People detained at a jail in northwestern Arkansas recently reported that the facility’s medical professionals deceived them into taking ivermectin — a drug being touted by Republican lawmakers, talk show hosts and a small number of doctors and patient advocates for treating covid-19 — although the Food and Drug Administration has not approved the drug for this purpose.

Ivermectin can be toxic for humans and can cause vomiting, coma, seizures and even death. The jail’s doctor, Rob Karas, advocated ivermectin use on Facebook and claimed that 350 people detained at the jail voluntarily took the drug. However, Karas and nurses allegedly told inmates they were taking vitamins. Learning about Karas’s treatments through a news report, however, one man responded: “It was not consensual. They used us as an experiment, like we’re livestock.”

This incident recalls a period in the 20th century when doctors working in Guatemala for the Pan American Sanitary Bureau infected almost 1,500 marginalized Guatemalans, including Indigenous and poor people, prisoners, soldiers, women and the disabled with syphilis, gonorrhea and chancroid without their consent to study whether penicillin and other drugs prevented the spread of sexually transmitted infections. It reminds us how nonconsensual research and the experimental use of drugs on vulnerable people remain common — despite evidence of its danger and laws designed to prevent it.

In the late 1940s, 23 Nazi doctors and scientists stood trial before an American military tribunal in Nuremberg, Germany, for deadly experiments that they performed on people in concentration camps. In the end, seven were sentenced to death and many others received long prison sentences. And yet, during the trial, German doctors accused U.S. researchers of conducting similar nontherapeutic experiments on prisoners during World War II. The German doctors’ efforts to deflect blame were ignored, but they weren’t incorrect. At the time of the trial, U.S. and Guatemalan doctors were inserting syphilis into Guatemalan people’s eyes and abrading men’s penises.

The convictions paved the way for the Nuremberg Code, which established the ethical imperative for researchers to obtain informed consent from their subjects. Still, they caused little soul searching among American researchers. Years after the end of the infamous 40-year (1932-1972) U.S. Public Health Service study in Tuskegee, Ala. — in which researchers withheld treatment for syphilis in African Americans — PHS doctor John Heller balked at the question of whether the Nuremberg Code had inspired the U.S. group to reflect on its own research. “But they were Nazis,” Heller said.

While dismissing the idea that the Nuremberg Code should apply to them, U.S. researchers still made an effort to hide research that they knew was ethically questionable. As historian Susan Lederer has shown in her study of medical ethics, “at no time were American investigators free to do whatever they pleased with their human subjects.” In 1947, U.S. researchers shared among themselves a New York Times article that said, “shooting living syphilis germs” into humans, as researchers had tried in rabbits, would be “ethically impossible.”