Without Consent

Aug 1947

The rule. In December 1946 an American military tribunal opened a trial at Nuremberg of 23 German physicians and administrators for war crimes and crimes against humanity. Sixteen were found guilty and seven were sentenced to death. In August 1947 the judges set out ten points on permitted medical experiments, and the first is the line shown here. This story follows four American programs in which the government’s own later inquiries found people used in experiments without their consent.

Sep 1943

Volunteers. In September 1943 the U.S. Public Health Service began trying to infect prisoners at Terre Haute, Indiana, with gonorrhea. Dr. John Cutler, 28, ran the work at the prison. The men had to be at least 21 and to understand the purpose and the risks, and each got $100, a certificate and a letter to the parole board. The infections could not be produced reliably and the work ended in 1944 with 241 prisoners involved; the Commission says it gave “a scientific impetus for the experiments in Guatemala.”

Feb 1947

Guatemala City. Cutler arrived in August 1946. The Pan American Sanitary Bureau, with a Public Health Service grant, built a laboratory and made agreements giving the researchers access to Guatemala’s hospitals, army and prisons. Cutler later wrote that the idea originated with a Guatemalan physician, Dr. Juan Funes, and the director of the psychiatric hospital, Dr. Carlos Salvado, made staff available. In February 1947 a Public Health Service colleague wrote Cutler that when he told Surgeon General Parran about the project, “a merry twinkle came into his eye” and Parran said the words shown here.

27 Apr 1947

Ethically impossible. On 27 April 1947 the New York Times science editor, Waldemar Kaempffert, wrote that it would be “ethically impossible” to “shoot living syphilis germs into human bodies.” The Commission found that Cutler and his colleagues had been planning that kind of experiment for months, with prisoners and psychiatric patients in Guatemala. One of them, Dr. Arnold, wrote to Cutler that he was uneasy about the psychiatric patients because they “cannot give consent.” Cutler sent the Times note to his director and urged more secrecy.

1948

The count. The researchers intentionally exposed prisoners, soldiers from several parts of the army, and patients of a state psychiatric hospital; commercial sex workers, who in most cases were also intentionally infected, were used to pass on disease. They also ran diagnostic tests on 5,128 people, some of them among those exposed, including 1,384 children who had blood drawn and, in some cases, lumbar punctures. Cutler’s own records note 83 deaths, whose relation to the experiments the Commission calls unclear. The Commission found “no evidence of voluntary consent by the subjects.”

23 Aug 1948

Berta. The Commission profiles one patient of the psychiatric hospital, Berta; her age and illness are unknown. In February 1948 Cutler injected her with syphilis, and she was not treated for it until three months later. On 23 August, the Commission says, he wrote that she appeared about to die, and the same day he infected her eyes, urethra and rectum with gonorrhea. She died on 27 August. The Commission concluded that the people who approved, conducted, facilitated and funded the experiments “are morally culpable to various degrees.”

1932

Bad blood. In 1932 the U.S. Public Health Service, working with the Tuskegee Institute, began a study in Macon County, Alabama. The notices announcing it went only to Black men, the men’s attorney Fred Gray told the Senate: “Only blacks were given notices.” The CDC says the men were told they were being treated for “bad blood”; the Public Health Service left those with syphilis untreated and watched, in the words of the 2011 Commission, “the progress of their infections.” The 1973 federal panel found no evidence of informed consent: “Submitting voluntarily is not informed consent.”

1941

Not on the list. Letters from February 1941 to August 1942 between Dr. Vonderlehr and health officials in Tuskegee show that a draft board was given a list of 256 study men under 45 and asked to exclude them “from the list of draftees needing treatment”; some had already received notices “to begin their antisyphilitic treatment immediately.” In 1950 Wenger, of the Public Health Service, wrote the words shown here. A 1969 summary counted “only seven patients whose primary cause of death was ascribed to syphilis.” The men’s wives, widows and children were added to the federal benefit program in 1975.

1953

Penicillin. The sources date it three ways: the CDC says penicillin was the treatment of choice by 1943; the Encyclopedia of Alabama, widely available in the late 1940s, adding that it might not have helped men already in the last stages; the panel, “generally available” in 1953. The panel heard that treatment was deliberately withheld and also that men who sought it were not denied, and found most had some treatment from doctors outside the study, whose adequacy is not known. The Encyclopedia says the Public Health Service made an effort to keep the drug from the men. The panel’s judgment is the line shown here.

Nov 1966

A letter from San Francisco. Peter Buxtun, a Public Health Service venereal disease tracker in San Francisco, heard about the study and sent for the reports. He went to the library to look up the German war crimes proceedings and, he told the writer Carl Elliott, “directly compared” the work of the CDC in Tuskegee to what the Nazis had done. In March 1967 he was summoned to Atlanta, where, in his telling, John Cutler said: “This is serious work we are doing.” Buxtun left the service in 1968.

6 Feb 1969

Never repeated? On 6 February 1969 an ad hoc committee met for three hours and ten minutes to decide whether the study should end or go on. Its summary said that such a study would never be repeated, that there were medical facts still to be learned by continuing, and that treatment was “not indicated” unless the men had signs of active syphilis; it listed the danger of a late Herxheimer reaction. The study went on. In 1970 Drs. Anne Yobs and Arnold Schroeter recommended procedures for its orderly termination, and Dr. James Lucas, Assistant Chief of the CDC’s Venereal Disease Branch, wrote that nothing learned would “prevent, find, or cure a single case of infectious syphilis.”

25 Jul 1972

July 1972. Buxtun gave his documents to Jean Heller of the Associated Press, who published the story on 25 July 1972. A panel advised stopping the study in October and the Assistant Secretary for Health announced its end a month later; a class action ended in 1974 with $10 million and medical care for the families, and, notes the Encyclopedia of Alabama, no one was ever prosecuted. The panel called the study “scientifically unsound.” A. Caplan wrote in 2010 that “Many African-Americans believe that the government let doctors give people syphilis,” which “did not happen in Tuskegee”; the 2011 Commission says Guatemala’s subjects were “deliberately exposed,” most not already infected, “again unlike Tuskegee,” where the CDC counts 399 men who had it and 201 who did not, though the panel found that controls who caught syphilis were moved to the untreated group.

1973

In his own words. In 1973 Charles Pollard and Lester Scott told the Senate Health Subcommittee what happened to them, with Fred Gray, their attorney. Pollard said the doctors “said I had bad blood and they was working on it,” and that “they give me a spinal tap.” Asked by Senator Edward Kennedy whether anyone said he was in a test or an experiment, he answered as above. After 25 years, he said, they “gave me $25, a $20 and a $5 bill.”

16 May 1997

The apology. On 16 May 1997 President Bill Clinton named the eight surviving men: Mr. Shaw, Charlie Pollard, Carter Howard, Fred Simmons and Frederick Moss in the East Room, and Sam Doner, Ernest Hendon and George Key through their families. He said the government “did something that was wrong – deeply, profoundly, morally wrong,” and that even once a cure was discovered the men “were denied help, and they were lied to by their government.” To African American citizens he said he was sorry that “your federal government orchestrated a study so clearly racist.” He also apologised to Macon County, to Tuskegee and “to the doctors who have been wrongly associated with the events there.”

13 Apr 1953

MKULTRA. On 13 April 1953 the Director of Central Intelligence approved a funding channel, proposed by Richard Helms, for sensitive research on chemical and biological agents. The Church Committee set it in Cold War fear: the belief that hostile powers had used such agents in interrogations and brainwashing, and reports that the Soviet Union was making LSD. The CIA’s Inspector General warned in 1957 that exposure of its “unethical and illicit activities” would have serious repercussions, and in 1963 that the program raised questions of legality, put the rights of U.S. citizens in jeopardy, and could cause “serious adverse reaction in U.S. public opinion.” The Church Committee found that the tests, continued for years after the danger was known, “demonstrate a fundamental disregard for the value of human life.”

19 Nov 1953

The cabin. The Church Committee reported that on 19 November 1953, at a cabin in Maryland, Frank Olson, an Army civilian at Fort Detrick, drank a liqueur into which CIA officer Robert Lashbrook had put LSD, in an experiment he and Sidney Gottlieb performed. Olson fell from a tenth-floor window of a New York hotel on 28 November; the Rockefeller Commission wrote that he “jumped.” The CIA’s General Counsel wrote that failure to take reasonable precautions “was culpable negligence,” yet the Director’s letters to two men were, the Church Committee said, “not reprimands,” and the CIA did not tell the family what had happened.

1955

Ten more years. After Olson’s death the dangers of secret LSD dosing were clear, the Church Committee said, “yet the CIA continued or initiated” such a project; the Rockefeller Commission called the tests on unaware people “clearly illegal.” In 1977 Admiral Turner confirmed safe houses in San Francisco and New York City, said six of the 149 subprojects had enough evidence of unwitting testing, and, asked how many people were recruited, answered “No idea.” In 1964 Helms asked for the testing to be resumed or definitively cancelled, wrote “we have no answer to the moral issue,” and, the Committee said, got no formal action. The Committee counted two deaths from these programs; one, Harold Blauer’s in January 1953, came in tests under an Army contract, and the Army also gave LSD to 16 unwitting subjects.

3 Aug 1977

What was left. In January 1973 the CIA destroyed most MKULTRA records; Gottlieb testified, and Helms confirmed, that Gottlieb acted on Helms’s verbal order. The Church Committee said the destruction also prevented the CIA from finding and helping the people who had been subjects. The seven boxes found in 1977 were discovered in March and Congress was told in July; Senator Inouye asked if Admiral Turner was satisfied they had not been kept from the Senate, and he said: “I have no way to prove that, sir.” Senator Kennedy said the CIA “drugged American citizens without their knowledge or consent.”

1945

Eighteen patients. From 1945 through 1947, the Advisory Committee on Human Radiation Experiments reported, Manhattan Project researchers injected eighteen hospital patients with plutonium to learn how to measure it in workers’ bodies: one at Oak Ridge, eleven at Rochester, three at Chicago and three at the University of California. Its verdict: “we believe that these experiments were unethical,” because people were used as a means and deceived, though it also said the results were useful. A 1974 inquiry by the Atomic Energy Commission found fifteen of sixteen charts without a record of consent, and its investigators found “some form of disclosure” in California and Chicago. Of Ebb Cade, injected at Oak Ridge, a physician reported that his consent was not obtained; a researcher said of Albert Stevens in California, “to my knowledge he never found out”; and Elmer Allen’s daughter told the Committee her father “was not an informed participant.”

3 Oct 1995

Fear of embarrassment. Clinton set up the Advisory Committee in January 1994. Receiving its report on 3 October 1995 he said thousands of government-sponsored experiments had taken place, most ethical and some unethical “not only by today’s standards, but by the standards of the time”; in one, “scientists injected plutonium into 18 patients without their knowledge.” The Committee itself found that the Atomic Energy Commission decided on secrecy from 1 January 1947 for “legal liability and adverse public reaction, not national security.” On behalf of the United States, Clinton offered “a sincere apology” to the subjects, their families and their communities.

5 Apr 1995

A question left open. The radiation committee’s staff drafted a memo on Operation Paperclip because the Air Force School of Aviation Medicine, which conducted dozens of human radiation experiments, recruited from it; the memo is marked a draft for discussion. At least 1,600 scientists and dependents came through Paperclip and its successor projects, and its director, Navy Captain Bosquet Wev, wrote in 1948 that most had belonged to Nazi organizations, “with a very few exceptions” through pressure, while the staff noted that many claimed inactive membership. The staff found no documents that one recruit, Dr. Gerstner, took part in human experiments in Germany; another, Hubertus Strughold, denied involvement with Nazi experiments. Another recruit was Wernher von Braun, who led V-2 development; NASA says he “was involved in decision-making about the use of slave labor.”

1 Oct 2010

Found in an archive. Cutler gave his records to the University of Pittsburgh in 1990; the historian Susan Reverby found them there in June 2003 and presented them in May 2010. On 1 October 2010 President Obama telephoned Guatemala’s President Álvaro Colom to apologise, and the Commission records that he expressed “deep regret.” The Secretaries of Health and of State apologised “to all the individuals who were affected by such abhorrent research practices.” The Commission reported “gross violations of ethics” by today’s standards and the researchers’ own, and said Guatemala sent it no documents; Guatemala’s own commission reported separately, and its findings are not given here.

21 Jul 1975

The Olson family. On 21 July 1975 the White House said Ford apologised on behalf of the U.S. government for the circumstances of Olson’s death; Congress then paid his sons $187,500 each in return for waiving their claims. In 1994 the family exhumed his body, and an autopsy found a hematoma on the temple which, a forensic scientist said, came from a blow before the fall; the New York district attorney changed the cause of death from “suicide” to “unknown.” In 2012 the sons sued, alleging murder; in July 2013 a federal judge wrote that “the public record supports many of the allegations,” and dismissed the suit, finding most allegations untimely and waived by the 1976 settlement, without ruling on how Olson died. No court has found that he was killed.

Sep 2011

What was paid. Clinton apologised for the radiation experiments in 1995 and for Tuskegee in 1997, and Obama for Guatemala in 2010. Tuskegee ended in a $10 million settlement and medical care; the government settled with 16 families of the plutonium patients. The sources read here show no payment for Guatemala or MKULTRA, and no apology for MKULTRA as a whole. This story did not read the Rockefeller report beyond a few pages, the rest of the radiation committee’s report, or any Guatemalan source.