Unethical human experimentation

Unethical human experimentation refers to any research performed on human subjects in an illegal or irresponsible manner. The experiments may have been performed on subjects without their knowledge or consent. They may also have been performed with little or no regard for the life or safety of the human subject. The issue of unethical human experimentation is closely tied to broader concepts of medical ethics and human rights.

Views on human experimentation in general have evolved throughout history, and the scientific consensus around research ethics has evolved as well. In the formative days of modern medicine, some doctors purposely infected subjects with diseases in hopes of developing a cure. Well into the modern era, research was sometimes performed on minorities, prisoners, or the mentally disabled without their knowledge. Some of these tests resulted in or contributed to medical breakthroughs, but the methods have come to be condemned by the research community. During World War II (1939–1945), some governments performed cruel and horrific experiments on human subjects, killing many thousands of people in the process. The widespread public and professional outcry against these atrocities led to international efforts to establish a standard code of medical ethics, exemplified by the 1964 Declaration of Helsinki created by the World Medical Association.

Background

Throughout much of human history, doctors and medical researchers have been expected to follow ethical guidelines in treating patients and illness. One of the oldest and best-known standards is the Hippocratic Oath, a text attributed to fourth-century Greek physician Hippocrates. The oath calls on doctors to use their abilities to attempt to cure suffering and not to harm their patients.

The doctors of the ancient and medieval periods did not have an understanding of medicine even close to modern standards. Many of the methods commonly used to "cure" patients did considerable harm. For example, physicians frequently believed some illnesses could be cured by removing blood from the body to maintain a proper balance in bodily fluids. They did this by cutting or scraping the skin or by placing leeches on the patient, treatments that often had serious negative effects.

In the early nineteenth century, English physician Thomas Percival developed one of the first modern codes of medical ethics. He advised doctors to act in a moral and professional manner and weigh the potential for good and harm to the patient before acting. Percival's guidelines became the basis for several ethics codes of the nineteenth century, including that of the American Medical Association (AMA). Medical practice also influenced views on ethics in related emerging fields such as psychology.

Medicine and medical ethics continued to evolve in the twentieth century. As doctors developed new beneficial medications, a need arose to test these drugs before they could be given to the public. Human trials were considered necessary, and guidelines were created to make the testing as ethical as possible. These and other medical codes developed at the time stressed open and honest communication with subjects before performing any tests or administering drugs. Patients were required to be informed of the potential effects of the research and give their consent for it to proceed.

Notable Examples

The concept of informed consent was unheard of in the late eighteenth century when English doctor Edward Jenner was attempting to develop a cure for smallpox. Smallpox is an infectious virus that, at the time, was considered one of the world's deadliest diseases. To prove his theory that injecting a less deadly form of cowpox into a person would create immunity to smallpox, Jenner used his own eleven-month-old son and several other children in his experiments. His methods were met with much criticism, but they did result in the development of a smallpox vaccine. Jenner's vaccine saved millions of lives, and he is regarded as the father of immunology.

Even after the implementation of medical ethics polices, some researchers continued to use humans as unsuspecting test subjects. Oftentimes, these subjects belonged to a minority group or marginalized social class. In 1942, a study funded by the government of the United States allowed an experimental influenza vaccine to be injected into patients at a mental institution in Michigan. The subjects were then purposely given the flu to gauge the vaccine's effectiveness. A similar experiment was performed on inmates at a Maryland prison in 1957. In the 1940s, patients at two Connecticut mental hospitals were exposed to the viral disease hepatitis in an attempt to study the illness. In the 1960s, intellectually disabled children at a New York school were given milkshakes containing hepatitis-infected human waste. The information gained from the research eventually led to the development of a vaccine for hepatitis B, one of the forms of the disease.

One of the longest-running examples of unethical human testing was the Tuskegee syphilis study, which was conducted in Alabama from 1932 to 1972. Doctors wanted to study the effects of untreated syphilis on African American men. Syphilis is a sexually transmitted disease that if left untreated can lead to brain, nerve, and heart damage and possibly death. The test subjects were never informed they had syphilis. They were promised free treatment for an illness they were told was called "bad blood." The men were instead given non-effective treatments so that the researchers could monitor the progress of the disease. Even after a cure for syphilis became available, the researchers refused to administer it to the subjects. The study was uncovered and stopped in 1972, and in 1997, the US government issued an official apology to the survivors.

Human experimentation was also taken to horrific extremes during World War II, when both the German and Japanese governments conducted secret testing programs on prisoners and local populations. The Nazis performed numerous experiments on Jews and other persecuted minority groups held at concentration camps during the war. Some of the experiments tested the effects of diseases or extreme conditions on the human body to develop safeguards for German soldiers. Other tests were conducted in an attempt to discover supposed physiological differences between races and medical "proof" of German racial superiority. Many of the doctors and other officials involved in the experiments were tried for war crimes and crimes against humanity by US authorities after the war, with several sentenced to death and others to lengthy prison terms. The tribunal also led to the development of the Nuremberg Code, an outline of ethical principles for human experimentation that would prove highly influential over the following decades.

Japanese doctors stationed in China before and during World War II also performed inhumane experiments on the local Chinese population. The Japanese performed surgery on victims without anesthesia and removed limbs, only to sew them onto other parts of the body. Subjects were exposed to extreme cold to observe the effects of frostbite on human skin. The Japanese also tested diseases such as bubonic plague on whole villages in an attempt to develop a biological weapon. Tens of thousands of people are believed to have died as a result of the experiments. Only a few of the doctors involved were prosecuted for their actions. US authorities notably worked to pardon many of the Japanese officials behind these programs and cover up evidence of their potential war crimes, in exchange for access to their data.

The atrocities of World War II drove international pressure to establish global standards for medical ethics. Building on the Nuremberg Code, the World Medical Association developed the Declaration of Helsinki in 1964, laying out basic principles for ethical human experimentation. The declaration was revised several times into the twenty-first century. While not a binding treaty in international law, the Declaration of Helsinki became widely influential and promoted the key concept of informed consent.

Despite growing awareness and regulatory efforts, instances of unethical human experimentation continued to appear through the late twentieth century and into the twenty-first. In the United States, for example, the public outcry when the Tuskegee experiment was revealed in the early 1970s brought fresh scrutiny of many other ongoing practices, such as the use of prisoners for pharmaceutical research. Even after additional safeguards were instituted domestically, US drug companies continued to at times face accusations of unethical experimentation on populations in developing countries. For instance, in 2000, reports emerged that the company Pfizer had not obtained informed consent when testing the antibiotic Trovan on children in Nigeria.

Another notable controversy over unethical human experimentation involved a Chinese researcher's 2018 claim to have modified the DNA of human fetuses to make them resistant to HIV. Many other scientists condemned the experiment as unethical due to the lack of informed consent by the fetuses themselves and other structural concerns, as well as the potential health risks involved. The researcher, He Jiankui, was subsequently suspended, fined, and sentenced to three years in prison by the Chinese authorities.

Bibliography

Avramova, Nina. "Unethical Experiments' Painful Contributions to Today's Medicine." CNN, 21 Jan. 2019, www.cnn.com/2019/01/09/health/unethical-experiments/index.html. Accessed 8 Oct. 2024.

Boodman, Eric. "These Medical Experiments Were Horrible, Unethical—and Useful." Stat, 13 Nov. 2015, www.statnews.com/2015/11/13/medical-experiments-horrible-unethical-also-useful/. Accessed 15 Dec. 2017.

Brody, Howard, et al. "US Responses to Japanese Wartime Inhuman Experimentation After World War II: National Security and Wartime Exigency." Cambridge Quarterly of Healthcare Ethics, vol. 23, no. 2, 2014.

George, Andrew. "Judging Jenner: Was His Smallpox Experiment Really Unethical?" The Conversation, 16 Feb. 2016, theconversation.com/judging-jenner-was-his-smallpox-experiment-really-unethical-54362. Accessed 15 Dec. 2017.

"Human Experimentation: An Introduction to the Ethical Issues." Physicians Committee for Responsible Medicine, www.pcrm.org/ethical-science/human-experimentation-an-introduction-to-the-ethical-issues. Accessed 8 Oct. 2024.

Lim, Su. "'First Do (No) Harm': Unethical Human Experimentation and Ethics." Grinnell College, 21 May 2016, lewiscar.sites.grinnell.edu/HistoryofMedicine/uncategorized/first-do-no-harm-unethical-human-experimentation-and-ethics/. Accessed 15 Dec. 2017.

"Nazi Medical Experiments." United States Holocaust Memorial Museum, encyclopedia.ushmm.org/content/en/article/nazi-medical-experiments. Accessed 8 Oct. 2024.

Nix, Elizabeth. "The Infamous, 40-Year Tuskegee Study." History, 13 June 2023, www.history.com/news/the-infamous-40-year-tuskegee-study. Accessed 8 Oct. 2024.

Schmidt, Ulf. Secret Science: A Century of Poison Warfare and Human Experiments. Oxford UP, 2015.

Sihra, Avani. "Unit 731." Atomic Heritage Foundation, ahf.nuclearmuseum.org/ahf/history/unit-731/. Accessed 8 Oct. 2024.

Stobbe, Mike. "Ugly Past of US Human Experiments Uncovered." NBC News, 27 Feb. 2011, www.nbcnews.com/id/41811750/ns/health-health‗care/t/ugly-past-us-human-experiments-uncovered/#.WjGhRd-nGUl. Accessed 8 Oct. 2024.

"Why Have Regulations to Protect Research Participants?" US Department of Health and Human Services, www.hhs.gov/ohrp/education-and-outreach/about-research-participation/protecting-research-volunteers/why-regulations/index.html. Accessed 8 Oct. 2024.