Wednesday, May 13, 2015

Warning, this post, like the real world, is disturbing

This is an actual warning.  This post is about  the Wikipedia article: "Unethical human experimentation in the United States".  This list contains some pretty awful things.  I’ve colored some of the text in such a way that it is unreadable unless you highlight it.  I’m doing this not to hide the information but to lower the barrier to entry of this blog post.  I’ve covered up things that might be controversial or particularly disturbing to some individuals.  As a quick preview, this blog post includes things like testing biological weapons on prisoners or giving radioactive oatmeal to mentally disable children and much worse than that.  This blog post also includes a lot of my thoughts, analysis, and recommendations, which are mostly at the front and back, they aren't much more disturbing than my normal blogs.

I think that this should be mandatory reading for all biology related majors.  Normally, when people think of unethical human experimentation, they think of Nazi Germany.  Many other unethical experiments were conducted by other superpowers, like imperial japan in world war II or the soviet union.  Someone wouldn’t be unjustified in having missed the US record behind all these.  The things the US has done are quite a bit better than Nazi Germany, but that doesn’t make them ok.  I am making this blog post to raise awareness by hopefully making it more accessible.

I think it’s important that people be aware of these types of problems.  You should be able to think about how your work is affecting people, even if it’s not so obvious.  Even if your work isn’t clinical, it might still affect people.  And even without being as bad as this list, bad practices can get people hurt.  Things like forging data can cause major problems in clinical trials.  There are some things that are still legal that people are doing right now that hurt people and some day you might be involved in one.  I’d like to hope that none of you do either of these but I’m not going to kid myself, its common.  The first thing is publication bias.  If you remove patients from a study because they yield negative results, it’s doctoring the data.  If you publish studies that support your conclusion and don’t publish ones that don’t, you’re legally in the clear.  A TED talk about the subject is here.  Without going into a political diatribe about my theory that the government is owned by big business, I’d like to talk quickly about quack medicine.  Basically in the US, it’s legal to sell fake medicine as medicine.  I don’t believe that anyone here will be selling homeopathy or “herbal supplements”, it’s still something you should know, and perhaps you can change it.  Basically in the US, you can sell “alternative medicine” as long as it has some asterisk text on the back saying (not intended to diagnose or treat any disease) and call it a supplement so it isn’t covered by the FDA.  This is unless its homeopathy, which due to some lobbying is exempt from this type of regulation.  None of these work (herbals, unusual uses for vitamins, least of all homeopathy), because the name for alternative medicine that works is “medicine”.  Not everyone knows about this though, there are plenty of people expecting that they are helping their health and taking these treatments instead of real ones.  I have a great uncle that died from cancer after trying to fix it with all kinds of fake stuff.  There is a lot of good research out there; it’s probably worth doing this yourself.  If you’re wondering what homeopathy is, it’s an old time snake oil treatment based on the false idea that diluting something makes it stronger.  It generally works by diluting something 1:100 30 (that’s 1 part in 10^60, Avogadro’s number is 10^28) times then eye dropping it on a sugar pill.

And now onto the really bad things, publication bias might be bad, but it really doesn’t stand up to testing biological weapons on prisoners.   I will be skipping some of the less interesting entries and a LOT of detail, so you should really visit the list at http://en.wikipedia.org/wiki/Unethical_human_experimentation_in_the_United_States

This blog post is going to be very long, feel free not to read all of it (especially ones with warnings), I'm making this post this long to impress upon you how shamefully long this list is.  The number and duration of these experiments is staggering.  Please make sure that you don't do anything to make this list longer.

Start of summary

MK Ultra
This is the most extreme one on the list in terms of how crazy it sounds in my opinion.  There is too much to cover in this blog post.  I demand that you look this up yourself.  The Wikipedia article is probably good, a podcast called “stuff you should know” has a good episode on it.  This is the actual CIA conspiracy, where the CIA did several experiments on enhanced interrogation and mind control (the second one didn't work but that didn't stop them from trying).  This included developing torture techniques, brainwashing techniques, and the use of drugs.  They also tested drugs, including LSD, on members of the general public without their consent or knowledge of the tests.


The list opens with surgical experimentation.  A lot of research now is done in a way that looks like chemistry, with tubes and things, but it’s important to remember that surgery is still part of biology.  The first entry is surgery performed on enslaved African women and their children before the civil war.  In addition to a lack of consent, this included not using anesthetic, lack of sterile procedure which frequently caused death (common at the time but it should make you avoid unnecessary surgery), and causing morphine addiction to allow offering morphine as a reward for compliance.  I think this article makes an omission here, I am sure that these kinds of unethical experiments (as well as normal torture and very brutal executions) were completely common before the end of slavery in the United States.  In 1874, while a patient was being treated for cancer, the doctor cut open her skull and shocked her brain with a needle until she entered a coma (and possibly kept going after that).  In 1896 a doctor performed spinal taps on 29 children to see if it would harm them.
[This next example is disturbing beyond my vocabulary]
[This is not a joke, it involves transplanting testicles]
From 1913 to 1951 performed many experiments including on prisoners.  These include forced sterilization and the implantation of testicles from various animals and executed inmates into prisoners.

Deliberately infecting people with pathogens to study their effects or potential treatments is the next entry on this list.  A lot of these experiments are testing biological weapons, either for use in war or for developing countermeasures.  If you don’t think you’re going to do this yourself, I’d like to remind you that accidents do happen, one of the most recent small pox deaths was due to a faulty fume hood.  Remember that next time you feel like spraying everything down in the TC room feels boring.  Various cases include giving prisoners bubonic plague in the Philippines, spraying the city of San Francisco with a supposedly harmless bacteria (it wasn't, this is why clinical trials are so hard, you would be surprised how many things look harmless until you give them to a lot of people) (this also kept going on for 19 years), several mass releases of mosquitoes and fleas in Georgia to test their utility as delivery vehicle, spraying biological agents on thousands of us military personnel from 1960-1969, and releasing harmless bacteria into the New York and Chicago subway to test how it spreads.

Normal diseases were tested as well.  The most striking case is Doctor Southam.  Basically to see if it would take, in 1952 he injected live cancer cells into prisoners and 300 healthy women.  The hypothesis he was testing was if it would give the women cancer, he expected he would give unsuspecting people cancer.  Later, in 1963, he did the same experiment again, injecting 22 elderly patients with live cancer cells.  His punishment was one year probation by the medical licensing board followed by election to the American Cancer Society’s Vice President position.  Contagious cancers are a real thing in dogs and Tasmanian devils, and this doctor knew that the cancers may survive in the patients.  These types of studies weren't frowned upon much.  In response to a study infecting mental institute patients with influenza, the editor of the journal of experimental medicine said "That the tests were wholly justified goes without saying".  Kind of a side note, the supreme court ruled in Buck vs. Bell in 1927 that it is legal to force "undesirables" (criminals and the mentally disabled) to be sterilized.  The US has had some  moral problems in its past and I think it’s foolish to say that future generations won’t think similar things about us now.  Other cases include giving dozens of orphans tuberculosis in 1908, giving orphans molluscum contagiosum in 1909, and infecting prisoners and psychiatric patients with malaria in the 1940s.

[The next section is about giving people STDs without their informed consent]
A lot (most actually) of the entries here are for STDs, I have grouped them together so that they won't be present in the normal pathogens summary in case it would discourage someone from reading it.  When I say "give" here, its unofficial shorthand, I'm not referring to any particular administration method.  Some of the diseases covered here are not exclusively sexually transmitted (such as hepatitis).  The most famous of which is the Tuskegee syphilis experiment.  Between 1932 and 1972, the US gave black men in Tuskegee Alabama syphilis the systematically prevented them from learning that they had syphilis and from getting treatment (even after antibiotics became widely available).  This caused additional infections to occur and some major suffering.  This study also had nearly no benefit, as a cure was discovered and there were plenty of cases available for study without inoculating anyone.  Another large study was conducted in Guatemala to avoid persecution.  The study involved using prostitutes to infect various people (including orphans) with STDs to test the effects of antibiotics.  This also included other administration including injections into the spine.  Other related incidence include giving 6 girls (<12 years) syphilis in the 1880s, giving several children gonorrhea in the late 19th century, giving 146 patients (including children) syphilis in a hospital, giving a black infant herpes in 1941, giving around 200 female prisoners viral hepatitis in 1950, and giving mentally disabled students viral hepatitis from 1950-1972.

The United States performed many studies to see what radiation would do to people’s health due to the possible use of nuclear weapons or dirty bombs.  This does not include the follow up studies done on Japanese citizens after we dropped the two atomic bombs in World War II.  It is possible that some of these doses were below the levels that are harmful, I don't know and I haven't checked.  Radiation poisoning is one of the least pleasant diseases known to man, it kills all the rapidly dividing cells in your body, so you get skin lesions, it causes hair loss, the lining of your intestines dies and falls off, and your bone marrow dies.  This will eventually kill you from anemia, but it kills your immune system so you die of infection first.  Other symptoms include your teeth falling out.
The United States tested nuclear bombs in open atmosphere near populated areas, subjecting large numbers of people to radiation, causing at least 11,000 excess doses of thyroid cancer and 1,100 deaths. One larger case included testing various things, including spinal taps and irradiated milk, on children at Sonoma State hospital that had mental disorders.  Over 1,400 patients died at this clinic.  Other cases include:  In 1949, 500,000 acres of space and three towns were exposed to iodine 131 and xenon 133, in 1953 pregnant women were given iodine-131 to see how if accumulated in fetuses (measured after abortion) and infants were given iodine 131 to see how it was processed in their bodies, in 1953 iodine-131 processing was tested on 65 premature and full term infants to check for a difference, in the 1960s over 100 Alaskans were subjected to continual iodine-131 exposure, in 1946-47 six people were injected with uranium 234 and 235 to see how much it takes to cause kidney damage (uranium is toxic like other heavy metals such as lead or mercury), in 1945-47 18 people were injected with plutonium, in 1945 a man was injected with plutonium and given surgery to treat non-existent cancer, following world war II pregnant women were given radioactive iron (disguised as a vitamin supplement) resulting in several deaths and radiation poisoning, in 1946-57 mentally disabled children were given isotope labelled oatmeal to track nutrient absorption, in the 1950's many burn victims were given large doses of radiation that caused increased mortality, in 1956 mentally disabled children were given radioactive calcium and had cerebrospinal fluid drawn, and in 1960-71 cancer patients were subjected to full body irradiation without their knowledge or consent causing intense pain and vomiting.

[warning, the next section may be more unpleasant]
In 1963-73 prisoners were paid for having their testes irradiated then paid for having a vasectomy (for fairly eugenic reasons).  In 1963, the testes of 232 prisoners were irradiated, at least four had children with birth defects but no follow up was done.

chemical agents
Chemical agents were tested on human subjects for much the same reasons as biological agents and nuclear technologies.  Cases include:  subjecting thousands of military personnel to mustard gas, feeding African American prisoners nothing but molasses for five weeks to test if sulphuric acid was a safe additive, in 1953 blistering agents were used on 41 children to test its effect, in 1851-74 71 prisoners were given dioxin (active ingredient of agent orange), a follow up of the previous study using 468 times the authorized dose (calibrated to factory worker exposure levels), before 1964 hundreds of inmates were used as test subjects for various cosmetics, and in 1967 blistering agents were applied to inmates skin.

Several drugs tests of notable lack of ethics are listed.  in the 1940s synthetic estrogen was tested on pregnant women without their knowledge causing miscarriages and low birth weight, in 1962 a test of acne medication was continued after severe liver damage appeared in the test population, and in 1971 oral contraceptives were tested on women without telling them if they were in the study or control group, leading to several unwanted pregnancies.

End of Summary

This list is really shocking.  It’s not only shocking that people thought these things were good ideas, but that some of these went on for a long time.  A lot of these studies required large groups of people to stay silent, when it should only take one person to tell the press to end it.  Other studies probably wouldn’t have been stopped even if someone did speak up because they had some large organization behind them.  Everyone knew the US government was testing nuclear weapons out in the open; there are pictures from Las Vegas of a mushroom cloud from a nuclear test that was just out in the open.  Please make it your duty to stop this list from getting any longer.

I’d heavily suggest taking some ethics classes.  MIT offers a lot; there is even an ethics concentration (which I will probably be taking).  If the philosophy is too boring or hard to grasp or silly sounding, MIT offers bioethics, which is a good class to take.  Even if you’re planning on quitting biology because of all those minipreps, taking an ethics class gives you a lot of tools that are useful for the other parts of your life.

If you’ve read this and you’re thinking that you want to do something to help people, I’d suggest looking into blood donation.  Wait till finals are over if you’re doing anything with red cells though.  You can donate platelets, which don’t make you tired at all.  The official information is available at http://www.redcrossblood.org/.  I’ve donated about one of everything (whole blood [the normal stuff], platelets, and double red), so I can answer any questions.  I've donated 4.5 gallons at time of writing.  I’m signed up to donate two days after this blog post goes live.  It includes a free blood typing, so if you ever get hit by a car the paramedics don’t have to hesitate to give you a transfusion.  It also includes a disease screen but please do not donate if that is useful to you, there are free HIV testing projects that won’t give cancer patients AIDS if they make a false negative.  You can download the Red Cross app as well.  It makes scheduling appointments easier, keeps track of your donations, allows you to get coupons in exchange for donating, and has a camera app for taking selfies (#bloodselfy to be exact, the red cross made that up on their own, not sketchy at all).  It also gives you xbox live rip-off achievements, like hat trick for donating three times.

If you aren't sad yet, may I suggest the most depressing wikipedia article "Fermi paradox" (http://en.wikipedia.org/wiki/Fermi_paradox) or the most existentially terrifying thing I've ever seen, CPG Grey's "Humans need not apply" (https://www.youtube.com/watch?v=7Pq-S557XQU).  The first is why we have not observed inteligent aliens.  The answer is probably that all civilizations are doomed to kill themselves or by killed, and all of the optimistic solutions (like maybe we're the first) are extremely unlikely.  The second is why you will be replaced by the machines and they wont have any reason to keep you alive.

If you want some less sad lists on wikipedia, here are some of my favorites:
                I don't like it because I'm a hipster but statistically you will find this funny.
                I have no words
                I have less than no words
                best quote:"This is an incomplete list"
                There is a compound called fucitol
And if you don’t believe that wikipedia is reliable, here is an article saying it is (it’s a joke about epistemology, it’s like a used car salesman telling you they aren’t lying, it doesn’t actually tell you anything)
                Reliability of Wikipedia
That's 7 pages in Word without images

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