Numerous experiments which were performed on human test subjects in the United States in the past are now considered to have been unethical, because they were performed without the knowledge or informed consent of the test subjects. Such tests have been performed throughout American history, but have become significantly less frequent with the advent and adoption of various safeguarding efforts. Despite these safeguards, unethical experimentation involving human subjects is still occasionally uncovered.
Past examples of unethical experiments include the exposure of humans to chemical and biological weapons (including infections with deadly or debilitating diseases), human radiation experiments, injections of toxic and radioactive chemicals, surgical experiments, interrogation and torture experiments, tests which involve mind-altering substances, and a wide variety of other experiments. Many of these tests are performed on children, the sick, and mentally disabled individuals, often under the guise of "medical treatment". In many of the studies, a large portion of the subjects were poor, racial minorities, or prisoners.
Many of these experiments violated US law even at the time and were in some cases directly sponsored by government agencies or rogue elements thereof, including the Centers for Disease Control (CDC), the US military, and the Central Intelligence Agency (CIA); and in other cases were sponsored by private corporations which were involved in military activities. The human research programs were usually highly secretive and performed without the knowledge or authorization of Congress, and in many cases information about them was not released until many years after the studies had been performed.
The ethical, professional, and legal implications of this in the US medical and scientific community were quite significant and led to many institutions and policies that attempted to ensure that future human subject research in the US would be ethical and legal. Public outrage in the late 20th century over the discovery of government experiments on human subjects led to numerous congressional investigations and hearings, including the Church Committee and Rockefeller Commission, both of 1975, and the 1994 Advisory Committee on Human Radiation Experiments, among others.
Surgical experiments Throughout the 1840s, J. Marion Sims, who is often referred to as "the father of gynecology," performed surgical experiments on infants, enslaved African women, and girls as young as 13 without anesthesia to treat conditions including vesicovaginal fistula, neonatal tetanus, and other similar conditions. Slaveowners were willing to negotiate with Sims for access to these women due to their fertility's economic value if cured.
The patients—one of whom was operated on 30 times—suffered from infections and many failed surgeries before they were cured of vaginal fistula. The period between 1845 and 1849 during which Sims operated on enslaved women was one during which the new practice of anesthesia was not universally accepted as safe and effective. While Sims did not use anesthesia in the experiments he performed on enslaved women, he later used it on white female patients.
In 1874, Irish servant Mary Rafferty came to Roberts Bartholow of the Good Samaritan Hospital in Cincinnati, Ohio for treatment of a head lesion. The lesion was diagnosed as a cancerous ulcer and surgical treatments were attempted. Bartholow saw Rafferty's condition as terminal but felt there was a research opportunity. With no intention of treating her, he inserted electrode needles into her exposed brain matter to gauge her responses. Although Rafferty came out of the coma caused by the experiment three days later, she died from a massive seizure the following day. Bartholow described his experiment as follows:
In the subsequent autopsy, Bartholow noted that some brain damage occurred due to the electrodes but that Rafferty died due to the cancer. He was criticized by fellow physicians and the American Medical Association (AMA) formally condemned his experiments as he caused direct harm to the patient not in an attempt to treat her but solely to gain knowledge. Additional issues were raised with the consent obtained. Although she gave "cheerful assent" to the procedure, she was described as "feeble-minded" and may not have fully understood. Bartholow apologized for his actions and expressed regret that some knowledge had been gained "at the expense of some injury to the patient."Lederer, 1997: pp. 7–8
In 1896, Arthur Wentworth performed spinal taps on 29 young children without their parents' knowledge or consent at Children's Hospital Boston (now Boston Children's Hospital) in Boston, Massachusetts to discover whether doing so would be harmful.Grodin & Glantz, 1994: pp. 7–11
From 1913 to 1951, Leo Stanley, chief surgeon at the San Quentin Prison, performed a wide variety of experiments on hundreds of prisoners. Many of the experiments involved testicular implants, where Stanley would extract testicles from executed prisoners and surgically implant them into living prisoners. In other experiments, he attempted to implant the testicles of rams, goats, and boars into living prisoners. Stanley also performed various eugenics experiments and forced sterilizations on prisoners. Stanley believed his experiments would rejuvenate old men, control crime (which he believed had biological causes), and prevent the "unfit" from reproducing.Hornblum, 1998: p. 79
From 1955 to 1960, Sonoma State Hospital in northern California served as a permanent drop-off location for mentally disabled children diagnosed with cerebral palsy or lesser disorders. The children subsequently underwent painful experimentation without adult consent. Many were given spinal taps "for which they received no direct benefit." Reporters of 60 Minutes learned that in these five years, the brain of every child with cerebral palsy who died at Sonoma State was removed and studied without parental consent.Rebecca Leung. "A Dark Chapter In Medical History". CBS News, February 11, 2009.
Pathogens, disease and biological warfare agents
Late 19th century In the 1880s, in Hawaii, a Californian physician working at a hospital for lepers injected six girls under the age of 12 with syphilis.
In 1895, New York City pediatrician Henry Heiman intentionally infected two mentally disabled boys—one four-year-old and one sixteen-year-old—with gonorrhea as part of a medical experiment. A review of the medical literature of the late 19th and early 20th centuries found more than 40 reports of experimental infections with gonorrheal culture, including some where gonorrheal organisms were applied to the eyes of sick children.Lederer, 1997: p. 3Shamoo & Resnick, 2009: pp. 238–239
US Army doctors in the Philippines infected five prisoners with bubonic plague directly, and separately induced beriberi in 29 prisoners resulting in the deaths of four test subjects.Cina & Perper, 2010: p. 89 In 1906, Professor Richard P. Strong of Harvard University intentionally infected 24 Filipino prisoners with a live cholera vaccine, which had somehow become contaminated with bubonic plague. He did this without the consent of the patients, and without informing them of what he was doing. All of the subjects became sick and 13 died.Hornblum, 1998: pp. 76–77
Early 20th century In 1908, three Philadelphia researchers infected dozens of children with tuberculin at St. Vincent Orphanage in Philadelphia, Pennsylvania, causing permanent blindness in some and painful lesions and inflammation of the eyes in many others. In the study, they refer to the children as "material used".
In 1909, Frank Crozer Knowles published a study in the Journal of the American Medical Association describing how he deliberately infected two children in an orphanage with Molluscum contagiosum—a virus that causes wart-like growths but usually disappears entirely—after an outbreak in the orphanage, to study the disease. The author then admits that the mechanisms studied were already well understood and described in literature, so well in fact that he found it unnecessary to go beyond providing basic explanations of the processes at work, stating quote; "The subject has been so fully described in the excellent paper of C. J. White and W. H. Eobey, Jr., that only a few of the important points will be emphasized here."
In 1911, Professor William Henry Welch, Board of Scientific Directors at the Rockefeller Institute for Medical Research in New York City urged staff member Hideyo Noguchi, who developed a diagnostic test for syphilis, to conduct human trials. Of 571 subjects, 315 previously had syphilis. The rest were control. The remaining subjects were hospital patients; some of whom were between the ages of 2 and 18 years. The test using inactive syphilis extract was distributed to hospitals which administered it. No subjects were infected with syphilis as it had been sterilized, but the patients were not given sufficient information to consent, breaching the right of patients. It was considered 'a wrong without injury' and a breach of ethics by the Rockefeller Institute.
The Tuskegee syphilis experiment ("Tuskegee Study of Untreated Syphilis in the Negro Male") was a clinical study conducted between 1932 and 1972 in Tuskegee, Alabama, by the US PHS. In the experiment, 399 impoverished black males infected with syphilis were offered "treatment" by the researchers, who did not tell the test subjects that they had syphilis or treat them for the disease, but rather just studied them to chart the progress of the disease. By 1947, penicillin became available as treatment, but those running the study prevented the participants from receiving treatment elsewhere, lying to them about their true condition, so that they could observe the effects of syphilis on the human body. By the end of the study in 1972, only 74 of the test subjects were alive. 28 of the original 399 men had died of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children were born with congenital syphilis. The study was not shut down until 1972, when its existence was leaked to the press, forcing the researchers to stop in the face of a public outcry.The Tuskegee Syphilis Experiment Borgna Brunner. Retrieved March 25, 2010
1940s In 1941, at the University of Michigan, virologists Thomas Francis, Jonas Salk and other researchers deliberately infected patients at several Michigan mental institutions with the influenza virus by spraying the virus into their nasal passages.Meiklejohn, Gordon N., M.D. "Commission on Influenza." in Histories' of the Commissions Ed. Theodore E. Woodward, M.D., The Armed Forced Epidemiological Board, 1994 Francis Peyton Rous, based at the Rockefeller Institute and editor of the Journal of Experimental Medicine, wrote the following to Francis regarding the experiments:
Rous closely monitored the articles he published since the 1930s, when revival of the anti-vivisectionist movement raised pressure against certain human experimentation.Lederer, Susan E. Subjected to Science: Human Experimentation in America before the Second World War, Johns Hopkins University Press, 1995/1997