Ethical violations in landmark medical research studies and their implications

¶ … medical and ethical dilemmas, even if the activities were deemed technically legal or not questioned at the time. The fact that the studies sought to gain information from human subjects under unfair and undesirable circumstances means their results cannot be condoned and the findings cannot be accepted or used as viable study data. Each study directly crosses the line into scientific unacceptability in different ways; and while their underlying approaches raise interesting historical and philosophical questions -- that did not need to be tested to be debated -- there is no way to weed out the biases that contaminate the data.

This being said, it is generally safe to say that all of the studies were improper (unethical and/or illegal) at the time that they were being undertaken. This can be seen in the fact that in every instance the medical professionals involved were either directly or indirectly punished for the actions once the circumstances became known. While some of the specific individuals may have escaped their own condemnation and may have even been initially rewarded, they were chastised professionally or isolated and had to hide their involvement. Today, we accept that having a cavalier attitude about a study (by insisting that most participants won't get cancer because the subject's bodies will reject the cells, as was the case in the Jewish Chronic Disease study) is no more acceptable than using mentally incompetent or forced subjects. Willowbrook's infection of persons unable to be medically informed of what they are going through is no different than using the power of any institution to forcibly make a group or class of people go through dangerous or barbaric studies.

Could the results have been carried out differently? In many instances yes, even though the results might have taken longer to find using better scientific methods. The subjects could have been asked, could have been given the chance to volunteer, or could have been used in less harsh ways to begin building parts of the answers to the problems. But even this is misleading because there can be no scientifically valid reason for using such coercive tactics. Stress and deception can probably change the way people act or react to stimuli, which would call into question any or all of the results that were obtained. And, of course, some of the most barbaric of Nazi studies were likely not worth studying at all. For these reasons all of the data is suspect and not worth the level of invalidity introduced by these methods.

I have never knowingly been a witness to scientific misconduct at these kinds. And, of course, I hope that such activities are not happening. I am concerned like other professionals that some medical studies are still biased because of racial, gender and economic considerations. When I believe this is happening I try to make notes about the issues or concerns to at least to document the realities so others might learn of these prejudices. How people use medicines and procedures is influenced by a number of social factors. I am aware of patients who use prescription drugs in inappropriate ways because they cannot afford to take proper dosages, for example, or they take dosages in ways that stretch out their supplies. Making notes about this is one way to address these kinds of biases.