Doctor's Review: Medicine on the Move

December 12, 2017
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Wanted dead or alive

The notorious Tuskegee Syphilis Study and other low points in modern medical research

Far-fetched plots from The X-Files aside, the American government doesn't exactly have the greatest record when it comes to secret medical experiments on its own citizens (and possibly even aliens). For the military, inspiration often arose from finding better ways to kill people on a large scale.

Apparently, the greater good — also known as the hunt for effective biological weapons — easily justified playing fast and loose with people's lives, even when those lives hadn't been given much of a say in the matter. The mid 20th century was a free-for-all for military and civilian mad scientists, giddy with the ever-burgeoning possibilities of harnessing science and free from significant legal restraints or (apparently) codes of ethics.

Between 1949 and 1969, the US Army waged biological warfare on hapless townspeople across the nation by releasing various infectious diseases here and there, just to see what would happen. Beginning in the mid '40s, the American government also conducted abominable radiation trials on human subjects without their knowledge or consent. (There were even some early instances of children being fed irradiated oatmeal!)

Though one might think that the effects of injecting folks with generous doses of plutonium and uranium would have become apparent soon enough, these experiments continued well into the 1970s. And the jury's still out on the government's role in Gulf-War Syndrome, which may be linked with the mandatory, but untested botulism, vaccines forced on soldiers. If past behaviour is indeed the best predictor of future behaviour, the army will likely not come out of any inquiry smelling like a rose.

Canada's Bad Trip
And lest anyone think Canadians are any better, I refer you to Dr Ewan Cameron. His LSD and electroshock studies on unwitting patients at Montreal's Allan Memorial psychiatric hospital were bankrolled by the CIA, who hoped to find a way to weaponize the strong hallucinogenic effects of the drug and possibly use it as a form of mind control (or at the very least as a way to "break" prisoners of war).

From 1957 to 1964, Cameron's subjects — who usually began as outpatients with mild psychological problems such as anxiety, insomnia and post-partum depression — went on acid-induced bad trips that would often last the rest of their lives.

Some were kept deliberately comatose for months on end; others were subjected to combinations of high-dose hallucinogens and incessant, disturbing audio-visual stimulation (think: "You killed your mother" playing on a speaker beneath your pillow for 23 days straight, with plenty of LSD thrown in for good measure), all with predictably unpleasant results. Similar experiments were conducted in Saskatchewan and at the women's penitentiary in Kingston, Ontario.

These types of "studies" weren't always the handiwork of the military. Perhaps the most infamous case of all was the US government's charming 1935 experiment to see what would happen when a little STD by the name of syphilis went untreated. Though at first they were simply eager to find better ways to treat the troublesome disease, a group of doctors in the venereal diseases division of the US Public Health Service (PHS) decided to find out.

One problem: Who on earth would agree to be a guinea pig for this one? The age-old solution: don't tell the subjects. Without their knowledge or consent, 600 men were tricked into participating in an unbelievably cruel experiment that would be more at home in a science-fiction movie than a medical textbook. Before it was over, "The Tuskegee Study of Untreated Syphilis in the Negro Male" would become the longest-lasting non-therapeutic study on human subjects in the history of medicine.

Preying on the Poor
The study began began in 1932, when Dr Taliaferro Clark — head of the PHS — recruited subjects from Macon County, Alabama. The area and surrounding counties were home mostly to poor African-American sharecroppers, the direct descendants of slaves. The Tuskegee Study was initially set up to test the incidence of the disease in the local population, but quickly devolved into an examination of syphilis's unsettling effects. (The whole thing was only intended to last six months, after which point a treatment phase would begin.)

At first, everything seemed on the up and up — the PHS study raised no alarms and was even supported by the Tuskegee Institute, the black university founded in 1881 by renowned educator Booker T. Washington.

In a classic bait-and-switch, word was put out that the PHS was offering free medical care and men showed up in droves. Those accepted included 399 men with syphilis, and 201 healthy men who would form the control group. Very little information about the study was disclosed to them, and since few (if any) had ever even seen a doctor before, the regular appointments and excessive testing they were subjected to didn't raise their suspicion.

Invasive procedures and injections became routine. In one case, when the researchers decided they needed to perform lumbar punctures on their subjects, the men were enticed to participate by the promise of a "Last Chance for Special Free Treatment."

When and if the ailing sufferers questioned their doctors as to what was wrong with them, they were simply told that they had "bad blood." Though several effective (and toxic) treatments, like mercury and bismuth-based medicines existed at the time the study began, most of the men were never offered them or given placebos or experimental treatments.

The PHS even blocked study participants from receiving the new penicillin cure after they were drafted for service in WWII, thereby preventing them from going to war. By the late 1940s, the war against syphilis had been won, thanks to the combination of penicillin and government treatment centres which were set up to administer doses to remaining sufferers. But the Tuskegee subjects never saw a drop of penicillin.

Ethics "Lite"
Dr Clark's team published data from 1934 onward, but nobody in the scientific or medical communities stepped in to stop the study, whose ethical constraints — weak to begin with — were deteriorating as rapidly as its subjects. For those 399 men, primary syphilis soon became secondary syphilis, which eventually became tertiary syphilis, the final stage of the disease.

Devastating skin lesions, organ shutdown, paralysis, cardiovascular symptoms, blindness, neurological problems and insanity were par for the course. Death was their ultimate reward for participation in the study, at which point the researchers eagerly autopsied their bodies to record their findings. As a thank-you, the government generously offered 50 bucks towards the cost of their coffins.

Although only expected to last six months, the study was still in full swing 40 years later. After 25 years, the Surgeon General sent subjects "certificates of appreciation" for their involvement. Not only were many of the original participants dead of syphilis and related complications, but their families were devastated as well. Their wives acquired the disease, and many of their children were born with congenital syphilis, damning them to a lifetime of social stigma and medical complications.

By all accounts, nothing remotely usable ever came of the study. Its results were not only ethically tainted, but pointless as well: no information gleaned from what happened to those unfortunate men would help provide better treatments for any venereal disease or help stem its spread.

News of what was going on finally broke in July 1972. Peter Buxtun, a Public Health Service investigator, grew tired of his complaints to his superiors at the PHS and the Centers for Disease Control going unheeded — he gave a tell-all interview to a reporter from the Associated Press. The entire country was appalled to hear of what had and was continuing to happen. After four decades, the "Tuskegee Study of Untreated Syphilis in the Negro Male" was officially shut down.

Congressional hearings soon followed, eventually leading to greater protection for research subjects through strict codes of informed consent. Though a $1.8-billion class-action lawsuit was launched, and settled out of court for $10 million, something was still missing: closure. It wouldn't come until 1997, a full 25 years after news of the study broke, when President Bill Clinton finally issued an official apology to the men and their families, who'd been so egregiously treated by their own government. Of the 600 victims, only eight survived to hear his words.

Round Two?
Thankfully, the fear of lawsuits is enough to keep even the most dubious of mad scientists in line these days. Lawyers, ethics committees, human-rights advocates and investigative journalists now act as watchdogs to make sure medical studies first do no harm to participants. Unless, of course, you happen to be living in Guantanamo Bay.

As the subtle erosion of civil rights south of the border continues under the guise of anti-terrorism legislation, the pendulum of public opinion may be swinging back a little to the other side. The wartime tactics employed to "coax" caught terrorists to spill their guts signals an implicit acceptance of old-fashioned torture for the public good. And where there's torture, can sketchy medical experimentation be far behind?

It may sound far-fetched, but if the shameful scientific studies of the past are any indication, history may indeed be repeating itself. Today, terrorists are often demonized in precisely the same way as those subjected to yesterday's irresponsible scientific research.

The Nazis' medical atrocities during WWII, the Tuskegee Syphilis Study, and no shortage of other harmful experiments were most often perpetrated against those segments of society who were powerless, oppressed or maligned — minorities, the mentally ill, prisoners, soldiers. As history has proven time and time again, the complex campaign to dehumanize entire segments of society creates legions of individuals who can all too quickly devolve from being patients to being nothing more than mere subjects.

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