1 / 107

Doctors Gone Bad

Doctors Gone Bad. Human Subject Experimentation (WW II – the present) Torturers Murderers and Despots Martin Donohoe. “When a doctor [goes] wrong, he is the first of criminals. He has nerve and he has knowledge.” - Sherlock Holmes to Dr. Watson, Arthur Conan Doyle. Nazi Medicine.

dakota
Télécharger la présentation

Doctors Gone Bad

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Doctors Gone Bad Human Subject Experimentation (WW II – the present) Torturers Murderers and Despots Martin Donohoe

  2. “When a doctor [goes] wrong, he is the first of criminals. He has nerve and he has knowledge.” - Sherlock Holmes to Dr. Watson, Arthur Conan Doyle

  3. Nazi Medicine • Guiding philosophy = Hegelian (rational utility) • Social Darwinism - parallels in American and British Eugenics Movement • medical journals relatively silent • Ethics reduces morality to efficiency, economics, and aesthetics

  4. Nazi Medicine • An arm of state policy • Focus on racial purity • from eugenic sterilization (370,000) • to involuntary euthanasia (70,000) • to large-scale genocide (over 6 million)

  5. Nazi Medicine • Individual worth stated in economic terms; propaganda re obligations to the state • “I Accuse” • “Mathematics in the Service of Political Education”

  6. Nazi Medicine • Doctoring the nation more important than doctoring individuals - Nazism as “applied biology” (Rudolph Hess) • Focus on preventive medicine and public health: anti-tobacco and anti-alcohol campaigns, environmental toxins, organic farming -to improve Aryan stock • Nazi soldiers given anabolic steroids to increase aggressiveness • cf. professional athletes doping

  7. Nazi Physicians • 52,000 physicians • National Socialist Party Members • Jews ostracized; replaced by young Aryans • today 0.2% of German physicians are Jews, c/w 17% pre-Nazis • 5% of non-Aryans committed suicide; 25% murdered

  8. Nazi Physicians • Economic hard times, physicians salaries rise, academic perks • Blutkitt (“blood cement”) • Rare resistance • Catholics • Marxists • Dutch

  9. Nazi “Physician-Researchers”(Torturers) • Dr. Sigmund Rascher - coagulation/amputation studies; hypothermia experiments • Dr. Karl Gebhart: heteroplastic transplantation experiments • c.f. Stalin’s attempts to create interspecies (half-men/half-apes) “super-warriors” • 2016 – US govt. plans to lift moratorium on funding of certain types of chimeras

  10. Nazi “Physician-Researchers”(Torturers) • Drs. Karl Clausberg and Viktor Brack: X-irradiation/sterilization • Drs. Joachim Mrugowsky, Erwin Ding-Schuler, and Waldemar Hoven: IV phenol and gasoline executions

  11. Nazi “Physician-Researchers”(Torturers) • Dr. Friedrich Wegener (“Wegener’s Granulomatosis”): German pathologist, Nazi party member, autopsied a prisoner with oxygen injected into his bloodstream in an embolism study; may have participated in experiments on concentration camp inmates

  12. Nazi “Physician-Researchers”(Torturers) • Dr Hans Conrad Reiter (formerly “Reiter’s Syndrome”, now “reactive arthritis”): senior Nazi official • Dr. Joseph Mengele: Septicemia/twin vivisection studies • Dr. Hans Eppinger – water deprivation experiments, “father of modern hepatology”

  13. “Indirect Participants” • Prof. J Hallevorden: “Look here now, boys, if you are going to kill all these people at least take the brains out so that the material could be utilized … the more (brains) the better….I accepted these brains of course. Where they came from and how they came to me was really none of my business.”

  14. Doctors and Resistance • German invasion of Poland (1939) • Drs Eugene Lazowski and Stanislaw Matulewicz created a fake typhus epidemic, using a harmless bacterium to innoculate non-Jews, knowing that infected Jews would be summarily executed • Germans fooled, quarantined area, many Jews escaped death

  15. Nuremberg Doctors’ Trial • 23 German physicians tried • 16 found guilty • 7 hanged (incl. Gebhardt, Brack, Hoven, and Mrugowsky)

  16. Nuremberg Doctors’ Trial • Rascher died before trial • Mengele fled for Argentina (remains verified 1985) • Hallevorden committed suicide before trial • Otto Ambros (chemist) – invented sarin (nerve gas), convicted of mass murder at Nuremberg Trials, later freed and worked with US chemical industry on thalidomide

  17. Nuremberg Code • Voluntary consent is absolutely essential • Avoidance of unnecessary physical and mental suffering • Option to quit/responsibility to terminate • Other safeguards

  18. Declaration of Geneva • “I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient” • “I will not use my medical knowledge contrary to the laws of humanity.” • “It is unethical for physicians to employ scientific knowledge to imperil health or destroy life.”

  19. Declaration of Helsinki • Patients’ rights to respect, self determination, informed decision-making • Investigators’ duties: primacy of subjects’ welfare, ethical considerations take precedence over laws and regulation • Allows for surrogate consent

  20. Federal Policy for Human Subject Protection (Common Rule) Undergoing Revisions • Recommendations: • Studies must not violate domestic and international laws • Voluntary consent absolutely essential • Address special problems and needs of developing countries • Provide treatment and compensation for research-related injuries • US must wait sovereign immunity and other procedural obstacles regarding developing country studies

  21. Japanese Abuses in WW II • Extensive biological and chemical weapons program involving prisoners of war • Over 10,000 doctors and researchers involved (led by Shiro Ishii, Chief Medical Officer of the Imperial Japanese Army)

  22. Japanese Abuses in WW II • “Experiments:” • Deliberate infections with plague, cholera, typhoid, anthrax, and TB • Testing of drugs and vaccines not previously tested in animals • Surgeries (for training purposes) without anesthesia, followed by vivisection/death • Detonation of bombs, followed by vivisections • Number of victims unclear, likely in six figure range • Subjects referred to as maruta (“logs”)

  23. Japanese Abuses in WW II • Many participants later achieved positions of prominence in Japanese medical schools and societies • E.g., Tokyo Prefectural University, Olympic Committee, Green Cross, Japanese NIH, and private sector companies

  24. Japanese Abuses in WW II • U.S. government made secret deal with Ishii and top collaborators - 250,000 yen and immunity from prosecution in exchange for exclusive access to data • Japanese scientists brought to Fort Detrick, MD, to help establish U.S. biological/chemical weapons program • Unclear if Ishii went to Ft. Detrick or stayed in Japan; may have opened children’s clinic, converted to Christianity prior to death in 1967 • U.S. has never apologized for protecting these war criminals

  25. Post-WW II • Over 700 Nazi rocket scientists and their families brought to the U.S. (including Werner von Braun) to help build nuclear missile program • Operation Paperclip

  26. U.S. Immigration Policy • U.S. government excluded Jewish refugees from Nazi Germany from coming to the U.S. in the 1930s; turned SS St. Louis with 900 Jewish refugees back from Miami )1/3 later murdered by Nazis)

  27. U.S. Immigration Policy • Immigration quotas on “undesirables” throughout 20th and 21st Centuries (except when needed for dangerous labor) • Current limits on refugee resettlement, attitudes towards Latinos and Muslims

  28. Post-WW II • German Medical Association unanimously issues blunt, straightforward apology for its role in the Holocaust (2012)

  29. Post-WW II Human Subject Experimentation • James Ketchum (psychiatrist), L Wilson Green (scientist), Van Murray Sim – psychochemical warfare studies for US Army • Ketchum later joined faculty of University of Texas Medical School

  30. Post-WW II Human Subject Experimentation:Tuskegee Syphilis Study • Longitudinal study of untreated syphilis in almost 400 African-Americans • Sponsored by USPHS • Racist assumptions that syphilis behaved “differently” in Blacks

  31. Post-WW II Human Subject Experimentation:Tuskegee Syphilis Study • Mid-1940s: Penicillin accepted as treatment for all stages of syphilis • By 1972: 28 had died of syphilis, 100 were dead of related complications, 40 wives had been infected, and 19 children were born with congenital syphilis

  32. Post-WW II Human Subject Experimentation:Tuskegee Syphilis Study • 1972: Newspaper reports condemn; study ends • 1970s: Participants and families compensated by federal government • 1997: President Clinton formally apologizes

  33. Post-WW II Human Subject Experimentation:Tuskegee Syphilis Study • “The men’s status did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people.” • Dr John Heller, Director of Venereal Diseases at PHS between 1943 and 1948 (interviewed in 1976)

  34. Studies on Native Americans • Sterilizations • Radioactive iodine to study adaptation of thyroid gland to extreme cold • Forced removal of children to English language, religious schools (c.f., Australia, Canada) • Distrust and reluctance of minorities to participate in medical research

  35. Research on Prisoners • Very common historically (infectious diseases, radiation, pharmaceuticals, illicit drugs) • 1905: cholera experiments on “volunteers” • 1915: Joseph Goldberger – pellagra studies • Prisoners pardoned or paroled in exchange for participation • 1941: Physician William Black infects children with herpes virus, paper published by J Peds • WW II: gonorrhea, gas gangrene, dengue fever, malaria

  36. Post-WW II Human Subject Experimentation • Pharmaceutical and government sponsored studies on prisoners • 1940s and 1950s esp. • Halted in mid-1970s after drug company executives admitted prisoners were cheaper to use than chimpanzees • Of note, in 2015, the NIH announced its intention to end use of chimpanzees in biomedical research

  37. Post-WW II Human Subject Experimentation • Guatemala STD study (1946-8) • U.S. researchers deliberately infected 1,308 prisoners, military conscripts, prostitutes, orphans (provided by Sisters of Charity), and mental health patients with gonorrhea and syphilis • Scientists treated 87% of those infected (10% later required re-treatment), lost track of 13%

  38. Post-WW II Human Subject Experimentation • Guatemala STD study (1946-8) • Wives, children, and grandchildren treated, but sexual contacts not traced • Study approved by Guatemalan government • Received material for resource-starved institutions in return • Subjects received cigarettes for participating

  39. Post-WW II Human Subject Experimentation • Guatemala STD study (1946-8) • U.S. apologized (2010), has pledged $1 million to study research ethics, $775,000 to fight STDs in Guatemala • Class action lawsuit against U.S. government filed on behalf of 700 victims/relatives (2011)

  40. Post-WW II Human Subject Experimentation • Guatemala STD study (1946-8) • Dr. John Cutler (research coordinator): “Unless the law winks occasionally, you have no progress in medicine” • In 1943, Cutler infected volunteer federal prisoners in Indiana with gonorrhea in exchange for cash

  41. Post-WW II Human Subject Experimentation • Guatemala STD study (1946-8) • After Guatemala, Cutler oversaw the Tuskegee Syphilis Study • Was acting dean at University of Pittsburgh in 1960s

  42. Post-WW II Human Subject Experimentation • University of Minnesota malaria study (1940s) • Drs. Thomas Francis, Jr. and Jonas Salk infect psychiatric hospital residents with influenza (?if consent adequate?)

  43. Post-WW II Human Subject Experimentation • Atlanta, Alabama, and Terre Haute prison gonorrhea studies (1940s and 1950s) • Study evaluating effects of antibiotics on growth rate (1950s, Navy recruits, mentally disabled, Guatemalan schoolchildren) • Patuxent prison Asian flu experiment (1957)

  44. Post-WW II Human Subject Experimentation • U.S. govt.-sponsored radiation experiments (e.g., Strong Memorial Hospital/University of Rochester (NY), Dr Wright Langham) • LSD/sensory-deprivation/electroshock investigations (CIA - MK Ultra)

  45. Post-WW II Human Subject Experimentation • Pentagon/CIA experiments on soldiers and civilians • Edgewood Arsenal Experiments (involving more than 7,000 soldiers who were exposed to at least 250 biological and chemical agents) • Including sarin, VX, LSD, ritalin • Caused long-term health effects • Deliberate release of Serratia over San Francisco Bay; radioactive cadmium over St. Louis

  46. Post-WW II Human Subject Experimentation • 1963: Dr. Chester Southam injects tumor cells into extremely infirm patients at Jewish Hospital for Chronic Disease in NY without informing them that the shots contain cancer cells • Southam later elected President of American Association for Cancer Research

  47. Post-WW II Human Subject Experimentation • Willowbrook Hepatitis Experiments (1960s) • Pre-WW1: Joseph Goldberger’s pellagra experiments on Mississippi prisoners • Henry Beecher, NEJM (1966) – documented numerous published studies involving ethical breeches (e.g., non-treatment of strep-infected patients, manipulations under anesthesia, deliberate injection of cancer cells into healthy patients) • little public attention when researchers unmasked in 1991

  48. Post-WW II Human Subject Experimentation • Sterilization programs (70,000 victims in U.S.) • Native Americans • Buck v. Bell (USSC, 1927) • WI, NJ, CA, IN, NC, OR, others • Alabama’s Governor Graves vetoed law in 1930s law citing “hazard to personal rights” • Oregon governor Kitzhaber apologized in 2002 for the over 2500 state-forced sterilizations that occurred between 1917 and 1983 • 2012 – NC to compensate victims

  49. Post-WW II Human Subject Experimentation • Iowa elementary school race experiment (1968; good or bad?) • Milgram’s obedience studies (1963); Milgram redux (2008) • Soviet psychiatry • US military/pharmaceutical vaccine and medication trials in the developing world

More Related