The Body Hunters (12 page)

As documented by University of Virginia bioethicist Jonathan D. Moreno in his 2000 book on secret state experiments,
Undue Risk
, thousands of American soldiers were used in experiments designed to determine the fatal dose of poison gas, which had felled scores in World War I. In one test, termed a trial of “summer clothing,” soldiers were locked into gas chambers full of mustard gas in exchange for a three-day pass. Wearing only street clothes and a gas mask, some pleaded with their captors to be released but were denied until falling unconscious.
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Starting in 1946, scientists working with the Atomic Energy Commission (later renamed the Nuclear Regulatory Commission) launched a series of studies involving human consumption of radioactive materials at two schools for troubled children in Massachusetts, Fernald and Wrentham. The child inmates at these brutal institutions were heavily tranquilized, and were consigned half naked to bare, cement-floored rooms outfitted with grates into which their urine and feces could be hosed. Scientists fed the children meals contaminated with radioactive material, drawing their blood afterward to study how their bodies fared.

The children were so neglected, as one resident subject remembered years later, that they “would do practically anything for attention.” Even so, their parents had to be actively misled in order for the experiments to proceed. In letters to the parents the studies were presented as “examinations” on nutrition, aimed at “brighter children” who would receive “special diets” as part of their membership in a special “Science Club.” The Fernald and Wrentham studies continued until 1973, with periodic reports appearing in medical journals.
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While the government pursued these inquiries in order to further their political and military goals, university scientists signed on for a chance to enter the exciting new field of radiation experimentation. As one prominent scientist remembered, “This was something like bacteriology . . . this was going to be a terrific field.”
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In a 1945 study eighteen hospitalized patients under the care of physicians from the University of Rochester, the University of Chicago, and the University of California were secretly injected with plutonium. The purpose was to discern how the body processed the metal, and researchers pored over their plutonium-injected patients' urine and stools and sampled their extracted teeth to find out. Patients were told that the doctors' pointed and ongoing interest in them had nothing to do with experimentation but was part and parcel of their “long-term care,” as Moreno writes. Some were even dug up from their graves to see how much plutonium remained in their bones; their families were told this was in order to discern the effects of “past medical treatment.”
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Similar state experimentation proceeded in other Western countries. In Australia, over eight hundred Jewish refugees and injured soldiers were purposely infected with malaria, sometimes at doses equal to the bites of thirteen thousand infected mosquitoes. The government scientists withheld antimalarial treatment from their shivering charges while they removed up to two pints of blood and injected them with insulin and adrenalin in order to simulate blood loss, starvation, and anxiety. “They never told us anything,” recalls one subject who survived the trial. “At first
I didn't realize it was dangerous. . . . I thought it would be an adventure and that is why I went,” recalled another.
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Physicians in Fascist Germany and imperial Japan likewise performed nontherapeutic experiments, but in their cases, subjects were condemned to death regardless of the results. Japanese scientists injected their Chinese prisoners with plague, cholera, and other pathogens, slaughtering them when they finally became too weak to provide any interesting data. They also conducted “field tests” on unsuspecting Chinese villages, poisoning more than one thousand wells with typhoid bacilli, releasing plague-infested rats and spraying typhus and cholera on wheat fields.
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During World War II Nazi scientists conducted a range of grisly experiments on concentration camp inmates. Eager to understand how the human body functioned at high altitudes, they encased subjects in decompression chambers, pumped all the air out, and then dissected the subjects while still alive to study their lungs. To see firsthand the effects of dehydration they starved subjects and forced them to drink only saltwater. They injected children with gasoline. They removed their subjects' bones and limbs, many dying from infections after their useless surgeries, others simply being shot. Inmates were injected with phenol to see how long it would take them to die.
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Prisoners were used, a Nazi officer later explained, because “volunteers could not very well be expected, as the experiments could be fatal.”
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The Nazi regime's medical research program fell under scrutiny soon after the war ended. Some twenty Nazi doctors of the hundreds or more who may have been involved in Germany's wartime experimentation were selected to stand trial before the International Military Tribunal, set up in Nuremberg by the United States and the rest of the victorious allies.
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Though the U.S. government's own deceptive and exploitative wartime experiments would not see the light of day for nearly fifty years,
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it still wasn't easy for the Americans to prove that their medical research was substantively different from that of the
Nazis. Each submerged the interests of human subjects in order to procure scientific data.

The defendants argued that their wartime experiments were essentially run-of-the-mill medical research, “the logical expression of the values of German medical science,” as University of California historian Anita Guerrini notes in her 2003 book,
Experimenting with Humans and Animals
. The subjects were volunteers, they said, who were scheduled to be killed anyway. And their suffering had to be balanced against the benefits the research would bestow upon others. That is, “it was legitimate that a few should have been made to suffer for the good of the many,” Guerrini wrote.
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Wasn't this the guiding philosophy of all Western medical research? Hadn't American doctors purposely given prisoners a fatal disease in their own experiments? the Nazis' defense lawyers asked the court, reciting from the 1945
Life
magazine article on the government's prisoner-malaria experiments.
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To uphold the reputation of American medical research, the prosecution called upon its star medical ethics expert, the University of Illinois's Andrew Ivy, MD. The fact was, though, that nobody in the American medical research establishment had questioned the ethics of the prisoner-malaria experiments when the
Life
spread appeared in 1945. Nobody had said anything in 1946, when PHS doctors had reported that their untreated patients at Tuskegee were dying at nearly twice the rate as their healthy controls. The truth was, while the Hippocratic oath guided medical practice no American medical researcher was bound by any written ethical principles.
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Nazi medical experimentation may have fallen into a lower category of depravity than what was happening in the United States, conducted as it was in the context of wholesale butchery, but the fact was that little could be called upon to prove this was so, at least not without knocking the medical research establishment off its pedestal. Ivy was forced to act quickly. As the trial progressed he convened a panel to investigate the prisoner-malaria experiments and wrote up some ethical principles to govern human
experimentation, presenting his draft to the American Medical Association. Ivy represented his hastily improvised solutions, yet to be considered by the AMA, as “the basic principles approved by the American Medical Association for the use of human beings as subjects in medical experiments.” He also presented his newly formed panel on the prisoner-malaria experiments as an ongoing one, though it had yet to meet even once. If the public's high regard for medical research were any guide, it should have been easy to prove Nazi medical research worse than America's, but the country's leading medical ethics expert had to perjure himself in order to do it.
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In the end, four Nazi doctors were hanged after their trial at Nuremberg and eight were sentenced to prison. The rest, along with others who were not tried, returned home to their university jobs and medical practices.
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The judges, in their decision, issued a new set of ethical guidelines to govern medical experiments. These would become known weightily as the Nuremberg Code, but in fact were mostly lifted directly from the few principles jotted down by Andrew Ivy.
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The most pertinent of the ten principles was the first one: that human subjects in experiments should understand what they are getting into and agree to participate. Experimental subjects should not be powerless prisoners of war and the like either, but “so situated as to be able to exercise free power of choice.” Experiments should only be conducted when absolutely necessary “so as to yield fruitful results for the good of society,” and risks to subjects should be minimized by all means possible. Any dangers to the subjects must be outweighed by the “humanitarian importance of the problem to be solved by the experiment,” and certainly should include none that researchers knew in advance might result in death or disability.
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The medical profession lauded the code publicly, but privately tended to dismiss it. Yale psychiatrist Jay Katz remembered his professors' reactions to the Nuremberg Code: “It was a good code for barbarians but an unnecessary code for ordinary physicians.”
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And in any case, the new code was voluntary and vague. When the medical establishment used the code to consider whether a given experiment's potential social benefits outweighed definite risks to subjects living today, they were usually able to err on the side of the former. For example, in most countries the Nuremberg Code was interpreted to exclude prisoners from any kind of medical research. In the United States Ivy's committee found the government's prisoner-malaria experiments ethically “ideal,” a view it announced in the February 14, 1948, issue of
JAMA
.
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During the 1950s and 1960s medical researchers continued to conduct experiments on powerless subjects that fell well short of Nuremberg's ideal of minimal risk and informed and voluntary consent. For example, in 1952 Jonas Salk conducted early trials of his experimental polio vaccine on mentally retarded children at the Polk State School in Pennsylvania; in many cases, only the state officials who were the legal guardians of the children gave permission. Between 1957 and 1960 another polio researcher, the drug industry–sponsored Hilary Koprowski likewise tested his polio vaccine on retarded children in New York, as well as on 325,000 children in what was then called the Belgian Congo.
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In other cases informed consent was skipped over entirely, for the experiments themselves were secret. Between 1944 and 1960 government researchers secretly released radioactive material over mostly Native American and Latino communities in order to determine how the material dispersed and its effects on human health. Likewise, in a series of experiments conducted between 1953 and 1957 medical researchers at Massachusetts General Hospital exposed eleven unsuspecting patients to uranium, hoping to find out how the substance might affect inadvertently exposed government workers.
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The doctrine of minimizing risks to test subjects was fuzzy enough to allow investigators to openly infect otherwise healthy people in order to see what might happen. For example, in a series
of medical experiments between 1963 and 1966 New York University pediatrician Saul Krugman injected healthy children with hepatitis virus, a liver-infecting pathogen spread through fecal matter. Working at Willowbrook State School, a state-run institution for mentally retarded and other disabled children, Krugman's team obtained hepatitis-laden feces, centrifuged, heated, and treated it with antibiotics, and then mixed it with five parts of chocolate milk to one part of feces. They fed the contaminated concoction to uninfected children and tracked their deterioration. According to Krugman, purposely infecting the children didn't subject them to any great risk, because Willowbrook was rife with infectious diseases anyway.
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This was a facility, after all, where inmates sometimes smeared the walls with feces.
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Krugman's Willowbrook studies went on until the 1970s, resulting in breakthroughs in hepatitis research that made Krugman a medical hero. He was awarded some of the most prestigious prizes in medicine.
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These transgressions only started to leak into public notice in the mid-1960s. First, in 1966, a Harvard anesthesiology professor named Henry K. Beecher described dozens of studies that violated Nuremberg standards in a
New England Journal of Medicine
paper, including one in which subjects in a typhoid study had been denied effective medication, leading to twenty-three deaths, and another in which ill patients had been purposely injected with live cancer cells. The following year, across the Atlantic, British physician Maurice Pappworth released his book
Human Guinea Pigs: Experimentation on Man
, likening the research practices of Western scientists to those of the Nazi doctors.
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Revelations from Beecher and Pappworth proved insufficiently persuasive to many investigators, including those continuing their inquiries in Tuskegee. Outraged letters to the Public Health Service about the study started to trickle in,
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but when the Centers for Disease Control (CDC) reviewed the study in the late 1960s (responsibility for the program had transferred to that agency in 1957
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), they nevertheless decided that it should continue until the
study's “endpoints” were reached, that is, until all of the ill subjects died. By 1969, untreated syphilis had felled up to hundred of the subjects of the study. “You will never have another study like this; take advantage of it,” a CDC reviewer suggested.
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