Human Subjects in Medical Research

HUMAN SUBJECTS IN MEDICAL RESEARCH

A Growing Debate

Humans had served as experimental subjects in medical research long before 1900. In 1799 and 1800 more than forty volunteers participated in extensive trials on the effects of inhaling nitrous oxide gas. In 1803 Englishman Thomas Percival wrote a classic text on medical ethics in which he discussed experimentation on patients. Contributing to the increase in this type of research was the acceptance in the United States, beginning in the 1880s, of the germ theory of disease causation, which required more research with both animals and humans. Basic research of all kinds was also beginning in American medical schools. In the closing decades of the nineteenth century many examples of research on hospital patients in the United States and Europe were publicized, and opposition to such work developed among both medical professionals and laymen. Many antivivisectionists who were critical of experimentation on animals soon joined this debate.

Human Vivisection

The word vivisection means to cut open a living human or animal. Around the turn of the century the term human vivisection came to mean any experimental procedure that did not offer direct benefit to a patient's health. Organizations such as the American Society for the Prevention of Cruelty to Animals and the American Humane Society, founded just after the Civil War, expanded their concerns from animals to children and adult human experimentation. In 1901 novelist Elizabeth Ward told Massachusetts legislators that "Dog or man, cat or baby, it does not matter so much—the fashion is to slice. Human vivisection follows animal vivisection naturally and easily, secretly or openly." The antivivisectionists were convinced that vulnerable animals and humans—such as children, hospital patients, and the institutionalized insane—were equally subject to exploitation by uncaring physician-researchers.

Professional Concerns

Throughout the first decade of the twentieth century Dr. Albert T. Leffingwell worked tirelessly at reform efforts and favored legal limits on animal research. In 1900 and 1902 Sen. Jacob H. Gallinger introduced a bill to regulate medical experiments on people in the District of Columbia, but the bill was defeated both times. Dr. William W. Keen, then president of the American Medical Association, and other physicians objected to such restrictions. They believed human vivisection was rare and could be regulated by the medical profession itself. Attempts to pass legislation similar to Gallinger's on the state level were made during the decade in Maryland and Illinois. The opening in 1904 of the Rockefeller Institute for Medical Research heightened public concern about medical research on animals. Three years later the institute opened a New Jersey facility for breeding laboratory animals; arsonists destroyed it in 1909. The continuing campaign against animal and human experimentation led the American Medical Association to form the Council on the Defense of Medical Research in 1908. Harvard physiologist Walter B. Cannon was appointed head of the council and spent almost twenty years defending medical research involving animal and human subjects.

The Debate Continues

The use of humans and animals as subjects for medical experimentation has often provoked controversy in the twentieth century. Nazi medical "experiments" in the 1940s, the infamous Tuskegee syphilis study that lasted from the 1930s until the 1960s, and other notorious examples have resulted in strong institutional controls in the United States over humans as subjects in medical and scientific research. While there is continuing pressure by the animal rights movement to ban animal experimentation and there remain concerns that scientists are too quick to involve human subjects, doctors and medical researchers have successfully defended the practice of vivisection and the autonomy of physicians in the laboratory and the operating room that was first meaningfully challenged at the beginning of the century.

Source:

Susan E. Lederei", Subjected to Science: Human Experimentation in America before the Second World War (Baltimore: Johns Hopkins University Press, 1995).