Human Radiation Experiments - Forwarded

[Stephen McGuire <SAM2@nrc.gov>]

The following note from the MEDPHYS server is very informative and interesting:
ate:

        Yesterday there was a report that the U.S. government will pay $4.8 million in
compensation for injecting eleven individuals with plutonium and one individual
with uranium without their knowledge as a part of a Cold War
-era radiation experiment.  This news was reported in today's Tulsa World under
the headline "U.S. to Pay Human Guinea Pigs."

        As we scientists review and learn more about this issue, we must keep the
facts associated with the human radiation experiments straight.
Each of us will have different perspectives regarding the matter but we must
exercise care not to misrepresent issues and facts to the public.  It appears that
some press and some elected and appointed officials are slanting perspectives on
radiation, radiation research, and radiation medicine in a manner that is unjustified. 
For example, Energy Secretary
Hazel O'Leary said, "This settlement goes to the very heart of the moral
accountability the government owes its citizens."  She suggests some great moral
wrong with this and related statements that is not apparent from the facts.  Slanted
representations may be done out of ignorance or in support of personal agendas.

        I was asked by the journal "Radiology" to review "The Human
Radiation Experiments -- Final Report of the President's Advisory
Committee" (the review should appear soon).  My review of this approximately 620
page book caused me to become well acquainted with the findings of the
Committee.  I learned that the evaluation of the human radiation experiments cost
about $22 million.  The Committee tried to ferret out perceived wrongs but it
appears that they identified no practice in human radiation experiments that
differed from general human research practices of the day.  In addition, the
committee identified no harm other than to some subjects who were given
therapeutic amounts of material with anticipated medical benefits outweighing
expected medical sequelae.  For example, the Committee found no injury in the
group that received the $4.8 million in settlements yesterday.  The press seems to
misrepresent this fact and reported one of the patient's attorneys as stating an
autopsy revealed bones "that looked like swiss cheese."  The implication is that
the appearance of the bones was caused by the plutonium injection.  The
Committee apparently found no evidence of this.  The appearance of the bones, if
accurately described, likely was caused by disease processes unrelated to
plutonium.

        Is it right to look at yesterday's practices through today's lens?
Certainly; we learn much through this exercise.  It helps us direct our future.  But
in many regards, the human radiation experiments seem to have become a
surrogate for the nation's collective shame and guilt regarding
Cold War excesses and general inhumanities.  If anything, the President's
Advisory Committee found this subrogation to be inappropriate and unsupported
by scientific facts.  Misrepresentation and inappropriate presentation of facts
promotes an unreasonable fear of radiation that tends to rob our citizens of the
benefits of radiation and radiation medicine.

        The Committee split on several important issues, but the Report is history.  It
cannot be changed.  However, it can be used accurately and reasonably. 
Remember that the Committee found that during the time in question:

1.  It was common for physicians to use patients as research subjects without the
patient's knowledge or consent;
2.  Physicians were given considerable moral authority, both by patients and by
society, to decide for patients what medical treatments they should receive;
3.  Physicians did not have the moral authority to use patients, without their
knowledge or consent, as subjects in research in which there was no expectation
that they could benefit medically.  (A few research subjects apparently were
identified who neither possessed knowledge nor gave proper consent for some
experiments.  No injury was identified in these subjects.);
4.  No injury was identified in any research subject who was not expected to benefit
medically from experiments;
5.  The present evaluation identified no potential for late injury, including cancer
and genetic defects, that required notification and medical follow-up for the purpose
of protecting health; and
6.  The Committee believed that the government withheld information from "a
couple dozen" research subjects or their families to avoid embarrassment or
potential liability.

        The Committee certainly showed that yesterday's medical and medical
research practices would not pass muster today.  I think everyone expected this. 
There even appears to be some "informed consent" issues that were outside of
yesterday's standards.  Importantly, 1) the Committee found no injury for those
research subjects not expected to receive medical benefit, and 2) the Committee
identified no secrecy associated with the human radiation experiments that differed
from the secrecy of the day with regard to medical research and national defense.

        We learn from yesterday's practices, but we must not allow the human
radiation experiments to be cast as some unique evil.  The Report clearly shows
this not to be the case.  As scientists, we must make sure that the story is told
accurately.


David Gooden, Ph.D., J.D.
Director, Biomedical Physics
Saint Francis Hospital
Tulsa, OK  74136
(918) 494-1444
FAX  (918) 494-1452
GOODEN@vms.ocom.okstate.edu