Bioethics panel blasts late U. Pittsburgh professor's 1940s tests in Guatemala

I have only two comments about this horrendous story (read the entire story at the link):<br /><br /><div style="border: medium none; text-align: left; background-color: transparent; color: rgb(0, 0, 0); overflow: hidden; text-decoration: none;"> <div class="story_headline" _counted="undefined"><a href="http://www.post-gazette.com/pg/11257/1174449-84-3.stm"></a></div><blockquote><div class="story_headline" _counted="undefined"><a href="http://www.post-gazette.com/pg/11257/1174449-84.stm">Bioethics panel blasts late Pitt professor's 1940s tests in Guatemala</a></div> <div class="story_lastupdate">Wednesday, September 14, 2011</div> <div class="story_byline">By Torsten Ove, Pittsburgh Post-Gazette<br /><br />In February 1948, John C. Cutler injected a Guatemalan mental patient named Berta with syphilis.<br /><br />A month later, she developed scabies, a skin disease, and a few weeks later Dr. Cutler noticed that she had lesions on her arms and legs and that her skin was wasting away.<br /><br />He finally treated her for syphilis, but on Aug. 23 wrote that she appeared to be dying.<br /><br />He wasn't sure what was killing her, yet on that same day he placed gonorrheal pus from a male subject into her eyes, her urethra and her rectum. A few days later her eyes had filled with pus and she was bleeding from her urethra.<br /><br />She died on Aug. 27.<br /><br />Berta was one of 83 subjects who died during the course of experiments and diagnostic testing conducted by Dr. Cutler and his U.S. Public Health Service colleagues on more than 5,000 subjects in Guatemala from 1946 to 1948.<br /><br />Her story was among several included in a report released Tuesday by an ethics panel that has been examining Dr. Cutler's research at the direction of President Barack Obama.<br /><br />The Presidential Commission for the Study of Bioethical Issues concluded that Dr. Cutler, an <span style="font-weight: bold;">assistant U.S. surgeon general and later a professor at the University of Pittsburgh</span>, engaged in "egregious moral wrongs" in intentionally infecting about 1,300 Guatemalans with syphilis.<br /><br />The report also concluded that his supervisors, including Surgeon General Thomas Parran, founder of Pitt's Graduate School of Public Health in 1948, <span style="font-weight: bold;">approved of what Dr. Cutler was doing in the name of what he called "pure science."</span><br /><br />"Rather than a faulty chain of command," the report says, "there was a failure of both professional and institutional leadership in disregarding the excesses of the Guatemala experiments."<br /><br />... After reviewing more than 125,000 pages of documents detailing events from 1935 to 1956 and also traveling to Guatemala, a team of full-time researchers found that Dr. Cutler's experiments involved a total of 5,500 Guatemalans. He drew blood from and conducted spinal taps on many of them, including orphans and school children, and deliberately infected 1,308 inmates, mental patients, soldiers and prostitutes with syphilis to see if penicillin would cure it.<br /><br />About half of those subjects were never treated. Researchers found that 83 of the 5,500 total died during the two years of the study, but they aren't sure what killed them.</div></blockquote><br />My comments are these:<br /><br />1. If someone can explain to me how this "research" for "pure science" differed from the <a href="http://en.wikipedia.org/wiki/Nazi_human_experimentation">medical "research" conducted by the Nazis</a>, I'd like to hear it.<br /><br />2. Are there "research projects" in this country or others ongoing presently that have been shaped by the same ethical mold? I.e., the experts know best, informed consent is optional or unnecessary, and keeping track of known injuries and deaths is rarely done?<br /><br />-- SS<br /><div style="border: medium none; text-align: left; background-color: transparent; color: rgb(0, 0, 0); overflow: hidden; text-decoration: none;"><p _counted="undefined"></p><a style="color: rgb(0, 51, 153);" href="http://www.post-gazette.com/pg/11257/1174449-84-2.stm#ixzz1XwYqh0UQ"></a></div><a style="color: rgb(0, 51, 153);" href="http://www.post-gazette.com/pg/11257/1174449-84.stm#ixzz1XwYhYDwm"></a></div>

Bioethics panel blasts late U. Pittsburgh professor's 1940s tests in Guatemala

I have only two comments about this horrendous story (read the entire story at the link): Bioethics panel blasts late Pitt professor's...

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Pogo at the NIH

If we, as health professionals, want health care to be more honestly and rationally managed, we must be prepared to do our best to conduct ourselves honestly and rationally. Of course, dealing honestly with others is a fundamental value for physicians, and is codified in, for example, the <a href="http://www.ama-assn.org/ama/pub/category/2512.html">AMA Principles of Medical Ethics</a>, and the <a href="http://www.mja.com.au/public/issues/177_05_020902/bre10417_fm.html">ACP-ASIM-ESIM Physician Charter</a>.<br /><br /><a href="http://www.washingtonpost.com/wp-dyn/articles/A58845-2005Feb2.html">Today's Washington Post has a disturbing report </a>about NIH staff reactions to the new ethics policy, (first reported on Health Care Renewal <a href="http://hcrenewal.blogspot.com/2005/02/ban-on-federal-scientists-consulting.html">here</a> and <a href="http://hcrenewal.blogspot.com/2005/02/nih-seeks-higher-standard-better-late.html">here</a>.) According to the Post, "nary a positive word had been uttered about the new policy, and there was more vented spleen around than a busy medical center like the NIH might normally see in a year." For example, <a href="http://www.bioethics.nih.gov/people/emanuel-bio.html">Chief of Clinical Bioethics Ezekiel Emanuel </a>"fumed" that his secretary would have to sell her stock, (presumably because the rules require that lower-ranking NIH employees limit individual stock holdings in drug, biotechnology, and similar companies to those valued at less than $15,000), and later asked "if we want to reassure the public, why don't we apply these [rules] to everyone who gets an NIH grant." There was indignation that the rules didn't apply to other federal departments, like Energy, Agriculture, and Defense, and that they didn't apply to grant reviewers.<br /><br />These comments seem to reflect a troubling lack of knowledge about how the NIH funds research outside of its walls. Hardly any individuals get NIH grants. The money goes to their institutions. Many research universities have had strict conflict of interest policies in place for quite a while. NIH grant reviewers have also had to follow strict conflict of interest rules going back to at least the 1980's. These rules, unlike those that applied to NIH full-time employees, were never, to my knowledge, relaxed.<br /><br />The comments also seem to exaggerate the hardships imposed by <a href="http://www.nih.gov/about/ethics/020105COIsummary.pdf">the new rules</a> for NIH full-time employees. NIH employees are not being asked to give their stock holdings away. They are being asked to sell them, and they get to keep the money. Nor are they being barred from most kinds of investment. They can own stock in any kind of company that is not directly involved with pharma, biotech, and the like, and they can own any mutual fund or other diversified holding.<br /><br />But it is most discouraging to hear high level NIH employees, and particularly their head of bioethics, complain that they should only be subject to the lowest common denominator of ethical rules, rather than at least acknowledge the need to set an example after their organization has been tarred by scandal.<br /><br />As Pogo said, <a href="http://www.igopogo.com/we_have_met.htm">"we have met the enemy and he is us."</a>

Pogo at the NIH

If we, as health professionals, want health care to be more honestly and rationally managed, we must be prepared to do our best to conduct o...

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