When Physicians Are Not Physicians

When Physicians Are Not Physicians

Letters to the Editor When Physicians Are Not Physicians January 20, 1999 To the Editor: The Tuskegee legacy paper and Editorial 1 ,2 reminded me of ...

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Letters to the Editor When Physicians Are Not Physicians January 20, 1999

To the Editor: The Tuskegee legacy paper and Editorial 1 ,2 reminded me of another controversial study that has largely disappeared from the public's attention and has occasioned no visits to the White House. Willowbrook, an institution for mentally defective children, located on Staten Island, New York, was the site chosen for studies on viral hepatitis. These studies, begun in 1955, included artificial induction of hepatitis by oral administration of the virus. By 1966, this study (but not the Tuskegee study) was cited in the New England Journal of Medicine as an example of ethically dubious "experimentation on a patient not for his benefit but for that, at least in theory, of patients in general."3 In 1971, the failure of the medical establishment to react to the Willowbrook studies finally led the Editor of The Lancet to write: "... [this issue] ought to have been faced long ago .... [one] could not justify the giving of infected material to children who would not directly benefit. 4 After Bad Blood 5 appeared, David J. Rothman, professor of history at Columbia University, reviewed the parallels between the Tuskegee and Willowbrook studies. 6 Both were sanctioned by the US Government, including financial support. Both were

THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES

experiments done on subjects (patients) whose rights were disregarded because of their social deprivation, and both violated Claude Bernard's dictum to never perform "on man an experiment which might be harmful to him to any extent, even though the result might be highly advantageous to science, i.e., to the health of others. " Rothman pointed out that more was at stake in the Willowbrook and Tuskegee studies than science gone mad: the research physicians maintained social deprivation so as not to disturb the experimental design. These two studies remind us that our zeal as researchers must never displace the social responsibility that goes with being a physician. Joseph M. Merrill, M.D. Department of Family and Community Medicine Baylor College of Medicine Houston, TX 77030 References 1. Corbie-Smith G. The continuing legacy of the Tuskegee Syphilis Study: considerations for clinical investigation. Am J Med Sci 1999;317:5-8 2. Thomas SB, Curran JW. Tuskegee: from science to conspiracy to metaphor [editoriall. Am J Med Sci 1999;317:1-4 3. Beecher HK. Ethics and clinical research. N Engl J Med 1966;274: 1354-60. 4. Golby S. Experiments at the Willowbrook State School. Lancet 1971;1:749. 5. Jones J. Bad Blood: the Tuskegee syphilis experiment. New York: Free Press; 1981. 6. Rothman DJ. Hastings Cent Rep 1982;12:5-7.

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