Last Thursday’s New York Times had an article about Dr. Perry Hudson, in 1950s a medical researcher at Columbia University. The article was about his research on skid row in New York City where he offered alcoholics in lower Manhattan an offer: If they agreed to surgical biopsies of their prostates, they would get a clean bed and three square meals for a few days, plus free medical care and treatment if they had prostate cancer.
Dr. Hudson’s goal was to show that if caught early prostate cancer could be cured, a laudable goal especially given that at that time all prostate cancer diagnosed was advanced and terminal. Despite having had the research approved by Columbia University Medical Center he never warned the men in the study that the biopsies could cause impotence and rectal tears (needle biopsies were not yet being used). Or that the treatment should cancer be found — surgery to remove their prostates and, often, their testicles — had not been proven to prolong life.
In all fairness to Dr. Hudson times were different then and generally people did not see how unethical his work had been. He was never called into question either by Columbia or by his Federal grantors. Today, under current standards, the general consensus is that his study was unethical because of both the powerlessness of the people who participated in it and the things done to them.
In the past, we have been guilty of many abuses in the interest of science. The United States has a rich history of forced sterilizations and research performed without consent and disclosure on our mentally retarded citizens. To be honest and to our shame Adolph Hitler used these studies as his rationalization for the many horrific medical studies that the Nazis performed during the 1930s and 1940s. Yes, we Americans wrote the first chapter of the script that led to the horrific medical experimentation of the Third Reich.
The Tuskegee Syphilis Study supported by the U.S. Public Health Service in partnership with the Tuskegee Institute is another infamous lapse of medical ethics. The study began in 1932, was designed to measure the progression of untreated syphilis. Penicillin by 1947 had been validated as an effective cure for syphilis. Despite this, study directors, until 1972, continued the study never offering the participants penicillin treatment. This study has induced a great fear among people of African descent given that the participants in the study were of African American background. This fear still is present in this community and today creates a huge barrier to participation of African Americans in clinical trials.
The United States sponsored additional human Syphilis experiments in Guatemala from 1946 to 1948. In the studies doctors infected soldiers, prisoners, and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects, and then treated them with antibiotics.
The United States has been anything but fair or ethical in its medical research of disadvantaged communities. Our record is abysmal at best. I do believe that today’s research is more ethical, but we must remain very vigilant in preventing future abuses.
Joel T. Nowak, M.A., M.S.W.