Examples of Medical Research that Exploited Test Subjects
Below you will find an overview of medical research in the United States from 1900 through the present time that exploited the poor, uneducated, or people of color. The birth control experiments of Puerto Rico did not take place on American soil, but were conducted by United States medical professionals in an American colony. All overviews contain the purpose of the tests, who conducted the experiments, when and where these studies were conducted, and a description of the test subjects.
In 1932, the Public Health Service and the Tuskegee Institute initiated the "Tuskegee Study of Untreated Syphilis in the Negro Male." This study was initiated as syphilis was becoming a major health problem, with 35% of the observed reproductive age population having the disease. In 1929, researchers attempted to cure syphilis with a combination of bismuth and mercury, but the cure rate was less than 30%. Additionally, the treatment itself was sometimes fatal. In 1931, funding for the program was removed, and Clark and Vondelehr decided to follow untreated men from the program to prove the need for it.
The subsequent study was organized into 600 black men, 399 with syphilis and 201 without. While initially expected to run six months, the study actually lasted over 40 years. Despite the fact that penicillin became an accepted, proven treatment for syphilis in 1947, the study continued into 1972. Robert Moton continued the work of Booker T. Washington after his death. He agreed to the study under two conditions. First, the Tuskegee Institute would receive full credit for the research. Second, black professionals would be assigned to the study. Dr. Dibble and Nurse Rivers were assigned in 1932.
Researchers told the men that they were being treated for "bad blood," and that they would receive free medical exams, meals, and burial service in compensation. However, they did not receive proper medical treatment. In 1936, it was decided to follow participants in the study until their death. There was no evidence that the men had ever been informed about the truth of the study, or that they were given the option of antibiotic treatment when it became available. In 1972, the study finally concluded after widespread condemnation in media articles. In 1974, a $10 million out-of-court settlement was reached, as well as lifetime medical benefits and free burial services for all survivors. On January 16, 1994, the last participant in the United States Public Health Service Syphilis Study at Tuskegee died.
WILLOWBROOK HEPATITIS EXPERIMENTS
In 1956, cognitively challenged children at the Willowbrook State School in Staten Island, New York, were intentionally infected with hepatitis in an attempt to track the development of the viral infection. The study lasted 14 years, and researchers justified their actions based in the fact that the infected children were likely to have contracted the disease anyway, due to high institutional infection rates. Dr. Krugman noted that the children who developed hepatitis and recovered seemed to be immune to future outbreaks, and he decided to take antibodies from those students and use them to attempt to create immunity. He believed that these antibody injections would result in less severe infections, as well as protection from future outbreaks. The study included 700 students, ranging in age from three to ten years.
The study consisted of students in two groups; those who were already at the facility, and those who had recently been admitted. The study demonstrated that the children who were deliberately infected had milder symptoms than those who contracted the virus naturally. Dr. Krugman obtained consent from the parents, although that is not currently viewed as morally justifiable. Also, it was noted that many of the parents were told their child would only be admitted to Willowbrook through the hepatitis unit. A video produced on the topic of the Willowbrook hepatitis experiments has also been published.
SKID ROW CANCER STUDY
The Skid Row cancer study, also known as the Bowery Series, was conducted in 1951 by Dr. Perry Hudson. Dr. Hudson was a urologist from Columbia University who conducted experiments on more than 1,200 homeless men from a shelter in New York. His experiment involved an open surgical biopsy of the men's prostates to examine cancer cellsThe subjects were offered clean beds and three meals daily for days that they were participated in the study. Dr. Hudson focused on men who were alcoholics, homeless, and physically or mentally "damaged." These patients were selected because there was a high rate of homeless men in New York at the time, producing a substantial population available for study. Additionally, their desperation over their circumstances led them to accept compensation without asking questions about safety and ethics.
The purpose of this study was to determine whether prostate cancer was a common disease, and to investigate diagnosis, treatment, and prevention. While he did receive consent from the subjects, he failed to inform them of the dangerous side effects of the experiment, which included risk of heart attack, stroke, and loss of muscle tone and stamina.
COLD WAR RADIATION STUDY
From 1960 to 1971, Dr. Eugene L. Saenger and his colleagues conducted experiments on 88 cancer patients, ages 9 to 84. The study was an attempt to determine how much radiation a soldier could withstand before becoming disabled or disoriented. Dr. Saenger hoped to develop a blood and urine test that could quickly indicate a person's radiation exposure level. Most of the patients had breast, lung, or gastrointestinal tumors that were considered inoperable. They were, however, considered strong enough to withstand the radiation levels of the study, and they were chosen due to already having terminal cancer and the ability to withstand the treatment. This study was requested by the Pentagon and conducted by the University of Cincinnati. Most of the patients were poor, and 60% were black. The study design included exposure to the highest levels of whole body radiation while recording the physical and mental responses of participants.
It is unknown how many of the patients who participated in this study died to radiation exposure rather than existing cancer. However, a 1972 report by three University of Cincinnati junior faculty members who evaluated the experiment determined that as many as a quarter of the patients died from radiation exposure. Documents show that 48 of the 88 patients developed nausea, vomiting, anorexia, abdominal pain, and mental confusion during the experiments. There had been doubt since 1959 about the use of whole or partial body radiation to treat the types of cancers with which these patients had been diagnosed. Dr. Saenger told the Pentagon that a test that could measure radiation exposure would be useful on the nuclear battlefield. The patients were never informed of the level of radiation to which they would be exposed, and there was clear evidence that the treatment was not expected to be useful in treating cancer. Therefore, it would appear that this study "was designed to test the effect of radiation on soldiers," according to Dr. Egilman who has studied the experiment.
PLANNED PARENTHOOD'S BIRTH CONTROL STUDY
In the 1950s, Planned Parenthood initiated human trials on an early version of the birth control pill on women in Puerto Rico. Dr. Gregory Pincus had invented a pill that could prevent women from conceiving, but he was having a difficult time finding a location to begin testing. Working together, Planned Parenthood and Dr. Pincus began testing in 1956. The women involved in the study were largely illiterate and worked in factories supplying goods to the United States. They were not told that the pill was in the testing phase, and they believed that the were taking an established method of birth control. Women involved in the study were unaware of any side effects or potential dangers. Many of the factories already had birth control centers, and female employees were encouraged to use them. Therefore, the structure was already there to distribute birth control pills. Due to high demand for products manufactured at these factories, United States business partners preferred that employees did not have families to distract them from work responsibilities.
Testing lasted for only a year before it was declared that the pill was 100% effective in preventing contraception. However, the women participating in the study experienced symptoms such as severe cramping, nausea, dizziness, headaches, stomach pain, and vomiting in 17% of cases, but these symptoms were disregarded and classified as psychosomatic. Three women died during the study, but there was no research conducted into the cause of death.
It is important to note that despite a long history of racism from the United States directed towards citizens of Puerto Rico, Planned Parenthood continues to deny any racist motivations in choosing the location for the drug trial.
HOLMeSBURG PRISON EXPERIMENTS
In 1951, Dr. Albert M. Kligman, a University of Pennsylvania dermatologist and the inventor of Retin-A, began using prisoners at Holmesburg as test subjects. His experiments involved the testing of toothpaste, deodorant, shampoo, skin creams, detergents, liquid diets, eye drops, foot powders, and hair dye. Subjects received constant biopsies and frequently painful procedures. The study was conceived when the prison pharmacist asked Dr. Kligman to examine a prison-wide problem with athlete's foot, but it continued for 20 years. It was later discovered that there were other tests conducted involving mind-altering drugs, radioactive isotopes, and dioxin.
The subjects were all paid prisoners, 85% of whom were black. Few participants had a high school diploma. They were chosen because access to inmates was easy to obtain. Inmates were told very little about the nature of the test. They were paid well compared to prison pay rates; participated in the study paid $10 to $300, compared to the $0.15 to $0.25 per day that the prison paid inmates. There are few documented cases of long term damage to any of the inmates; however, it is difficult to say for sure that participants suffered no long-term effects, as Dr. Kligman destroyed the records when the program ended in 1974.
Eli Lilly research on homeless
Eli Lilly was found by the Wall Street Journal in 1996 to have been conducting Phase I clinical drug trials utilizing the homeless as subjects. It was found that many of the subjects agreed to participate after drinking binges and may not have been able to make sound decisions in the matter. Many of the drugs that have been tested on the homeless are antipsychotics. These drugs often have serious side effects, and the subjects do not receive full pay if they leave the study early. As a result, many participants feel compelled to continue to participate. Dyskinesia (twitching of the mouth and tongue that can be permanent) and heart arrhythmias are potential side effects of antipsychotics.
There were no governmental regulations to ensure that subjects were being treated fairly, and some seemed to receive different levels of compensation. Many companies permit unhealthy subjects to participate in these types of trials, and subjects often continue to participate due to the ease of earning compensation.
From 1900 to the present time, there have been numerous cases of medical research in the United States in which the poor, uneducated, and/or people of color have been exploited. These studies include the Tuskegee Institute Syphilis study, Willowbrook hepatitis experiment, Skid Row cancer study, Cold War radiation tests, Puerto Rico birth control study, the Holmesburg prison experiments, and Eli Lilly's homeless studies. A video of the Willowbrook case can be found here, while an additional video containing information on cases including the Tuskegee experiments can be viewed here.