In 1946, a U.S. Military Tribunal prosecuted 23 National Socialist (Nazi) physicians for human experimentation abuses disguised as 'medical research.' As part of the defense put forth in the Doctors' Trial, lawyers for the Nazi doctors argued not only that human experimentation was part of “accepted medical procedure,” but also that U.S. physicians were guilty of the same abuses. How did the U.S. medical profession react to the allegations?
The “Brutalities of Nazi Physicians”
Not surprisingly, a great effort was made in U.S. medical journals to distinguish proper experimental medicine from the type of science conducted by Nazi doctors. A 1946 editorial published while the Doctors' Trial was still in progress declared flatly that Nazi physicians were guilty of “crimes and barbarities . . . performed with unnecessary suffering and injury.”
Some experiments were “sadistic and . . . performed by pseudoscientists and untrained personnel without adequate reason.” Other experiments were conducted “without the consent of the human beings who were the subjects.” Among the experiments condemned were those involving
- anatomical experiments on helpless victims, merely to satisfy curiosity;
- the injection of dangerous diseases into unwilling subjects; and
- defective human subjects who were sterilized to purify Nazi society.
The editorial concluded that “Not the slightest good has resulted to mankind from these experiments.”
By contrast, U.S. medical research was entirely ethical. After all, “Medical science has been advanced in our own country . . . by experiments on human beings who volunteered for the purpose. . . . In every instance the right of the human being to determine for himself whether or not he would participate was recognized.”
Was U.S. Medicine More Ethical?
Although such protestations were typical of the period, they were also quite untrue. In reality, as a 2006 editorial in the Harvard Law Review noted, the distinction between U.S. medical experiments and those committed by Nazi physicians was “in degree, certainly, but not in kind.”
Nevertheless, the immediate reaction to the abuses uncovered in Germany was that “only Nazis needed . . . regulation” (Shapiro 2001). In fact, human experimentation abuses occurred in the United States both before the Doctors' Trial and after it.
Roberts Bartholow Satisfies His Curiosity
In 1874, Dr. Roberts Bartholow attempted to treat a feeble-minded Irish servant girl named Mary Rafferty for an ulcerated tumor. When treatment proved ineffective, Dr. Bartholow seized the opportunity to experiment on the exposed portion of her brain.
Dr. Bartholow inserted needles into the parietal opening, applied electrical stimulation, and then recorded her convulsions. Although he claimed that Rafferty had consented to the experiment, her mental state and weakened physical condition raise doubts not only as to how much she understood, but also whether her permission was properly obtained.
Nevertheless, Dr. Bartholow was never punished for his curiosity. Instead, he advanced steadily in his professional career until his death 30 years later.
The Injection of Dangerous Diseases into Unwilling Subjects
Injecting diseases into vulnerable human subjects is not a German phenomena. From 1895 to 1944, U.S. physicians experimented on the mentally ill, orphans, and prisoners without their permission or consent:
- In 1895, Dr. Henry Heiman injected gonorrhea into two children “suffering from idiocy” (aged 4 years and 16 years), as well as a 26-year-old man dying of tuberculosis.
- In 1913, nearly 150 healthy orphan children in Pennsylvania were inoculated with syphilis without their consent.
- In 1944, some 400 prisoners at Illinois’ Stateville Prison were solicited to help the ‘war effort’ without ever being told the exact nature of their participation. In fact, the experiment involved being injected with malaria.
During the 1960s, Dr. Saul Krugman was a consulting physician at New York's Willowbrook State School. Dr. Krugman told parents of severely retarded children that he would be performing 'vaccinations' as a condition of enrollment. In fact, he injected the disabled children with hepatitis virus strains A or B, which Dr. Krugman was studying in an attempt to develop a vaccine. Dr. Krugman later became Chairman of Pediatrics at New York University and eventually received the Lasker Public Service Award in 1983.
Defective Human Subjects and Sterilization
In the period from 1933 to 1945, it has been estimated that Nazi physicians sterilized approximately 400,000 German citizens, including disabled children. The rationale for doing so was a combination of simple economics (i.e., it was cheaper to raise a healthy child than a defective child) and a desire to purify German society from imperfect elements.
This policy of selective breeding, however, was not introduced first in Nazi Germany. Several U.S. states already had sterilization laws in effect before 1946, including the Commonwealth of Virginia. These laws were designed to prevent mentally ill or handicapped people from reproducing.
In 1927, the legality of Virginia's sterilization statute was upheld by the U.S. Supreme Court in Buck v. Bell. Speaking for the majority, Justice Oliver Wendell Holmes, Jr., ordered the sterilization of a young woman named Carrie Buck to proceed: “Three generations of imbeciles are enough.”
The Ideology of Medicine in the Democratic State
The American Medical Association (AMA) sent Dr. Andrew C. Ivy to the Doctor's Trial as the AMA's expert witness on medical ethics. Following the trial, Ivy (1949) drew a firm distinction between the medical profession in Nazi Germany and that in the United States. “In contrast to the ideology of the totalitarian state, medicine in the democratic state has never been allowed to forget the individual.”
While this assessment idealized democracy, it also overlooked ongoing human experimentation abuses in the United States.
References
-------. 1946 (November 23). Editorial. The brutalities of Nazi physicians. JAMA. 132:714–715.
-------. 2006. The plaintiff as person: cause lawyering, human subject research, and the secret agent problem. Harvard Law Review. 119(5):1510–1531.
Ivy A. 1949. Nazi war crimes of a medical nature. JAMA. 139(3):131–135.
Shapiro HT. 2001 (December 5). Ethical considerations in research on human subjects: a time for change . . . again. 6th Annual Raymond Waggoner Lecture, The University of Michigan.
 |
