Which of the following unethical healthcare actions has not occurred in the United States?

• A. Made millions from a woman's cancer cells without telling the family
• B. Failed to treat men infected with syphilis
• C. Forced or paid women to undergo sterilization
• D. Sold outdated formula to poor communities instead of breastfeeding

Answer: (D)

A key idea is that unethical actions in health care can harm people in different ways—through exploitation in research, coercive treatment practices, or manipulative marketing that preys on vulnerable populations. The first three scenarios are well-documented in U.S. history: exploiting a patient's biological materials without consent, withholding treatment in a major study, and forcibly or coercively sterilizing individuals. The statement about selling outdated formula to poor communities is a type of unethical marketing that became notorious in international contexts, especially tied to campaigns in developing countries, not as a clearly documented practice inside the United States. Because this particular pattern is not associated with U.S. history in the same way, it’s the option that has not occurred in the United States.