LETTER
Joseph Goldberger: Unsung Hero
Bradley K. Evans
15 January 1995 | Volume 122 Issue 2 | Page 157
TO THE EDITOR:
For his pellagra studies in the first quarter of this century, Joseph Goldberger is considered a hero [1]. However, Goldberger deliberately induced pellagra in prisoners, and, in an attempt to show that pellagra was not infectious, he injected blood from patients with pellagra into volunteers and had them ingest feces from patients with pellagra. Elmore and Feinstein's opinion [1] is that the first study in prisoners, at least, is questionable: "This study would probably not receive institutional review board approval today. At the time of Goldberger's work ... some of our modern legal and ethical principles had not yet been developed ... Conducting research on prisoners was a common procedure".
However, ethical principles from religion and physicians—Hippocrates to Claude Bernard—were available to Goldberger. One basic principle is "never try to harm a patient." Goldberger obviously did not believe that this principle applied to his study. Perhaps he thought that he had consent, that the prisoners were not patients, that the harm would be small, or that there were overriding scientific and social concerns. If Goldberger was convinced that important issues were involved, it should be noted that his studies failed to convince scientists about pellagra ("Skeptics remained unconvinced ... ; These studies ... were also dismissed ...").
There is no doubt that this type of experiment in prisoners was common (and remained common—studies like Goldberger's continued for several decades [2] and, in this sense, Goldberger did leave a legacy). But we cannot believe that Goldberger, a hero, followed the crowd willy-nilly and did this type of experiment because everyone else did experiments in prisoners or that because everyone did this type of experiment, it was more acceptable. Finally, it is not as important to speculate about whether an institutional review board today would approve the study but to realize that an institutional review board then probably would have given approval (for example, a review committee in the late 1960s recommended continuing the Tuskegee syphilis study [3]).
1. Elmore JG, Feinstein AR. Joseph Goldberger: an unsung hero of American clinical epidemiology. Ann Intern Med. 1994; 121:372-5.
2. Evans AS. Further experimental attempts to transmit infectious mononucleosis to man. J Clin Invest. 1950; 29:508-12.
3. Jones JH. Bad Blood: The Tuskegee Syphilis Experiment. New York: Free Press; 1992.
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