Abstract
Undue Risk: Secret State Experiments on Humans By Jonathan D. Moreno, W. H. Freeman, 1999, 347 pages; $24.95
A compendium of state-sponsored experiments carried out on unwitting human subjects, Undue Risk chronicles the history of unethical medical experimentation in the United States from World War II to the present. Jonathan Moreno, a professor of biomedical ethics at the University of Virginia, is an excellent candidate to tell this story. In 1994, Moreno was appointed senior staff member of the Advisory Committee on Human Radiation Experiments, the special committee set up by President Bill Clinton in response to Eileen Welsome's investigation of government radiation experiments during the Cold War (see above).
Though this book covers some of the same terrain as Welsome's Plutonium Files, Moreno includes chemical and biological warfare experiments in his investigation. He also surveys the grim history of human experimentation in several other countries, including the Soviet Union, Nazi Germany, Japan, South Africa, and Iraq.
Most of the cases recounted in the book–including the Manhattan Project's plutonium injections, army “field tests” of bacteriological agents in U.S. cities, and the CIA's LSD experiments–are well known. Moreno, however, uses these cases to explore the evolution of U.S. government policies regulating human experiments. Based on personal interviews, previous investigations, and government documents made available to him as a member of the advisory committee, Moreno presents a behind-the-scenes look at the government's struggle with medical ethics and its often half-hearted attempt to impose guidelines on human experimentation.
A central theme of the book is the clash between the government's need to undertake human experiments for national security purposes and the moral dilemmas such experiments present. Moreno writes, “A paradox of human experiments is that they often must be done to learn about the dangers of some agents, in spite of the general ethical obligation not to expose people to harm.”
However, many government agencies that undertook medical-military experiments during and after World War II not only ignored the ethical subtleties of their experiments, but failed to implement the cardinal rule of human experimentation–that subjects volunteer for an experiment after being informed of its nature and risks.
Moreno places much of the blame for this failure on the government's inability to implement rigid policies governing human experiments. An example of this is the ethics policy established by Defense Secretary Charles Wilson in 1953. The policy, which was based heavily on the Nuremberg Code, was intended to govern human experiments undertaken by the various branches of the Defense Department.
The policy was not well-received within the national security establishment. Moreno writes, “Medical and military critics in the Pentagon were opposed to any written policy that threatened to restrict human experiments for national security needs.” As it turned out, the critics' concerns were not warranted because the policy was ignored. During the years that Wilson's ethics policy remained the official Defense Department code, the military undertook hundreds of experiments that clearly violated its fundamental tenets.
According to Moreno, part of the problem with Wilson's policy–and with other policies that came later–was that it was shrouded in secrecy. Possibly because of its references to “the sensitive subject of unconventional warfare,” the policy had a “top secret” designation that prevented it from being properly disseminated among the many agencies involved in human experimentation. He writes, “Critics asked how it was expected that scientists, including many university professors on contracts whose careers depended on publishing [the results of their experiments], could be guided by a top-secret document!”
Another problem with Wilson's policy was that it failed to adequately address ethical issues. Moreno explains, “[The policy made clear] that there had to be subject consent but [it was] vague about how much risk people could be asked to accept in the name of national security research.”
One Defense Department agency, the army's Chemical Corps, had a particularly difficult time resolving this ethical dilemma. Because of a perceived need for improved protection against aerosolized microbes, in 1955 the corps' advisory board recommended that “tests on human subjects with biological agents be given a high priority.” The recommendation provoked widespread debate in the corps about how to determine what level of risk was appropriate in the experiment. One lieutenant colonel asked, “How can we develop and standardize [biological] and [chemical] agents when higher authority requires human dose-response data, yet these agents are considered by medical authorities to be too dangerous for human experimentation?”
Despite the shortcomings of the Wilson policy, it is clear that much of the fault for the government's abysmal record on human experimentation rests with the individuals who supported, organized, and undertook the experiments. But Moreno, who excoriates the “exploitation [of human subjects] in the name of national defense,” often fails to stress the importance of individual responsibility. Instead, he frequently chooses to focus blame on policy. But should educated doctors and military officers need written regulations to know that dangerous experiments on unwitting subjects violate these subjects' human rights and should not be undertaken–regardless of their potential national security value?
Moreno presents a convincing case for the importance of strong policies. Human experiments, he argues, will be necessary “as long as the nation's security is threatened by novel weapons of war.” A carefully crafted and widely promoted policy to guide researchers is the best assurance we can have that those charged with protecting us do not violate fundamental rights in the name of national security.
Moreno closes his narrative with an appeal: “In a dangerous world, let those who would protect us not add to the sources of undue risk.”