Abstract The U.S. Public Health Service’s sexually transmitted disease (STD) experiments in Guatemala are an important case study not only in human subjects research transgressions but also in the response to serious lapses in research ethics. This case study describes how individuals in the STD experiments were tested, exposed to STDs, and exploited as the source of biological specimens—all without informed consent and often with active deceit. It also explores and evaluates governmental and professional responses that followed the public revelation of these experiments, including by academic institutions, professional organizations, and the U.S. federal government, pushing us to reconsider both how we prevent such lapses in the future and how we respond when they are first revealed.
Extract In September 2014, a little boy named Vincent was born prematurely, but healthy. While such a birth would usually attract the attention of family and friends, baby Vincent’s arrival made world news. He is the world’s first “womb transplant baby.” Like Louise Brown, Vincent is marked for history. Weeks after Vincent’s birth, two more women gave birth to boys, this time each mother carrying her child in the same womb in which she herself was gestated. . .
. . . This essay explores some of the research and issues raised by uterus transplantation. As is appropriate for an emerging biomedical technology, we approach these new developments with caution. My conclusions are preliminary. While I address some of the arguments pro and con, I will merely suggest some of the theological and biblical themes. These merit a lengthier treatment and charitable dialogue with others.
Extract While recent scholarship has – for the past two decades – endeavoured to transcend initial reservations about these forms of testimony, the difficulty with some of these memoirs – namely their authors’ implicit complicity in unethical medical research and in the Nazi Holocaust in general – remains however problematic. To address this thorny issue, in this article I consider the memoirs of a Jewish inmate doctor and forensic pathologist who worked with and for SS medical officers in Auschwitz, particularly Josef Mengele. His name was Mikló Nyiszli. . .
Howard Brody, Sarah E. Leonard, Jing-Bao Nie, Paul Weindling
Abstract In 1945–46, representatives of the U.S. government made similar discoveries in both Germany and Japan, unearthing evidence of unethical experiments on human beings that could be viewed as war crimes. The outcomes in the two defeated nations, however, were strikingly different. In Germany, the United States, influenced by the Canadian physician John Thompson, played a key role in bringing Nazi physicians to trial and publicizing their misdeeds. In Japan, the United States played an equally key role in concealing information about the biological warfare experiments and in securing immunity from prosecution for the perpetrators. The greater force of appeals to national security and wartime exigency help to explain these different outcomes.
Extract As is now known, from 1946–48, the Venereal Disease Research Laboratory of the U.S. Public Health Service (PHS), the Pan American Sanitary Bureau (PASB), and the Guatemalan government spearheaded a study4 that intentionally infected and tested Guatemalan prisoners, asylum inmates, soldiers, and orphaned children.5 The research team, led by Dr. John C. Cutler, exposed Guatemalans to syphilis “through the use of infectious prostitutes or directly through [an] inoculum made from tissue of human and animal syphilitic gummas and chancres,”6 and then treated the Guatemalans with penicillin.7 Although the researchers acknowledged they could not use such methods in the United States,8 they experimented in secrecy and did not seek consent from human subjects.9 . . .
The Guatemala study was horrendous, and the legal standards and guidelines of its day failed to protect Guatemalans who were infected with syphilis. Similar studies are being conducted by U.S. researchers in developing nations around the world, whether through grants from the U.S. government or by private U.S. companies. These problems must be remedied, and the Research Participants Protection Modernization Act of 2011 provides the impetus for the U.S. to do so. As Amy Gutmann, Chair of the Presidential Commission for the Study of Bioethical Issues stated, “a civilization can be judged by the way that it treats its most vulnerable individuals. There is no position of vulnerability that is greater than to be the subject of a medical experiment.”.
In a military-sponsored research project begun during the Second World War, inmates of the Stateville Penitentiary in Illinois were infected with malaria and treated with experimental drugs that sometimes had vicious side effects. They were made into reservoirs for the disease and they provided a food supply for the mosquito cultures. They acted as secretaries and technicians, recording data on one another, administering malarious mosquito bites and experimental drugs to one another, and helping decide who was admitted to the project and who became eligible for early parole as a result of his participation. Thus, the prisoners were not simply research subjects; they were deeply constitutive of the research project. Because a prisoner’s time on the project was counted as part of his sentence, and because serving on the project could shorten one’s sentence, the project must be seen as simultaneously serving the functions of research and punishment. Michel Foucault wrote about such ‘mixed mechanisms’ in his Discipline and punish. His shining example of such a ‘transparent’ and subtle style of punishment was the panopticon, Jeremy Bentham’s architectural invention of prison cellblocks arrayed around a central guard tower. Stateville prison was designed on Bentham’s model; Foucault featured it in his own discussion. This paper, then, explores the power relations in this highly idiosyncratic experimental system, in which the various roles of model organism, reagent, and technician are all occupied by sentient beings who move among them fluidly. This, I argue, created an environment in the Stateville hospital wing more panoptic than that in the cellblocks. Research and punishment were completely interpenetrating, and mutually reinforcing.
Abstract This article introduces the life of Shomatsu Yokoyama ( 1913-1992), a physiologist and military doctor, to the reader. During the Sino-Japanese war, Yokoyama disobeyed orders given by his superior officer to conduct inhumane medical experiments on humans. Not only in Unit 731, but also in other units, many military doctors were involved in medical crimes against residents of the areas invaded by the Japanese Army. In human living-body experiments and vivisections were widely conducted at that time. There were, however, a small number of researchers who did not follow the orders to perform human body experiments. Highlighting the life of such a rare researcher for the purpose of ascertaining the reason for his noncompliance with the order will provide us with insights on medical ethics.
Extract There is a considerable amount of academic and popular literature on Nazi medical experimentation within concentration camps, however, the existing research largely focuses on the doctors and the details of their experiments and has neglected two interesting themes. The first neglected theme is the potential legal liabilities and defense strategies of those among the SS leadership, such as SS General Karl Wolff. Wolff facilitated these experiments in a purely administrative capacity, but without his contribution this type of war crime would not have been possible. Secondly, the research has neglected the extent to which Wolff was able to avoid legal accountability for these and other war crimes, as a result of his wartime cooperation with a U.S. intelligence agency and his post-war assistance to interrogators within the Allied Military Intelligence as well as the Nuremberg prosecutors.  The present article, which is the first in a series of related studies, focuses largely on the first theme. This article gives particular attention to Wolff’s attempts to avoid prosecution by insisting that the experiments were of a voluntary nature, based on the consent of the research subject, and were, therefore, not criminal acts. Additionally, the article focuses on Wolff’s claim that he did not possess the requisite mens rea or intent necessary to secure a criminal conviction.
Abstract Though the Nuremberg medical trial was a United States military tribunal, British forensic pathologists supplied extensive evidence for the trial. The BMJ had a correspondent at the trial, and he endorsed a utilitarian legitimation of clinical experiments, justifying the medical research carried out under Nazism as of long term scientific benefit despite the human costs. The British supported an international medical commission to evaluate the ethics and scientific quality of German research. Medical opinions differed over whether German medical atrocities should be given publicity or treated in confidence. The BMJ’s correspondent warned against medical researchers being taken over by a totalitarian state, and these arguments were used to oppose the NHS and any state control over medical research.
Abstract Defense attorneys at the Nuremberg Medical Trial argued that no ethical difference existed between experiments in Nazi Concentration camps and research in U.S. prisons. Investigations that had taken place in an Illinois prison became an early focus of this argument. Andrew C. Ivy, MD, whom the American Medical Association had selected as a consultant to the Nuremeberg prosecutors, responded to courtroom crticisim of research in his home state by encouraging the Illinois governor to establish a committee to evaluate prison research. The governor names a committee and accepted Ivy’s offer to chair the panel. Late in the trial, Ivy testified – drawing on the authority of this committee – that research on Us prisoners was ethically ideal. However, the governor’s committee had never met. After the trial’s conclusion, the report was published in JAMA, where it became a source of support for experimentation on prisoners.