HUMAN RADIATION EXPERIMENTS

[GOODEN@VMS.OCOM.OKSTATE.EDU]

	On Wednesday, Nov. 20, 1996, I made a posting regarding the Human 
Radiation Experiments to both the Radsafe and Medphys listservers.  Many 
have shared thoughts on this issue, especially on Radsafe.  Opinions vary.  
Differences of opinion may stimulate learning, understanding 
and change.  Remember that my original posting acknowledged that there 
would be differences of opinion on this issue.  I was more concerned with 
"accuracy."  Differences of opinion can be good.  Strong 
presentations of data and facts in the light that best supports one's 
position can be good.  Purposely slanting or misrepresenting the facts, 
however, is never good.  In the misguided premise, "the end justifies any 
means" may lie real evil.  

	The thread on the human radiation experiments has given us comments 
on many related subjects.  Below is the original posting again in its 
entirety.  


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	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