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Rationalizing Radiation Therapy, Reforming Health Care
Published in Barbara Bridgman Perkins, Cancer, Radiation Therapy, and the Market, 2017
Twenty years after the Cincinnati turmoil, public outcry erupted once again when a newspaper article identified some of the patients who had been experimentally injected with plutonium (to see how it affected the body’s metabolism).102Political response this time around set up a short-term Advisory Committee on Human Radiation Experiments (ACHRE), held Congressional hearings, and declassified voluminous files covering hitherto little-known radiation experiments. President Clinton charged ACHRE with determining whether the experiments met “ethical and scientific standards, including standards of informed consent, that prevailed at the time of the experiments and that exist today.”103 The committee’s purview explicitly excluded “common and routine clinical practices”—just what most patients thought they were receiving. The distinction would be problematic.
Informed consent
Published in Yann Joly, Bartha Maria Knoppers, Routledge Handbook of Medical Law and Ethics, 2014
The move towards stricter research ethics review of informed consent forms and more detailed rules does not mean that no further serious violations occurred in the decades following these developments. In fact, several reports have emerged of serious violations of informed consent standards following the adoption of informed consent requirements. New Zealand, for example, was confronted with a Tuskegee-like research scandal involving ‘observational studies’ of women suffering from cervical cancer, which led to a public inquiry (Committee of Inquiry 1988). In the US, President Clinton set up in 1994 an Advisory Committee to investigate postwar research involving radiation that took place in the context of the Cold War, and which revealed numerous instances of research with no or questionable informed consent from research subjects (Advisory Committee on Human Radiation Experiments 1995). More recently, Canadian historian Ian Mosby unearthed nutritional research undertaken in the post-WWII period on aboriginal communities and aboriginal children residing in residential schools, which raises troubling questions about failures of, or serious problems with, informed consent and exposure of research subjects to harm (Mosby 2013).
Nutopia
Published in Alan Perkins, Life and Death Rays, 2021
Many other experiments were performed, including whole body irradiation on poor and black patients with cancer in Cincinnati, where doses of up to 1 Sv were given and irradiation of the testicles of prisoners in Washington to assess the effects of radiation on testicular function. The details of these and many other experiments remained classified for 50 years. It was not until the early 1990s that the Albuquerque Tribune uncovered the nature of the human experiments and also the identity of the patients who were unknowingly enrolled into these studies. One of the journalists from the Tribune published a book in 1999 which was entitled The Plutonium Files: America’s secret medical experiments in the cold war. In response to these revelations President Bill Clinton set up an Advisory Committee on Human Radiation Experiments in 1994. Most of the American population were unaware of these experiments until this investigation. According to the 1995 report the Advisory Committee concluded that there was no single case where there was any expectation that these patients would benefit medically from the injection of radioactivity. However, the committee found that human radiation experimentation during the period between 1944 and 1974 contributed significantly to advances in medicine and thus to the overall health of the public. With some exceptions, most of the human studies involved adult subjects and were ‘tracer’ studies involving small amounts of radioactivity that were unlikely to have caused physical harm. These experiments were carried out at a time when patients generally had complete faith in the doctors that were treating them. The doctors could do what they thought was best and their actions were rarely questioned. There is no doubt that by today’s standards the conduct of the work and clinical oversight was entirely unethical. This has been the same for many medical discoveries of the past. When the English physician Edward Jenner tested his immunity hypothesis in 1796 by inoculating the 8-year-old son of his gardener, James Philips, with cowpox pus scraped from the hands of a milkmaid, this could hardly be considered to be ethical practice.
Radiation protection biology then and now
Published in International Journal of Radiation Biology, 2019
Andrzej Wojcik, Mats Harms-Ringdahl
The ICRP did not meet between 1937 and 1950 (Clarke and Valentin 2009), so no recommendations on internal exposure limits were given until 5 years after World War II. In its 1950 recommendations, the ICRP states that the commission ‘is not in a position to make firm recommendations regarding the maximum permissible amounts of radioactive isotopes that may be taken into, or retained in the body’ (ICRP 1951). Nevertheless, based on maximum permissible exposures to radioactive isotopes for occupational workers used in U.S.A., Canada and U.K., exposure limits were given for radium, plutonium, strontium, polonium, tritium, carbon 14, sodium 15, phosphor 32, cobalt 60, and iodine 131 (ICRP 1951). Although the ICRP does not specify the source of data for the limits, it can be assumed that they, at least partly, came from the extensive animal experiments (Haley et al. 2011). However, it must be mentioned that some of the knowledge must also have come from human radiation experiments which were commonly carried out between the years 1944 and 1974 in U.S.A. and other nuclear program states (Advisory Committee on Human Radiation Experiments, 1995). Medical patients, prisoners, soldiers and children were intentionally exposed to radiation and isotopes, often without their knowledge or consent. Human experiments were not unique to the radiation field but were in line with the ethical standards (or the lack of such) at the time. Also, the process of acquiring scientific results from the Life Span Study of Hiroshima and Nagasaki survivors during the first 20 years of the program carried out by the Atomic Bomb Casualty Commission (ABCC) was criticized for low ethical standards in that survivors were treated as Guinea pigs (Beatty 1993).