the Guatemalan 

experiments should make voluntary payments to provide health care for all victims and 

their descendants.  

 

Even if their voices are heard and resources are made available to them, restorative 

justice will not be achieved unless the governments of the United States and Guatemala 

make an effort to rebuild trust with the Guatemalan people. As one researcher has said of 

the Tuskegee Syphilis Experiments, one of the project’s greatest legacies is a “loss of 

faith within the African-American community toward the federal government.”205 To 

regain the faith of the Guatemalan people, it is necessary to not only acknowledge their 

suffering and provide financial reparations, but also take clear steps to make sure that 

such non-consensual human experimentation never happens again. The racial, 

socioeconomic, gender, geopolitical, and geographical features that permitted such 

violative medical experimentation to occur still exist. Preventing such experimentation in 

the future will require affirmative steps such as requiring community members to review 

and approve any experimentation before volunteers from vulnerable populations are 

sought. The people who are the intended subjects of any study should have an ex ante 

role in deciding whether to permit such study to go forward. 

 

CONCLUSION 

 

It is difficult to predict whether the victims of the Guatemalan experiments will 

achieve vindication in a court of law or before an international human rights organization. 

Access to excellent lawyers (who are willing to work for low or no fees) likely will be an 

important factor in litigation. The plaintiffs in the Alvarez case will need to present 

evidence that proves clearly that a particular victim suffered on account of the 

defendants’ actions.206 The plaintiffs also can benefit from increased public attention to 

their case. Public opinion may inform the determination of a human rights tribunal to 

 
203 See supra notes 118–16 and accompanying text. 

 
204 See, e.g., supra note 94 and accompanying text. 

 
205 Perkiss, supra note 198, at 88. 

 
206 See supra Part II.B. 



90 COLUMBIA JOURNAL OF GENDER AND LAW 39.2  

issue a report in the victims’ case. What the victims seek and deserve is for the truth to be 

known, and to receive “treatment, compensation[,] and restorative justice.”207

 
207 Press Release, Overdue Justice, supra note 144.