Reviews and Notes: History of Medicine: Subjected to Science: Human Experimentation in America before the Second World War

Subjected to Science: Human Experimentation in America before the Second World War

Susan E. Lederer. 192 pages. Baltimore: Johns Hopkins Univ Pr; 1995. $32.95. ISBN 0-8018-48202. Order phone 800-537-5487.

Recent revelations about the extensive human experimentation that occurred during the Cold War have shocked both physicians and the public. Although experimentation during this period was particularly aggressive, it was not an aberration. As Susan Lederer shows in Subjected to Science, researchers in the United States have enrolled humans in questionable protocols for more than 100 years.

Opposition to the use of humans as subjects, which arose in the late 1800s, was spearheaded by members of the animal anti-vivisection movement. Associating the supposed mistreatment of laboratory animals with experimentation on humans, various antivivisection groups tried unsuccessfully to get legislation passed to restrict the activities of "torture houses" and "temples of torment." Such efforts greatly distressed the medical profession, which saw research as the pathway to obtaining crucial scientific knowledge. Nevertheless, certain physicians advocated the adoption of practices, such as the obtaining of consent, that protected subjects from abuse.

Despite the presence of normative rules, however, overzealous experimentation continued. Researchers frequently did studies on "captive" populations of persons who either did not give consent or for whom consent was meaningless. In 1911, for example, Noguchi published data on the intradermal injection of an inactive syphilis preparation into 146 hospital patients and normal children. Researching pellagra in 1915, Goldberger studied prisoners who were promised freedom in exchange for their participation. During the Depression, Abbott paid a group of poor blacks to be intubated with a flexible 12-foot tube that reached from mouth to rectum. Most notorious, of course, is the Tuskegee study, in which the federal Public Health Service followed a group of untreated blacks with syphilis to "end point" (autopsy).

Why did these excesses occur? As Lederer shows, the medical profession did a poor job of policing itself. Researchers continued to suggest that experimentation was acceptable if they ensured that no harm came to the participants. Most crucial, perhaps, was the growth of a cult of medical research in the 1930s that celebrated past and present investigators who did experiments on both themselves and others for the benefit of science. Even Index Medicus, Lederer notes, indexed research-related deaths under the entries "Heroes" and "Martyrs."

Despite the testimony at Nuremberg about abuses committed by Nazi physicians, this adulation of the researcher continued during the Cold War, and thousands of persons in the United States were subjected to experiments involving radiation or other invasive therapies without their consent. As Subjected to Science teaches us, even heroes can make mistakes.