Jails and Cops Friday is back with a look at the past and a guy who is trying to dig it up. We'll be talking about medical experimentation on prisoners (which by the way, when I did a little research on this turns out to be something that is seriously being debated again as a fine idea). What we aren't talking about is simple neglect, bad as that is, we are going for the real thing here. The sort of stuff that was brought up at the Nuremberg Trials of Nazi war criminals and led to a code of medical conduct which outlawed the types of horrors that went on in the Camps. Many U.S. doctors essentially ignored the Nuremberg Code, arguing that they applied to Nazi atrocities - not to American medicine.
Officially, most of the medical experiments in US prisons occurred forty to eighty years ago. They included among other things according to a 2011 AP report by Mike Stobbe:
...giving hepatitis to mental patients in Connecticut, squirting a pandemic flu virus up the noses of prisoners in Maryland, and injecting cancer cells into chronically ill people at a New York hospital.
Stobbe found that these experiments weren't just about "lifesaving" treatments. They included, "...curiosity-satisfying experiments that hurt people but provided no useful results.”
Stobbe, by the way, confined his studies to medical experiments conducted by the federal government.
The AP review of past research found (hang on this will be lengthy but in case you missed it back in 2011, I want you to see it now):
-A federally funded study begun in 1942 injected experimental flu vaccine in male patients at a state insane asylum in Ypsilanti, Mich., then exposed them to flu several months later. It was co-authored by Dr. Jonas Salk, who a decade later would become famous as inventor of the polio vaccine. One newspaper account mentioned the test subjects were "senile and debilitated." Then it quickly moved on to the promising results.
-In federally funded studies in the 1940s, noted researcher Dr. W. Paul Havens Jr. exposed men to hepatitis in a series of experiments, including one using patients from mental institutions in Middletown and Norwich, Conn. Havens, a World Health Organization expert on viral diseases, was one of the first scientists to differentiate types of hepatitis and their causes. A search of various news archives found no mention of the mental patients study, which made eight healthy men ill but broke no new ground in understanding the disease.
-Researchers in the mid-1940s studied the transmission of a deadly stomach bug by having young men swallow unfiltered stool suspension. The study was conducted at the New York State Vocational Institution, a reformatory prison in West Coxsackie. The point was to see how well the disease spread that way as compared to spraying the germs and having test subjects breathe it. Swallowing it was a more effective way to spread the disease, the researchers concluded. The study doesn't explain if the men were rewarded for this awful task.
-A University of Minnesota study in the late 1940s injected 11 public service employee volunteers with malaria, then starved them for five days. Some were also subjected to hard labor, and those men lost an average of 14 pounds. They were treated for malarial fevers with quinine sulfate. One of the authors was Ancel Keys, a noted dietary scientist who developed K-rations for the military and the Mediterranean diet for the public. But a search of various news archives found no mention of the study.
-For a study in 1957, when the Asian flu pandemic was spreading, federal researchers sprayed the virus in the noses of 23 inmates at Patuxent prison in Jessup, Md., to compare their reactions to those of 32 virus-exposed inmates who had been given a new vaccine.
-Government researchers in the 1950s tried to infect about two dozen volunteering prison inmates with gonorrhea using two different methods in an experiment at a federal penitentiary in Atlanta. The bacteria was pumped directly into the urinary tract through the penis, according to their paper. The men quickly developed the disease, but the researchers noted this method wasn't comparable to how men normally got infected - by having sex with an infected partner. The men were later treated with antibiotics. The study was published in the Journal of the American Medical Association.
There is one more that I want to pass along,
Holmesburg Prison in Philadelphia made extensive use of inmates for medical experiments. Some of the victims are still around to talk about it. Edward "Yusef" Anthony, featured in a book about the studies, says he agreed to have a layer of skin peeled off his back, which was coated with searing chemicals to test a drug. He did that for money to buy cigarettes in prison.
"I said 'Oh my God, my back is on fire! Take this ... off me!'" Anthony said in an interview with The Associated Press, as he recalled the beginning of weeks of intense itching and agonizing pain.
Asked in an interview with NPR whether or not the prisoners provided consent, Stobbe replies:
It’s an interesting question. If you go back and read the journals, the articles in the old medical publications, they generally refer to the test subjects as volunteers. But, some of the studies make clear that test subjects at times had trouble describing symptoms. We know from some press coverage of a few of the studies that test subjects were incapacitated.
In one study in Brooklyn in the early 1960s, they were volunteers but they didn’t know they were being injected with cancer cells. No one ever told them that. What seems to have happened, in a lot of studies, they were told, you know — would you like to participate in this study? We’re looking for at a treatment, sometimes they’d say what they were looking at, a vaccine or a treatment against “X.” But they wouldn’t necessarily tell them, here’s what we’re going to do to you. And these are the risks that you’re facing.
I interviewed one prisoner who’d been at a prison in Philadelphia in the 1960s. He went through some terrible studies, that were initially described to him — one of them was described to him as a test for a new type of bubble bath. He went through excruciating pain. They removed a layer of skin from his back and put on very painful chemicals. Not what you’d expect for a test for bubble bath. They didn’t always understand what they were getting into.
Another interesting tid bit of history is that during World War II, malaria research was conducted in prisons. A notable example was the experiments at Stateville Penitentiary in Illinois, in which prisoner-subjects were infected with malaria for the purpose of testing the safety and efficacy of novel anti-malaria drugs. Uh hello, human beings were infected with malaria.
"When you give somebody a disease - even by the standards of their time - you really cross the key ethical norm of the profession," said Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics.
It goes on, In These Times reported:
In the name of science, doctors have dosed prisoners with LSD, placed them in extreme isolation to develop “mind control” techniques, and, in Washington State between 1963 and 1973, radiated their testicles and then sliced them open. (This last case brought about one of the few successful lawsuits by prisoners against medical experimentation.)
In These Times again,
A 1978 federal regulation stated that prisoners can participate in federally-funded research only if the “experiment poses no more than ‘minimal’ risk,” which it defined as a “risk of physical or psychological harm that is no greater in probability and severity than that ordinarily encountered in the daily lives, or in the routine medical, dental or psychological examinations of healthy persons.” While that would seem to make a certain amount of sense, federal oversight and monitoring of medical experimentation has been incredibly sloppy and disorganized, even according to those who have been responsible for that oversight. “What we’ve got from the regulatory standpoint is a mess,” said Dr. Thomas Puglisi, the former director of compliance for the Office of Protection from Research Risks–now the Office of Human Research Protections (OHRP)–at a medical research summit in March 2001. “I couldn’t say that when I worked for the federal government, but I can say that now.”
And it’s worth noting that the only national oversight is of clinical trials in prisons that receive federal funds. Pharmaceutical companies that want to fund their own studies have no oversight body outside of what a prison or state might deem minimally necessary. A national database of medical experimentation on prisoners does not exist. Research studies don’t even always end up being published–particularly when they fail, sometimes causing serious injury or death to their human subjects.
Surely this has all been relegated to the past.
But is the time ripe to reconsider how prison populations could or should be incorporated into studies? Consider the lack of diversity in current clinical trials in the U.S. Whereas African-Americans represent 12 percent of the U.S. population they amount to only 5 percent of clinical trial participants, according to data from the U.S. Food and Drug Administration. Hispanics, meanwhile, make up 16 percent of the population but only 1 percent of clinical trial participants. And because prison populations are disproportionately from minority groups and may have a greater burden of certain maladies, should they be included in larger studies...
Heather Draper, a biomedical ethicist at the University of Birmingham in England says participating in research “can be regarded as a public good,” and prisoners should be afforded the opportunity to contribute. A paper she wrote on the subject fails to suggest any proposals for how "concerns" about coercion could be overcome. In the Scientific American article she has this answer though:
“We do accept that additional safeguards may be necessary; but researchers have managed to strike a balance between inclusion and protection in the case of other potentially vulnerable participants,” Draper says. One possible protective mechanism offered by the IOM report in the U.S. was to create a national registry of prisoner research to provide greater accountability. Another was that when prisoners are included in larger phase III clinical trials, the prisoner to nonprisoner ratio should not exceed 50 percent, ensuring a fairer distribution of research burdens.
Paul Wright, editor of
Every day prisoners around the country are dying of medical neglect because they are not provided with simple, known and available medical care. It is laughable to think that somehow cutting-edge medical treatment is suddenly going to be made available to prisoners. The people carrying out the drug testing have a fiduciary duty to enrich their shareholders and employers, not provide the best medical care for prisoners.