For the greater good?

The list of non-consensual medical experimentation on humans is too long, they are ‘undesirables’ and the...

In 1946, the Nuremberg Doctor’s trial opened in occupied Germany. Prosecutors listened as Nazi doctors detailed experiments they had conducted on thousands of Jews, gypsies and other ‘undesirables’.

These included forced inoculation with deadly diseases such as Typhus in order to test experimental drugs. Other experiments were to benefit German soldiers in the field: gypsy inmates were forced to drink nothing but seawater for days; prisoners were stripped naked and immersed in ice water in order to determine the exact temperature at which a human being freezes to death.

Thus was born the Nuremberg code, hailed as the most important document in the history of medical ethics. It states, among other things, that no experiment will be conducted without the express consent of the participant and that no experiment should be conducted where there is a reason to believe that death or a disabling injury will occur. The year the code was adopted was 1946, the same year penicillin became accepted as the treatment for syphilis.

The link is significant for one reason: The now-infamous Tuskegee experiments in which over 400 poor African-Americans with syphilis were recruited into a clinical study which, they were told, would cure them of ‘bad blood’, a catch-all phrase then used to describe syphilis, anaemia and fatigue. The participants were not told they had syphilis, and even when the use of penicillin became widespread, were denied treatment. All this was done simply to observe what the disease does to a human being.

The Tuskegee experiments, which only ended when a whistleblower exposed them in 1972, at least did not involve deliberately infecting people with deadly diseases. For that, we have to travel to Guatemala, where in the 1940s a US government doctor, John C Cutler, with the knowledge of the US government and some Guatemalan officials, deliberately infected soldiers, prisoners and mental patients with syphilis in order to see what cure worked best. The victims were not told they were being infected and many went on to unknowingly infect others. It is unclear how many of the 693 ‘subjects’ were cured and how many died in the agony and madness that this disease causes.

On his return to America, Dr Cutler was to play a central role in the Tuskegee experiments and his role in the Guatemalan experiments was only revealed when a researcher stumbled upon his files in October this year. The US government has now apologised to Guatemala for its role in this atrocity, just as Bill Clinton formally apologized for Tuskegee in 1997.

It is the choice of victims that links the death camps of Auschwitz to Tuskegee and Guatemala. In Nazi Germany, the subjects of choice were those deemed ‘unfit’: political dissidents, Slavs, Jews, homosexuals and the like. They were considered at least as expendable as the US government considered the Guatemalans and the African-Americans in Tuskegee. In fact, Dr Heller, who was involved in the Tuskegee experiments, went so far as to say, “The men's status did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people.”

The list of non-consensual medical experimentation on humans is too long to enumerate here, but if the governments, firms and methods involved vary, the victims almost invariably do not. They are the dispossessed, the poor, the ‘undesirables’ and the voiceless. And it seems that despite safeguards and outrage, such practices continue. It may be true, as famed virologist Thomas Rivers said, that “unless the law winks occasionally, you have no progress in medicine”, but that is of little comfort to the uncounted multitudes who have had to suffer for the sake of the greater good, or as the case may be, greater profit.

Published in The Express Tribune, October 18^th, 2010.