Tuesday, October 5, 2010

Auschwitz 1944, America 1947 and 2010, part 1

“Dr. Mark Siegler, director of the Maclean Center for Clinical Medical Ethics at the University of Chicago’s medical school, said he was stunned [at the revelation that American doctors deliberately infected Guatemalan prisoners with venereal diseases and neither informed nor treated them]. 'This is shocking,' Dr. Siegler said. 'This is much worse than Tuskegee — at least those men were infected by natural means.'

"He added: 'It’s ironic — no, it’s worse than that, it’s appalling — that, at the same time as the United States was prosecuting Nazi doctors for crimes against humanity, the U.S. government was supporting research that placed human subjects at enormous risk.’” - New York Times, October 1, 2010

In May 1974, at UCLA, as an SDS activist and briefly a student at the Law School (I had finished a long draft of a Ph.D. thesis at Harvard on Marx’s Politics, but thought there were no longer jobs in academia for political theorists and that I would study philosophy of law), I debated Dr. L. Jolyon West , nicknamed Dr. “Jolly,” over the “Violence” Center. This was a project of the Law Enforcement Assistance Administration (a branch of the “Justice” Department) and the UCLA Medical Center. The LEAA gave half a million dollars secretly to UCLA to coordinate experimentation on prisoners in California. This included psychosurgery – lobotomy – as well as “routine” experimentation – infecting people and watching the diseases run their course.

Massive student protest broke out, including referenda calling for the Violence Center, as a racist, sexist and criminal organization, to be closed. Students voted 66-34 per cent for this referendum. Dr, West, the first head of the Violence Center, was replaced by Dr. Joshua Golden. Proclaimed “apolitical,” Dr. Golden’s research had included chemical castration of prisoners in Franco’s Spain.* The experimentation in Vacaville – one of the main California prisons - which UCLA proposed to coordinate provided a little money for cigarettes or candy per day if one would sign:

“I voluntarily consent to procedure x.”

As Susan Reverby, a Professor at Wellesley and author of two studies of the 40 year crimes at Tuskegee, explains today on Democracynow here and here, most of the prisoners who volunteered for these procedures were white. The chance to receive such tokens was considered a reward or privilege amidst the desolation of prison life (the black prisoners may also have sensed or known better). The procedures were not explained to the experimental subjects; they were, nonetheless, sometimes asked to sign. I wonder if they have such consent forms for psychosurgery.

“I voluntarily consent…” Seized with a bad conscience, the doctors of course did not notice that “I consent” is the active voice. They added the redundant “voluntarily” just in case anyone might think that signing away your physical or mental wellbeing, if not your life, while in prison – a state of being hardly conducive to “voluntary” activity – was coerced. One might consider this an affirmation of consent in English in the same sense that John Yoo’s 2002 Torture Memos for Bush and Cheney and current teaching at Berkeley might be considered “law.”

I helped write a pamphlet with Jim Prickett and Humberto Bracho called “Stop the Violence Center.” A UCLA psychiatrist Dr. Frank Ervin chose the patients for psychosurgery. A surgeon, Dr. Vernon Mark, performed the operations. They had written a book together Violence and the Brain to assert that people who rebelled against racism in Detroit in 1967 had a particular kind of brain damage that only psychosurgery could correct. Now the police were actually violent against black people (murdered several protestors at the Algiers Motel). But even for the police Ervin’s and Mark’s proposal would be a monstrous thing.** They had already received LEAA funding; the Violence Center proposal aimed to expand their work.

I had the interesting experience of reading, sometimes along with Humberto Bracho, a brilliant Mexican doctor and zoologist, then teaching at UCLA, some of the medical articles reporting/advocating psychosurgery.*** These articles were little more experimentally or intellectually serious than many contributions to political “science.” Put differently, medicine is at times a science and investigators make real discoveries. Yet it is quite often something counterfeited for political reasons or drug company profits, false and even strange. See here.

Lobotomies, as we discovered and wrote in the pamphlet, were done overwhelmingly on housewives, angry in their marriages in the 1940s and 50s and suffering from “depression.” That their mental state was not the result of unhappy marriage with no possibilities of work or escape was not entertained by these doctors. They simply sent electroshocks into the victim’s brains.

The effect of psychosurgery is supposedly to disconnect one’s ability to act from the thoughts (to make “Stepford wives”). Thus, the thoughts continue. The operations do not relieve the agony. One young woman, described in a paper advocating this “procedure,” called her mother upon leaving the hospital, and then threw herself off a bridge. The medical description was, this far, inaccurate. She still had the will to commit suicide.

In addition to the evil, one wonders about the competence both of the authors/physicians and the editors of the journal.

Legitimizing experimentation on prisoners, sexism was thus intimately connected to racism. The licensing of the “procedure” was also, as Ervin and Mark’s reference to the Detroit rebellion of 1967 showed, racist; a good number of the prisoners in California who were (to be) experimented on were black. But poor whites – women initially as well as the male prisoners emphasized by Reverby – and even some middle class individuals were also caught up in the procedures. Sexism thus provided the trial run for racism; racism ferociously harms blacks but also whites, Chicanoes and Asians. This thought was the core principle of the International Committee against Racism and is, to this day, a surprising insight. See Michael Reich, Racial Inequality: a political-economic analysis (Princeton, 1984).

We had only the UCLA proposals to the Law Enforcement Assistance Administration, which some human being in the bureaucracy, horrified by the proposal, had leaked. We did not have statistics on what they actually did in the prison, some of which Susan Reverby has now uncovered.

Jim Prickett, an historian, knew the deep analogy of past practices. In the South, according to white “doctors,” slaves often had “drapetomania,” the flight from home madness. The cure: cutting off the toes. See Kenneth M. Stampp, The Peculiar Institution. Analogously, women have bad thoughts; cut on their brains. The American contributions to the Nazi doctors were rich and deep. It is good to remember that John Brown and Abraham Lincoln were also Americans…

In debating Dr “Jolly”, I brought up some of these facts in the opening statement and in response to questions. Dr. “Jolly” began his opening statement droningly, “In 1948 I took the Hippocratic oath that I would do no harm…” and continued to the effect that he was a doctor and obviously a good guy. Though he had ascended to leader of the UCLA medical center, West, a psychiatrist, hadn’t written many articles himself. One was on the Kennedy and King assassinations, which included the peculiar statement that “it doesn’t matter whether you have black blood or white blood running your veins,” your assassination is a tragedy. Blood is human, I thought – but perhaps I lack the qualifications for this sort of “medical” research.

West also wanted to study the effect of LSD on elephants (perhaps he thought he could read their minds or give them an IQ test). He was no Temple Grandin...West injected a poor elephant with LSD, estimating the amount by the body weight, as he reported, not the brain weight. He murdered the elephant. But he reported this “scientific result” in the article to warn other researchers, should they get an elephant and have some LSD, not to make his mistake.

West had been, as a young doctor, a member of the Medical Committee on Human Rights (an organization allying doctors in the communist party and others to protest against horrific medical practices). Dr. Irving Selikoff, one of the members, was the first to connect cancer – asbestosis – with the production of asbestos (that production is so poisonous**** that today Johns Mansville has its headquarters in Denver, and very far from any actual asbestos production). Members of this Committee would have known quite a lot about Nazi war crimes. Dr. West, as can be seen from the articles, was not deep. Nonetheless, one might surmise that he abandoned certain insights to go for the power and money. That was the phenomenon visible at Harvard last week which divided those who were repelled by Peretz’s racism and Harvard taking the money. See here and here. It is the phenomenon in mainstream American politics that many politicians know about the rule of law and reject torture elsewhere but coddle war criminals if they are high American officials. Thus, John McCain led the Sentate in voting 91 to 9 against torture, but wanted the Presidency more than to be a decent person. When the Bush administration issued “signing statements” violating American and international law and even this resolution, he fell silent.

A leaftlet put out by the International Committee against Racism at the debate named: Auschwitz 1944 UCLA 1974. Libraries today sometimes have Jessica Mitford’s amusing but horrifying Kind and Usual Punishment. See here.***** It traces much of the experimentation in American prisons, in which “prisoners are cheaper than chimpanzees” as one enthusiast put it.

There were some newspaper reports, continuing demonstrations and a lot of embarassment for the UCLA administration. Nonetheless, the project continued.******

In the late 1970s, Ted Kennedy launched Senate hearings about the Tuskegee experiments. Here American doctors over 40 years exhibited Nazi-like racism. Their "data" was important, the consent of individuals – of “inferior races” unimportant. Doctor John Cutler, participated in the Guatemala research, went on to Tuskegee, and sadly lived out his life in denial about the criminal and monster he was (even those who have done great crimes, as Gandhi and King suggest, can, if stopped and if they are fortunate, turn from these things and act against them). As a result there are now strict protocols about research on human subjects. At the University of Denver, these are often wooden and bureaucratic, applying even to field research in the school of international studies (a brilliant Egyptian student writing on protest movements among rural women in Egypt and how they are not studied well though Orientalist and sexist perspectives had to file one on his upcoming interviews). Nonetheless, these guidelines are admirable. They seek to prevent horrors.

Experimentation on prisoners in America has abated, though, according to Reverby’s interview today, it is still being debated. Nonetheless, psychologists, anthropologists and other professionals have participated in “medicalizing” torture. As opposed to the American Medical and Psychiatric Associations which stood against war crimes, the leadership of the American Psychological Association has participated in certifying “walling” – so that a torturer who throws a prisoner against a wall without maiming her is just doing "kind and usual punishment" – and the like. The CIA has long corrupted medical research, working on sensory deprivation – covering the body in an orange suit, wearing goggles, distorting the senses, getting the prisoner in a diaper on the way to be tortured on Jeppeson airlines in Egypt or Uzbekistan or Guantanamo – to break down the person’s psyche (see Albert W. McCoy, A Question of Torture). Charles Graner, who went to jail for Abu Ghraib, "taking the fall" for the crimes of Bush, Cheney, Rumsfeld and Rice inter alia, was a prison guard in America. He learned to put women’s underwear on the heads of naked men long before he got to Abu Ghraib.

Still, the medical experimentation practiced by government-instigated or sponsored physicians on prisoners in the US and Guatemala, and developed largely on a racist and sexist basis, has been stopped or, to some extent, abated. Now, however, similar procedures are engaged in by officials and doctor/psychologists torturing Arab and Muslim captives. The seemingly consolidated gains of one era have been undercut, in a sharply authoritarian direction, by the Bush-Cheney administation. They have been limited by Obama (as in the case of Hilary Clinton's apology to the Guatemalan government), but the criminals have also been protected by the Obama administration. Jessica Mitford once quipped, "You may not be able to change the world, but at least you can embarrass the guilty." But sometimes, real victories can be won after long and difficult struggle. They are always, however, in danger of erosion. This is perhaps the most devastating argument against "reformism." At the least, the will to fight must be constantly renewed. The American doctors knew they were "not Nazis"; in the absence of movements from below against racism, however, they distinguished - and today distinguish - themselves in the annals of crime,

U.S. Apologizes for Syphilis Tests in Guatemala
Published: October 1, 2010, New York Times

From 1946 to 1948, American public health doctors deliberately infected nearly 700 Guatemalans — prison inmates, mental patients and soldiers — with venereal diseases in what was meant as an effort to test the effectiveness of penicillin.

American tax dollars, through the National Institutes of Health, even paid for syphilis-infected prostitutes to sleep with prisoners, since Guatemalan prisons allowed such visits. When the prostitutes did not succeed in infecting the men, some prisoners had the bacteria poured onto scrapes made on their penises, faces or arms, and in some cases it was injected by spinal puncture.
If the subjects contracted the disease, they were given antibiotics.

“However, whether everyone was then cured is not clear,” said Susan M. Reverby, the professor at Wellesley College who brought the experiments to light in a research paper that prompted American health officials to investigate.

The revelations were made public on Friday, when Secretary of State Hillary Rodham Clinton and Health and Human Services Secretary Kathleen Sebelius apologized to the government of Guatemala and the survivors and descendants of those infected. They called the experiments “clearly unethical.”

“Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health,” the secretaries said in a statement. “We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices.”

In a twist to the revelation, the public health doctor who led the experiment, John C. Cutler, would later have an important role in the Tuskegee study in which black American men with syphilis were deliberately left untreated for decades. Late in his own life, Dr. Cutler continued to defend the Tuskegee work.

His unpublished Guatemala work was unearthed recently in the archives of the University of Pittsburgh by Professor Reverby, a medical historian who has written two books about Tuskegee.

President Álvaro Colom of Guatemala, who first learned of the experiments on Thursday in a phone call from Mrs. Clinton, called them “hair-raising” and “crimes against humanity.” His government said it would cooperate with the American investigation and do its own.

The experiments are “a dark chapter in the history of medicine,” said Dr. Francis S. Collins, director of the National Institutes of Health. Modern rules for federally financed research “absolutely prohibit” infecting people without their informed consent, Dr. Collins said.

Professor Reverby presented her findings about the Guatemalan experiments at a conference in January, but nobody took notice, she said in a telephone interview Friday. In June, she sent a draft of an article she was preparing for the January 2011 issue of the Journal of Policy History to Dr. David J. Sencer, a former director of the Centers for Disease Control. He prodded the government to investigate.

In the 1940s, Professor Reverby said, the United States Public Health Service “was deeply interested in whether penicillin could be used to prevent, not just cure, early syphilis infection, whether better blood tests for the disease could be established, what dosages of penicillin actually cured infection, and to understand the process of re-infection after cures.”

It had difficulties growing syphilis in the laboratory, and its tests on rabbits and chimpanzees told it little about how penicillin worked in humans.

In 1944, it injected prison “volunteers” at the Terre Haute Federal Penitentiary in Indiana with lab-grown gonorrhea, but found it hard to infect people that way.

In 1946, Dr. Cutler was asked to lead the Guatemala mission, which ended two years later, partly because of medical “gossip” about the work, Professor Reverby said, and partly because he was using so much penicillin, which was costly and in short supply.

Dr. Cutler would later join the study in Tuskegee, Ala., which had begun relatively innocuously in 1932 as an observation of how syphilis progressed in black male sharecroppers. In 1972, it was revealed that, even when early antibiotics were invented, doctors hid that fact from the men in order to keep studying them. Dr. Cutler, who died in 2003, defended the Tuskegee experiment in a 1993 documentary.

Deception was also used in Guatemala, Professor Reverby said. Dr. Thomas Parran, the former surgeon general who oversaw the start of Tuskegee, acknowledged that the Guatemala work could not be done domestically, and details were hidden from Guatemalan officials.
Professor Reverby said she found some of Dr. Cutler’s papers at the University of Pittsburgh, where he taught until 1985, while she was researching Dr. Parran.

“I’m sifting through them, and I find ‘Guatemala ... inoculation ...’ and I think ‘What the heck is this?’ And then it was ‘Oh my god, oh my god, oh my god.’ My partner was with me, and I told him, ‘You aren’t going to believe this.’ ”

Fernando de la Cerda, minister counselor at the Guatemalan Embassy in Washington, said that Mrs. Clinton apologized to President Colom in her Thursday phone call. “We thank the United States for its transparency in telling us the facts,” he said.

Asked about the possibility of reparations for survivors or descendants, Mr. de la Cerda said that was still unclear.

The public response on the Web sites of Guatemalan news outlets was furious. One commenter, Cesar Duran, on the site of Prensa Libre wrote: “APOLOGIES ... please ... this is what has come to light, but what is still hidden? They should pay an indemnity to the state of Guatemala, not just apologize.”

Dr. Mark Siegler, director of the Maclean Center for Clinical Medical Ethics at the University of Chicago’s medical school, said he was stunned. “This is shocking,” Dr. Siegler said. “This is much worse than Tuskegee — at least those men were infected by natural means.”

He added: “It’s ironic — no, it’s worse than that, it’s appalling — that, at the same time as the United States was prosecuting Nazi doctors for crimes against humanity, the U.S. government was supporting research that placed human subjects at enormous risk.”

The Nuremberg trials of Nazi doctors who experimented on concentration camp inmates and prisoners led to a code of ethics, though it had no force of law. In the 1964 Helsinki Declaration, the medical associations of many countries adopted a code.

The Tuskegee scandal and the hearings into it conducted by Senator Edward M. Kennedy became the basis for the 1981 American laws governing research on human subjects, Dr. Siegler said.

It was preceded by other domestic scandals. From 1963 to 1966, researchers at the Willowbrook State School on Staten Island infected retarded children with hepatitis to test gamma globulin against it. And in 1963, elderly patients at the Brooklyn Jewish Chronic Disease Hospital were injected with live cancer cells to see if they caused tumors.

Elisabeth Malkin contributed reporting from Mexico City.

US says sorry for 'outrageous and abhorrent' Guatemalan syphilis tests
Experiments in 1940s saw hundreds of Guatemalan prisoners and soldiers deliberately infected to test effects of penicillin

Chris McGreal in Washington
guardian.co.uk, Friday 1 October 2010 19.25 BST

The US today apologised for "outrageous and abhorrent" experiments in Guatemala by American doctors who infected hundreds of prisoners, soldiers and mental patients with syphilis in the 1940s.

The experiments were intended to test the use of penicillin, then an early antibiotic. Medical researchers sought out prostitutes with syphilis to deliberately pass on the sexually transmitted disease to men through intercourse. Other men were injected. Conducted between 1946 and 1948, the experiments were led by John Cutler, a US health service physician who would later be part of the notorious Tuskegee syphilis study in Alabama in the 1960s.

According to Susan Reverby, a Wellesley College professor who uncovered records of the experiment and thereby led to today's apology, Cutler chose Guatemala because he would not have been permitted to do the experiments in the US.

The researchers were interested in whether penicillin could prevent, not just cure, early syphilis infection.

"Cutler and the other physicians chose men in the Guatemala national penitentiary, then in an army barracks, and men and women in the national mental health hospital for a total of 696 subjects.

"Permissions were gained from the authorities but not from individuals, not an uncommon practice at the time, and supplies were offered to the institutions in exchange for access," Reverby wrote in a research paper.

"The doctors used prostitutes with the disease to pass it to the prisoners (since sexual visits were allowed by law in Guatemalan prisons) and then did direct inoculations made from syphilis bacteria poured onto the men's penises or on forearms and faces that were slightly abraded when the 'normal exposure' produced little disease, or in a few cases through spinal punctures."

Reverby said that the men were given penicillin after they had contracted the disease but it is not clear whether they were cured, and "not everyone received what was even then considered adequate treatment".

The US apologised in a joint statement by the secretary of state, Hillary Clinton, and the health secretary, Kathleen Sebelius, in which they described the experiments as "clearly unethical".
"Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health. We deeply regret that it happened, and we apologise to all the individuals who were affected by such abhorrent research practices. The conduct exhibited during the study does not represent the values of the US, or our commitment to human dignity and great respect for the people of Guatemala."

Guatemala said it would study whether there were grounds to take the case to an international court. "President Alvaro Colom considers these experiments crimes against humanity and Guatemala reserves the right to denounce them in an international court," said a government statement, which announced a commission to investigate.

Guatemalan rights activists called for the victims' families to be compensated, but a US official said it was not clear there would be any compensation.

The revelations have echoes of the Tuskegee study, in which over four decades from the 1930s, hundreds of African American men were left untreated after having contracted syphilis.

*Francisco Franco was the fascist leader of Spain who with Hitler’s support destroyed the Spanish Republic.

**Needless to say, Ervin and Mark did not mention police murder nor the possibility of such operations on officers. The LEAA would have given no money for that.

***The chairman of the Department subsequently organized a campaign to fire Humberto on the grounds that he spoke English with a Spanish accent and was “hard for students to understand." The chair encouraged/recruited some racist students to try to complain about him in classes. After Bracho's denial of tenure, I and Floyd Banks, Humberto’s research assistant, a black graduate student, defended Humberto at an appeal hearing. The chair, who was German, but I suppose spoke English with an acceptably "Aryan" accent, ended up, after four hours, mouthing at me especially, under his breath, “mother fucker, mother fucker, mother fucker…” I was, I guess, “a traitor to the white race” although as I am a Jew, he may have been confused.

The department was forced to keep Humberto on the faculty. But there was, sadly, no wisdom or reconciliation about it.

**** Selikoff would not let anyone know where he was going to be for several years after publishing his paper in 1954. He was attending a rumor that Johns Mansville had taken out a contract on him. In the early 1970s, my friend Dr. Jim Dahlgren identified three other kinds of job-related cancers, which resulted in no workers surviving Johns Mansville after retirement age. 10 year old girls who had brought their fathers lunch at the plant would die of asbestos-related cancers twenty years later. The fibers went with the wind. White collar workers in the adjoining Mansville office buildings had high rates of early death from such cancers.

Jim was offered a half million dollar a year job by a workman’s comp medical firm organized by the leading company doctor in Los Angeles. The companies had workmen’s comp sown up. Lose a limb, become blind; maximum award: $40,000. But if one identified new industrially-related diseases as Jim had…

*****Mitford is JK Rowling's favorite author.

******In 1976 in Denver, I was listening to NPR news as I drove to work one day, and there was an expert witness testifying for Patty Hearst (Hearst had been kidnapped by the Symbionese Liberation Army, but had been coerced into/persuaded herself to take part in a robbery). Her relative, of the Hearst fortune, was on the Board of Regents of UCLA. "Oh my goodness," I exclaimed, "it's Dr. Jolly."

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