AP IMPACT: Past medical testing on humans revealed
By MIKE STOBBE
The Associated Press
Sunday, February 27, 2011; 9:15 PM
ATLANTA — Shocking as it may seem, U.S. government doctors once
thought it was fine to experiment on disabled people and prison
inmates. Such experiments included giving hepatitis to mental patients
in Connecticut, squirting a pandemic flu virus up the noses of
prisoners in Maryland, and injecting cancer cells into chronically ill
people at a New York hospital.
Much of this horrific history is 40 to 80 years old, but it is the
backdrop for a meeting in Washington this week by a presidential
bioethics commission. The meeting was triggered by the government’s
apology last fall for federal doctors infecting prisoners and mental
patients in Guatemala with syphilis 65 years ago.
U.S. officials also acknowledged there had been dozens of similar
experiments in the United States – studies that often involved making
healthy people sick.
An exhaustive review by The Associated Press of medical journal
reports and decades-old press clippings found more than 40 such
studies. At best, these were a search for lifesaving treatments; at
worst, some amounted to curiosity-satisfying experiments that hurt
people but provided no useful results.
Inevitably, they will be compared to the well-known Tuskegee syphilis
study. In that episode, U.S. health officials tracked 600 black men in
Alabama who already had syphilis but didn’t give them adequate
treatment even after penicillin became available.
These studies were worse in at least one respect – they violated the
concept of "first do no harm," a fundamental medical principle that
stretches back centuries.
"When you give somebody a disease – even by the standards of their
time – you really cross the key ethical norm of the profession," said
Arthur Caplan, director of the University of Pennsylvania’s Center for
Bioethics.
Some of these studies, mostly from the 1940s to the ’60s, apparently
were never covered by news media. Others were reported at the time,
but the focus was on the promise of enduring new cures, while glossing
over how test subjects were treated.
Attitudes about medical research were different then. Infectious
diseases killed many more people years ago, and doctors worked
urgently to invent and test cures. Many prominent researchers felt it
was legitimate to experiment on people who did not have full rights in
society – people like prisoners, mental patients, poor blacks. It was
an attitude in some ways similar to that of Nazi doctors experimenting
on Jews.
"There was definitely a sense – that we don’t have today – that
sacrifice for the nation was important," said Laura Stark, a Wesleyan
University assistant professor of science in society, who is writing a
book about past federal medical experiments.
The AP review of past research found:
-A federally funded study begun in 1942 injected experimental flu
vaccine in male patients at a state insane asylum in Ypsilanti, Mich.,
then exposed them to flu several months later. It was co-authored by
Dr. Jonas Salk, who a decade later would become famous as inventor of
the polio vaccine.
Some of the men weren’t able to describe their symptoms, raising
serious questions about how well they understood what was being done
to them. One newspaper account mentioned the test subjects were
"senile and debilitated." Then it quickly moved on to the promising
results.
-In federally funded studies in the 1940s, noted researcher Dr. W.
Paul Havens Jr. exposed men to hepatitis in a series of experiments,
including one using patients from mental institutions in Middletown
and Norwich, Conn. Havens, a World Health Organization expert on viral
diseases, was one of the first scientists to differentiate types of
hepatitis and their causes.
A search of various news archives found no mention of the mental
patients study, which made eight healthy men ill but broke no new
ground in understanding the disease.
-Researchers in the mid-1940s studied the transmission of a deadly
stomach bug by having young men swallow unfiltered stool suspension.
The study was conducted at the New York State Vocational Institution,
a reformatory prison in West Coxsackie. The point was to see how well
the disease spread that way as compared to spraying the germs and
having test subjects breathe it. Swallowing it was a more effective
way to spread the disease, the researchers concluded. The study
doesn’t explain if the men were rewarded for this awful task.
-A University of Minnesota study in the late 1940s injected 11 public
service employee volunteers with malaria, then starved them for five
days. Some were also subjected to hard labor, and those men lost an
average of 14 pounds. They were treated for malarial fevers with
quinine sulfate. One of the authors was Ancel Keys, a noted dietary
scientist who developed K-rations for the military and the
Mediterranean diet for the public. But a search of various news
archives found no mention of the study.
-For a study in 1957, when the Asian flu pandemic was spreading,
federal researchers sprayed the virus in the noses of 23 inmates at
Patuxent prison in Jessup, Md., to compare their reactions to those of
32 virus-exposed inmates who had been given a new vaccine.
-Government researchers in the 1950s tried to infect about two dozen
volunteering prison inmates with gonorrhea using two different methods
in an experiment at a federal penitentiary in Atlanta. The bacteria
was pumped directly into the urinary tract through the penis,
according to their paper.
The men quickly developed the disease, but the researchers noted this
method wasn’t comparable to how men normally got infected – by having
sex with an infected partner. The men were later treated with
antibiotics. The study was published in the Journal of the American
Medical Association, but there was no mention of it in various news
archives.
Though people in the studies were usually described as volunteers,
historians and ethicists have questioned how well these people
understood what was to be done to them and why, or whether they were
coerced.
Prisoners have long been victimized for the sake of science. In 1915,
the U.S. government’s Dr. Joseph Goldberger – today remembered as a
public health hero – recruited Mississippi inmates to go on special
rations to prove his theory that the painful illness pellagra was
caused by a dietary deficiency. (The men were offered pardons for
their participation.)
But studies using prisoners were uncommon in the first few decades of
the 20th century, and usually performed by researchers considered
eccentric even by the standards of the day. One was Dr. L.L. Stanley,
resident physician at San Quentin prison in California, who around
1920 attempted to treat older, "devitalized men" by implanting in them
testicles from livestock and from recently executed convicts.
Newspapers wrote about Stanley’s experiments, but the lack of outrage
is striking.
"Enter San Quentin penitentiary in the role of the Fountain of Youth –
an institution where the years are made to roll back for men of
failing mentality and vitality and where the spring is restored to the
step, wit to the brain, vigor to the muscles and ambition to the
spirit. All this has been done, is being done … by a surgeon with a
scalpel," began one rosy report published in November 1919 in The
Washington Post.
Around the time of World War II, prisoners were enlisted to help the
war effort by taking part in studies that could help the troops. For
example, a series of malaria studies at Stateville Penitentiary in
Illinois and two other prisons was designed to test antimalarial drugs
that could help soldiers fighting in the Pacific.
It was at about this time that prosecution of Nazi doctors in 1947 led
to the "Nuremberg Code," a set of international rules to protect human
test subjects. Many U.S. doctors essentially ignored them, arguing
that they applied to Nazi atrocities – not to American medicine.
The late 1940s and 1950s saw huge growth in the U.S. pharmaceutical
and health care industries, accompanied by a boom in prisoner
experiments funded by both the government and corporations. By the
1960s, at least half the states allowed prisoners to be used as
medical guinea pigs.
But two studies in the 1960s proved to be turning points in the
public’s attitude toward the way test subjects were treated.
The first came to light in 1963. Researchers injected cancer cells
into 19 old and debilitated patients at a Jewish Chronic Disease
Hospital in the New York borough of Brooklyn to see if their bodies
would reject them.
The hospital director said the patients were not told they were being
injected with cancer cells because there was no need – the cells were
deemed harmless. But the experiment upset a lawyer named William Hyman
who sat on the hospital’s board of directors. The state investigated,
and the hospital ultimately said any such experiments would require
the patient’s written consent.
At nearby Staten Island, from 1963 to 1966, a controversial medical
study was conducted at the Willowbrook State School for children with
mental retardation. The children were intentionally given hepatitis
orally and by injection to see if they could then be cured with gamma
globulin.
Those two studies – along with the Tuskegee experiment revealed in
1972 – proved to be a "holy trinity" that sparked extensive and
critical media coverage and public disgust, said Susan Reverby, the
Wellesley College historian who first discovered records of the
syphilis study in Guatemala.
By the early 1970s, even experiments involving prisoners were
considered scandalous. In widely covered congressional hearings in
1973, pharmaceutical industry officials acknowledged they were using
prisoners for testing because they were cheaper than chimpanzees.
Holmesburg Prison in Philadelphia made extensive use of inmates for
medical experiments. Some of the victims are still
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