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Editorial
What Were They Thinking?
October 2010
Many of us have had lapses in judgment in our lives. In hindsight we might respond as Dierks Bentley does in his song “What Was I Thinking?” Unfortunately, the recent revelation of yet another human experimental study perpetrated by the United States government and even funded by the National Institutes of Health on prisoners in Guatemala makes one revisit the question, “What were they thinking?”
Documents reveal that from 1946–1948 unsuspecting prisoners in Guatemalan jails were given a sexually transmitted disease (STD) in order to study the effect of penicillin on the treatment of the disease.1 Just for the record, no useful information was obtained for or against the treatment. But what of the poor people who were exposed to the ravages of a disease without their consent and may or may not have received adequate therapy? This ranks alongside the infamous Tuskegee Syphilis Study that the US government sanctioned through the US Public Health Service from 1932–1972, during which 623 men were intentionally given syphilis without their knowledge or consent just to see what long-term effects the untreated disease would have on humans.2 Yes, they were given the disease and purposefully not treated even after penicillin was recognized as a successful therapy. The study lasted 40 years until someone blew the whistle and the government had to admit the truth. By that time there were only seven “experimental subjects” left alive. What could they have been thinking to inflict such devastation on people?
One of the more interesting historical timelines is that these studies were started at the same time as the horrific atrocities inflicted by the Germans during World War II. In October 1939 the Nazis began “treatment” of “patients” with gas. Shortly after, many men, women, and children were selected to be human guinea pigs for horrible medical experiments that left most dead or maimed.3 The world was so outraged at these medical “experiments” that the leaders were found guilty of crimes against humanity in the Nuremberg Trials. It is interesting that history records little if any punishment for the physicians who performed these experiments. Do you think anyone was held responsible for the Tuskegee Study or will be held responsible for the Guatemala incident?
The overwhelming question is where was the moral outrage of the US medical community while all of this was happening? Were there any physicians who stood up to say this was wrong? Did all just agree it was reasonable to medically experiment on rural Southern black men and jailed foreigners? History records that no one spoke up, as was the case in the medical community in Nazi Germany.4 This is what concerns me: If something were wrong in the practice of medicine today, would anyone stand up and say so? As the great Edmund Burke said, “The only thing necessary for the triumph of evil is for good men to do nothing.”
Fortunately, there are some who will stand and be counted. I am aware of a situation regarding early polio vaccine testing. The inventor of the vaccine wanted to test it on children at an orphanage in the Northeastern United States. The physician for the children determined that the vaccine was not entirely safe and refused to allow experimentation on the children. The developer then took the vaccine to a similar home in Europe for the testing. Numerous children on whom the vaccine was tested suffered severe complications resulting in the vaccine being reformulated (Personal communication, Dr. John Macdonald, July 2010).4 What courage it took for that physician not to allow a vaccine that had the potential to help millions of children be tested on those who could not make an informed decision for themselves.
In the case of “medical experiments” there are now stringent rules and regulations regarding recruitment of patients for clinical trials. Why did we need these rules? Has life become so meaningless that groups of people are expendable? What if a member of your family were in such a study? We cannot allow this to happen ever again, but to do this we must treat each other as we ourselves would want to be treated.
I still wonder—What were they thinking?
Email Dr. Treadwell: woundseditor@hmpcommunications.com.
Documents reveal that from 1946–1948 unsuspecting prisoners in Guatemalan jails were given a sexually transmitted disease (STD) in order to study the effect of penicillin on the treatment of the disease.1 Just for the record, no useful information was obtained for or against the treatment. But what of the poor people who were exposed to the ravages of a disease without their consent and may or may not have received adequate therapy? This ranks alongside the infamous Tuskegee Syphilis Study that the US government sanctioned through the US Public Health Service from 1932–1972, during which 623 men were intentionally given syphilis without their knowledge or consent just to see what long-term effects the untreated disease would have on humans.2 Yes, they were given the disease and purposefully not treated even after penicillin was recognized as a successful therapy. The study lasted 40 years until someone blew the whistle and the government had to admit the truth. By that time there were only seven “experimental subjects” left alive. What could they have been thinking to inflict such devastation on people?
One of the more interesting historical timelines is that these studies were started at the same time as the horrific atrocities inflicted by the Germans during World War II. In October 1939 the Nazis began “treatment” of “patients” with gas. Shortly after, many men, women, and children were selected to be human guinea pigs for horrible medical experiments that left most dead or maimed.3 The world was so outraged at these medical “experiments” that the leaders were found guilty of crimes against humanity in the Nuremberg Trials. It is interesting that history records little if any punishment for the physicians who performed these experiments. Do you think anyone was held responsible for the Tuskegee Study or will be held responsible for the Guatemala incident?
The overwhelming question is where was the moral outrage of the US medical community while all of this was happening? Were there any physicians who stood up to say this was wrong? Did all just agree it was reasonable to medically experiment on rural Southern black men and jailed foreigners? History records that no one spoke up, as was the case in the medical community in Nazi Germany.4 This is what concerns me: If something were wrong in the practice of medicine today, would anyone stand up and say so? As the great Edmund Burke said, “The only thing necessary for the triumph of evil is for good men to do nothing.”
Fortunately, there are some who will stand and be counted. I am aware of a situation regarding early polio vaccine testing. The inventor of the vaccine wanted to test it on children at an orphanage in the Northeastern United States. The physician for the children determined that the vaccine was not entirely safe and refused to allow experimentation on the children. The developer then took the vaccine to a similar home in Europe for the testing. Numerous children on whom the vaccine was tested suffered severe complications resulting in the vaccine being reformulated (Personal communication, Dr. John Macdonald, July 2010).4 What courage it took for that physician not to allow a vaccine that had the potential to help millions of children be tested on those who could not make an informed decision for themselves.
In the case of “medical experiments” there are now stringent rules and regulations regarding recruitment of patients for clinical trials. Why did we need these rules? Has life become so meaningless that groups of people are expendable? What if a member of your family were in such a study? We cannot allow this to happen ever again, but to do this we must treat each other as we ourselves would want to be treated.
I still wonder—What were they thinking?
Email Dr. Treadwell: woundseditor@hmpcommunications.com.
References
1) U.S. Apologizes for Study of STDs. USA Today. October 2, 2010. 2) Gray FD. The Tuskegee Syphilis Study: The Real Story and Beyond. Montgomery, AL: New South Books; 1998. 3) Spitz V. Doctors from Hell: The Horrific Account of Nazi Experiments on Humans. Boulder, CO: Sentient Publications; 1995. 4) Wiesel E. Without Conscience, Foreword. In: Spitz V. Doctors from Hell: The Horrific Account of Nazi Experiments on Humans. Boulder, CO: Sentient Publications; 1995:xviii.
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