The Seattle Times Web Edition: 50 Years from Trinity


RADIATION EXPERIMENTS on humans are not as clear-cut as the outrage over them might indicate. Many of the tests conducted in the Northwest were publicized years ago and led to important advances in medical treatment. But, as one ethicist says in this story published in the Seattle Times Jan. 12, 1994, no study can be justified solely by the knowledge it produces.

Seattle Times staff reporter

   Energy Secretary Hazel O'Leary will be in Seattle tomorrow to explore half a century of murky medical history and to try to walk the line between belated justice and a witch hunt of hindsight.
   In Clinton administration style, O'Leary is scheduled to host a town meeting exploring complaints that the federal government financed medical radiation experiments in the 1950s and 1960s, some of them involving prisoners or mentally disabled teenagers. Do the subjects now deserve compensation?
   There is no doubt she has hit a nerve. The crusade is getting O'Leary national publicity, with the most vocal critics comparing the doctors involved -- some of whom work or worked at the University of Washington Medical School and at Hanford -- to Nazi experimenters in concentration camps.
   Developmentally disabled teenagers in Massachusetts were fed radioactive milk, people were placed in an Idaho pasture in which officials were releasing radioactive iodine gas, and prison inmates in Washington and Oregon were deliberately made temporarily sterile by irradiating their testicles. The Clinton administration yesterday announced it would name an outside panel of scientists to identify radiation experiments that violated ethical standards.
    On some of the experiments, however, the scandal is not quite so clear-cut. Federal officials recognize that some cases being swept up in O'Leary's "come clean" effort were probably well within ethical standards.
   First, much of what is being pursued is old news. Stories about the Washington and Oregon prisoners were reported in the Seattle press in 1976 and reviewed here extensively again in 1986, when a congressional report was issued on 31 experiments, several in the Northwest.
   The experiments were not classified and most led to reports in medical literature. Al Jonsen, chairman of the UW's medical history and ethics department, served on a national committee that between 1972 and 1976 wrote today's research code in response to such early experiments, halting the use of prisoners or the developmentally disabled.
   What is new is that O'Leary, in office just a year, is reacting with more outrage to the experiments than earlier federal officials.
   Second, while prisoners were deliberately exposed to harmful levels that temporarily left them sterile - and they were subsequently encouraged to get vasectomies making them permanently sterile - proving that participants in such experiments were permanently harmed may be extremely difficult, Jonsen said.
   With one in three Americans expected to develop cancer anyway, how will the government determine if a subject's case can be tied to experiments decades before?
   Third, many of the experiments the Department of Energy is once more scrutinizing led to important advances in medical treatment.
   It was a routine day yesterday at University Hospital, where more than a dozen patients were having pictures of their heart, liver or skeleton exhibited on computer screens. The internal body parts were made detectable by injections of radioactive technetium, a procedure used on 10 million Americans a year.
   The technique was pioneered by the UW's Wil Nelp and Battelle researchers T.M. Beasley and H.E. Palmer at Hanford in a study published in the journal Health Physics in 1966. The trio injected eight volunteers aged 22 to 43 -- mostly housewives or medical students, Nelp said -- with 80 microcuries of the isotope technetium 95 and 96.
   Half of technetium left in the body decays away every six hours, meaning most of it is gone in a day or two. It is made in hospitals today from an isotope of molybdenum that in turn is delivered weekly from nuclear-power-plant reactors.
   By comparison, Nelp said, a heart examination with the technique today routinely exposes patients to 30,000 microcuries -- yet his study wound up on the list of those being scrutinized.
   So did studies by the UW's Clement Finch, now retired. One experiment inserted radioactive iron isotopes into food grown in the campus greenhouse and fed to volunteers, mostly medical students, to trace how different vegetables were taken up by the body to supply iron. "It gave us a much better idea of why there is so much iron deficiency in 500 million people in the world," Finch said.
   The radioactivity was used as a tracer to determine how humans used iron to build red blood cells and combat anemia, and in military studies of how to prolong the shelf life of blood plasma. A blood preservative called adenine spun off this research, Finch said.
   "I think it's just a lot of commotion," he said of the Energy Department's new probe.
   More controversial but previously reported were experiments by the UW's C. Alvin Paulsen in which the testicles of 64 prisoners at the state penitentiary at Walla Walla were subjected to 7.5 to 400 rads of radiation between 1963 and 1970.
   The prisoners were volunteers, paid $5 to $20 a month, but critics contend inmates can't really exercise free will. In 1986, three inmates complained they were not fully informed of possible side effects. Paulsen said he told them before treatment started that they would be asked to submit to vasectomies at its end to prevent any chance of producing genetically deformed children.
   Bobby Rhay, former warden at Walla Walla, said in 1986 that when the experiments were conducted he was told the government was concerned about the effect of space radiation on astronauts. Many of the volunteers were serving life sentences, he said.
   Five Oregon inmates sued for $4.3 million over similar experiments in 1976, but the suit was reportedly settled out of court for payments of $2,000 each.
   The experiment was initiated to determine what doses would harm human reproductive organs and came after some Hanford workers received accidental radiation doses in 1961, Paulsen explained. Because sperm cells produce rapidly, they are particularly sensitive to radiation. The information was later used to set worker safety limits.
   "We decided we needed to know the radiation effects in a well-structured, experimental design," Paulsen told The Times in 1986. He was in Washington, D.C. yesterday and unavailable for interview, but left a recorded comment on O'Leary's investigation that said, "She's entitled to say whatever she wants."
   Other experiments in the Northwest include:

   "The problem is that times have changed," Nelp said. "I grew up in an era when it was perfectly legitimate to do medical research in prison. Prisoners loved to volunteer because they got special treatment."
   "At the time," said Jonsen, "the consent of the subject was balanced against the social importance of the research."
   By the 1970s, however, the use of inmates had come under criticism and the medical profession set up a committee to review and approve proposals to use human volunteers.
   Jonsen said it is important for critics not to lump all radioactive experiments together: "Each one has to be judged on its own."
   Dr. Arthur Caplan, director of the Center for Biomedical Ethics at the University of Minnesota, agreed attitudes in medicine have changed. "I think we've made moral progress since those days," he said.
   But no study can be justified solely by the knowledge it produces, he said. Researchers must be certain the use of humans is the only way to obtain needed information, that they fully understand the possible consequences and voluntarily agree, and that the experiment does no harm.
   "No amount of benefit justifies those ethical violations - that's what we established at the (Nazi) Nuremberg trials in 1947," he said.

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