Treat Human Beings Ethically, Not as Research Subjects

Opinion   Bill Saunders and Evangeline Jones   Oct 5, 2011   |   1:32PM    Washington, DC

The Presidential Commission for the Study of Bioethical Issues recently released its report on medical experiments surreptitiously performed by American public health doctors on Guatemalan citizens during the 1940s.[1]

The report documents the appalling history of how, with the permission of local authorities and U.S. government sponsorship, American doctors deliberately infected hundreds of unknowing Guatemalan prisoners, mental health patients, prostitutes, and soldiers with sexually transmitted diseases, in order to observe the course of the illnesses and to test the effectiveness of penicillin in some of the patients (others were not treated). Among the details recounted are various painful methods of experimentation, demeaning inducements for patient cooperation, and the use of children at an orphanage for testing.

Concerns that the questionable research practices would become public brought the Guatemala project to an end. However, the principal researcher continued his career in the field of reproductive health research following the Guatemala experiments. He conducted medical experiments related to sexually-transmitted diseases on prisoners in the U.S., was involved with the controversial Tuskegee syphilis experiments, and became a prestigious professor of international health until his death in 2003. (His wife, who assisted with his work in Guatemala, later served on a Planned Parenthood board and raised funds for population control.[2])

The Commission found “gross violations of ethics” on the part of those most closely involved in the Guatemala project. Those who “…approved, conducted, facilitated and funded these experiments are morally culpable to various degrees for these wrongs.”[3] The U.S. government issued an apology to the Guatemalan president last fall.

The Commission’s next report, due in December 2011, will review and recommend contemporary guidelines to ensure protection of human research participants. Meanwhile, in this report, the Commission identified three principles to help inform future practices: treat all people fairly and with respect, particularly vulnerable populations; do not subject people to harm or risk of harm, even with their consent, unless the risk is reasonable and proportionate to the benefit; do not treat people as mere means to the ends of others.

The Commission’s review of the abuses of the Guatemalan study is commendable, and it is right to note basic principles that should guide human research (as acknowledged in the report, those identified are not new, and echo earlier standards such as the Nuremberg Code and the standards of the World Medical Association).  Though it should do so, the Commission is unlikely, nonetheless, to suggest that these principles and any new recommended guidelines extend to the protection of embryonic human beings.

If it does not, the Commission will sadly have missed what is perhaps the essential lesson of the Guatemalan study: all human beings must be treated ethically, and this is so “simply” because they are members of the human family.  This principle must be applied regardless of incidental aspects of a particular human being’s life (thus, the stage of development – embryonic – is as irrelevant as is the nationality – Guatemalan).  Otherwise, no one is safe; those who possess political power will find it irresistible (as they always have) not to define some less powerful human beings outside of the equal protection of the law.

The Commission’s review of the abuses in Guatemala should not be an exercise solely in condemning actions in the past.  Rather, it should guide our actions in the present.  In making public policy today, we must never forget the fundamental principle that all human beings are equal in dignity.

[1] Ethically Impossible: STD Research in Guatemala from 1946-1953 is available at http://www.bioethics.gov/cms/sites/default/files/Ethically-Impossible_PCSBI.pdf

2 http://news.google.com/newspapers?id=Uc8bAAAAIBAJ&sjid=z1AEAAAAIBAJ&pg=7438,531045&dq=john+c+cutler+planned+parenthood&hl=en

3 http://www.bioethics.gov/cms/node/308

LifeNews.com Note: Evangeline Jones is the Americans United for Life National Coordinator of Lawyers for Life.