An Ethical Problem Part 22

3. The experiment is performed without the intelligent, and full consent of the individual experimented upon. Such legal consent of course is impossible to obtain from children, from the feeble-minded, or from lunatics in public inst.i.tutions.

It is the purpose of this chapter to demonstratte that such experiments upon human beings have been performed. Naturally, it will be impossible to quote the cases in full. Enough, however, will be given to prove that the charge of human experimentation is not the exaggeration of ignorance or sentimentality; that such methods of research have been practised upon the sick, the friendless, the poor in public inst.i.tutions, without their knowledge or intelligent consent; that they are in vogue even in our own time; and that hospitals and inst.i.tutions, founded in many cases, for charitable purposes, have lent their influence and aid in furnis.h.i.+ng either victims or experimenters.

Commenting upon certain human vivisections in Germany, the British Medical Journal declared in its editorial columns:

"Gross abuses in any profession should not be hushed up, but should rather bemade public as freely as possible, so as to rouse public opinion against them and thus render their repet.i.tion or spread impossible. And therefore we have reason to thank the newspaper Vorw"arts for dragging into light the experiments made by Dr. Strubell on patients.... The whole medical profession must reprobate cruelties such as these perpetrated in the name of Science."[1]

[1] British Medical Journal, July 7, 1900, p. 60.

It is this sentiment which justifies present publicity. The cases to which attention will be directed are not many; but they suffice to ill.u.s.trate the practice, and to enable the reader to decide whether such experiments should meet approval or condemnation.

I. The Case of Mary Rafferty

An instance of human vivisection which ended by the death of the victim, occurred some years ago in the Good Samaritan Hospital in Cincinnati. It would be difficult to suggest a name for a hospital more suggestive of kindly consideration for the sick and unfortunate: and to this charitable inst.i.tution, there came one day a poor Irish servant girl by the name of Mary Rafferty.

She was not strong, either mentally or physically. Some years before, when a child, she had fallen into an open fire, and in some way had severely burned her scalp. In the scar tissue an eroding ulcer-- possibly of the nature of cancer,--had appeared; and it had progressed so far that the covering of the brain substance had been laid bare.

No cure could be expected; but with care and attention she might possibly have lived for several months. We are told that she made no complain of headache or dizziness; that she seemed "cheerful in manner," and that "she smiled easily and frequently,"--doubtless with the confidence of a child who without apprehension of evil, feels it is among friends. The accident, however, had made her good "material"; she offered opportunity for experimentation of a kind hitherto made only upon animals. "It is obvious," says the vivisector, "that it is exceedingly desirable to ascertain how far the results of experiments on the brain of animals may be employed to elucidate the functions of the human brain."[1]

[1] This case, under the significant t.i.tle, "Experimental Investigations into the Functions off the Human Brain," is related at length in the American Journal of the Medical Sciences, vol. 93 (N.S., 67).

At the outset the experiments seem to have been somewhat cautiously made. n.o.body knew exactly what would be the result. The experimenter began by inserting into Mary Rafferty's brain, thus exposed by disease, needle electrodes of various lengths, and connecting them with a battery. As a result, her arm was thrown out, the fingers extended, but in the brain substance no pain was felt. Presently, as the experimenter grew bolder, other phenomena appeared. The vivisector shall tell the story in his own words:

"The needle was now withdrawn from the left lobe, and pa.s.sed in the same way into the (brain) substance of the right. ... When the needle entered the brain substance, SHE COMPLAINED OF ACUTE PAIN IN THE NECK. IN ORDER TO DEVELOP MORE DECIDED REACTIONS, the strength of the current was increased by drawing out the wooden cylinder one inch.

When communication was made with the needles, HER COUNTENANCE EXHIBITED GREAT DISTRESS, and she began to cry. Very soon, the left hand was extended as if in the act of taking hold of some object in front of her; the arm presently was agitated with clonic spasms; her eyes became fixed with pupils widely dilated; lips were blue, and SHE FROTHED AT THE MOUTH; HER BREATHING BECAME STERTOROUS; SHE LOST CONSCIOUSNESS AND WAS VIOLENTLY CONVULSED. The convulsion lasted five minutes, and was succeeded by coma. She returned to consciousness in twenty minutes from the beginning of the attack."

The experiment was a success. Upon the body of the poor servant girl, the distinguished vivisector had produced the "violent epileptiform convulsion" which Fritsch and Hitzig and Ferrier had induced in animals, by the same method of experimentation.

There are those who feel that further vivisecting should have then ceased, and that Mary Rafferty should have been allowed to die in peace. Such views, however, were not permitted by the experimenter to interfere with his zeal for scientific research. Other "observations"

were made, and the needles were again pa.s.sed into the brain, evoking almost the same phenomena. The final experiments were thus described by the vivisector:[1]

"Two days subsequent to observation No. 4, Mary was brought into the electrical room with the intention to subject the posterior lobes (of the brain) to galvanic excitation. The proposed experiment was abandoned. SHE WAS PALE AND DEPRESSED; HER LIPS WERE BLUE, AND SHE HAD EVIDENT DIFFICULTY IN LOCOMOTION. She complained greatly of numbness.... On further examination, there was found to be decided PARESIS and rigidity of the muscles of the right side.... She became very pale; her eyes closed; and she was about to pa.s.s into unconsciousness, when we placed her in the rec.u.mbent posture, and Dr. S. gave her, at my request, chloroform by inhalation.

"The day after observation No. 5, MARY WAS DECIDEDLY WORSE. She remained in bed, was stupid and incoherent. In the evening she had a convulsive seizure.... AFTER THIS, SHE LAPSED INTO PROFOUND UNCONSCIOUSNESS, AND WAS FOUND TO BE COMPLETELY PARALYZED ON THE RIGHT SIDE.... The pupils were dilated and motionless."

[1] Italics not in original.

When did death come to her release? We do not know; the omission is significant; it may have been within a few moments. The next sentence in the report is headed by the ominous word, "AUTOPSY." The brain was taken out, and the track of the needles traced therein. One needle had penetrated an inch and a half. There was evidence of "INTENSE VASCULAR CONGESTION."

In cases like this, the investigation of a coroner apparently is not required. The experimenter himself was the physician to the hospital. He tells us of course that Mary's death was due to an extension of the disease, for the relief of which she had been led to the "Good Samaritan Hospital." Of the real cause of death, there was apparently but little doubt among scientific men. An English vivisector, Dr. David Ferrier, whose experiments upon monkeys had perhaps first suggested their repit.i.tion on a living human brain, questioned somewhath the propriety of the American experiments. In a letter to the London Medical Record, he referred to "the depth of penetration of the needles"; the "occurrence of epileptiform convulsions FROM THE GENERAL DIFFUSION OF THE IRRITATION WHEN THE CURRENTS WERE INTENSIFIED," and declared that the "EPILEPTIC CONVULSIONS AND ULTIMATE PARALYSIS are clearly accounted for by the inflammatory changes" thus induced.

That the experiments had been to some extent injurious to his victim, the vivisector himself, in a letter to the British Medical Journal, very cautiously admitted.[1] He regretted, he said, that the new facts which he had hoped would further the progress of Science were obtained at the expense of SOME injury to the patient. She was, however, "HOPELESSLY DISEASED,"--as if that fact tended to justify her martyrdom! "THE PATIENT CONSENTED TO HAVE THE EXPERIMENTS MADE." Is not this excuse the very height of hypocrisy? Twice, he had stated in his report of the case, that the young woman was "RATHER FEEBLE- MINDED"; he suggests that this poor, ignorant, feeble-minded servant- girl was mentally capable of giving an intelligent consent to repeated experiments upon her brain, the possible result of which even HE could not foresee!

[1] British Medical Journal, May 30, 1874, p. 727.

Who made these experiments? It was Dr. Roberts Bartholow, at that time the physician of the "Good Samaritan Hospital" in Cincinnati. His biographer says that he gained no credit "for his candour in reporting the whole affair,"--a hint, the significance of which for future experimenters, it is not very difficult ot perceive. Yet his treatment of Mary Rafferty was no bar to his professional advancement. Not long after his victim was in her grave, one of the oldest medical schools in the country,--Jefferson Medical College of Philadelphia--offered him a professor's chair; and for several years he was Dean of the medical faculty of that inst.i.tution.

It might seem impossible that any physician of the present day would care to come forward in defence of this experiment. Yet forty years after the deed was perpetrated, such justification was apparently attempted in an American journal, and republished in a pamphlet issued by the American Medical a.s.sociation.[1] It would seem at the outset that only by suppression of the worst facts relating to the case, could any defence be essayed. WAS THERE ANY SUCH SUPPRESSION OF MATERIAL FACTS? Let us see.

[1] "The Charge of Human Vivisection," by Richard M. Pearce, M.D., Journal of the American Medical a.s.sociation, February 28, 1914.

Did any injury to Mary Rafferty result from these experiments upon her brain? Bartholow himself admits some injury; he says that to repeat the experiments "would be in the highest degree criminal." The modern apologist, however will have it otherwise. At the beginning of the experiment, she smiled as if amused; and this, he tells us, "whows that she did not object, that the pain was not severe, AND THAT NO HARM WAS DONE HER." Is this a fair summary of the symptoms elicited during these experiments upon the brain? Why did the apologist mention only the "smile," and neglect altogether to mention the other symptoms reported by Dr. Bartholow? Why does he pa.s.s in silence her complain of "ACUTE PAIN IN THE NECK," the "GREAT DISTRESS" EXHIBITED, THE ARM AGITATED WITH CLONIC SPASMS, THE FIXED EYES, THE WIDELY DILATED PUPILS, THE BLUE LIPS, THE FROTHING AT THE MOUTH, THE STERTOROUS BREATHING, THE VIOLENT CONVULSION lasting for five minutes and the succeeding unconsciousness lasting for twenty minutes? Why does the apologist leave unmentioned the symptoms following the subsequent experiments,--the pallor and depression, the blue lips, the difficulty in locomotion, the decided paresis and rigidity of muscles, the profound unconsciousness, THE FINAL PARALYSIS? Do omissions like these suggest an ardent desire to present the whole truth of the matter for the information of the public?

The defender of the experiments tells us:

"It is not an uncommon procedure in neurologic surgery, to stimulate after operation, in conscious patients, certain areas of the brain.

This procedure is a familiar one to all neurologists, and it is THEREFORE DIFFICULT to understand why so much has been made of these early observations in Cincinnati."[1]

[1] Italics not in original.

Aside from the astounding confession contained in this admission of familiar procedure, it is difficult to understand what is meant by this paragraph. Is it a suggestion that these experiments upon Mary Rafferty were observations following a remedial surgical operation?

It is surely impossible that this can be the meaning; for in the original account of the "Investigations into the function of the human brain," there is not a line in support of such hypothesis. The reader may make his own interpretation of a paragraph which seems exceedingly obscure.

No apology for these experiments could be complete, which did not refer to the alleged "consent." It is thus presented:

"If the patient under these circ.u.mstances consented to the observations described, it would appear to be a matter between herself and the physician making the observations."

This is the view of the matter which the apologist invites us to accept. On the one side, stands a poor, ignorant, feeble-minded Irish servant girl, full of faith and implicit trust in the benevolence of those about her; on the other a learned scientist, eager, as he says, "to ascertain how far the results of experiments on the brains of animals may be employed to elucidate the functions of the human brain"; and her "consent" to procedures the purpose and dangers of which she knows nothing,--to experiments involving her life, are suggested as a justification of whatever was done, and as a matter with which Society need have no concern!

Upon such methods of vindication every intelligent reader may form his own judgment. He will doubtless reach the conclusion that such vital omission of essential facts,--no matter whether accidental or intentional,--absolutely nullifies the value of the entire apology.

Let us hope that the next defender of these experiments, writing not only for the instruction of the medical profession but also for the general public, will proceed along somewhat different lines; that every symptom which Bartholow mentions, he will mention also; that if he speaks of the "CONSENT" of the victim, he will frankly tell us that it was consent of one whom the experimenter himself called rather "feeble-minded"; and that if he thinks other palliating circ.u.mstances exist, he will at least graciously furnish us with references to the evidence presented by the experimenter, upon which he grounds his belief.

II. Experiments with Poison.

Of all experiments upon patients in hospitals, probably one of the boldest was Dr. Sydney Ringer, physician to the University College Hospital in London. His position in this inst.i.tution gave him a peculiarly favourable opportunity for the utilization of the human "material" under his care. The experiments upon his patients were frankly reported by himself, and were published in his well-known work on Therapeutics.[1] For the most part these experiments were made with poisonous drugs. Are we justified in cla.s.sing them as human vivisections? If in any case, the drug can be shown to have been administered for the welfare of the patient, it was legitimate medical treatment, to which criticism does not apply. Were the drugs so administered? The experimenter shall describe his work in his own language.

[1] "Handbook of Therapeutics," by Sydney Ringer, M.D. Eighth edition, William Wood and Co., New York.

Poisoning with Salicine

"In conjunction with Mr. Bury, I have made some investigations concerning the action of salicine on the human body, USING HEALTHY CHILDREN FOR OUR EXPERIMENTS, to whom we gave doses sufficient to produce toxic (poisonous) symptoms. We tested the effects of salicine in three sets of experiments ON THREE HEALTHY LADS. To the first two, we gave large doses, and produced decided symptoms.... Under toxic (poisonous) but not dangerous doses, the headache is often very severe, so that the patient buries his head in the pillow. There may be very marked muscular weakness and tremour...."

Another "set of experiments" was made on a boy ten years old, who had been brought to the hospital to be treated for belladonna poisoning.

"Our observations," said Dr. Rigner, "were not commnced TILL SOME DAYS AFER HIS COMPLETE RECOVERY." Among effects of the experiment was a severe headache,--"so severe that the lad shut his eyes and buried his head in his arm...became dull and stupid, lying with his eyes closed...."

Other experiments were made upon a boy only nine years old, almost well from an attack of pneumonia, the temperature having become normal over a week before. Dr. Ringer's experiment went so far as to give him apparently considerable apprehension. He speaks of the flushed face, the trembling hand, and lips, the laboured breathing, the spasmodic movements of limbs.

"These symptoms were at their height at midday, and were so marked, and the pulse and respirations so quick, that we must confess we felt a little relief when the toxic (poisonous) symptoms which became FAR MORE MARKED THAN WE EXPECTED, abated; not that at any time the boy was dangerously ill; but as the symptoms progressed, after discontinuing the medicine, WE DID NOT KNOW HOW LONG AND TO WHAT DEGREE THEY MIGHT INCREASE." (!)

What shall be said of experiments like these, made upon children who had almost or quite recovered from ailments for which medical advice was sought?

Poisoning with Ethyl-Atropium.

This drug has no recognized medical use. In order to make experiments with it upon patients under his care, Dr. Ringer was obliged to have it specially manufactured. He refers to "our experiments upon man,"

and states that the poisonous substance

"produces decided but transient paralysis, THE PATIENT BEING UNABLE TO STAND OR WALK, and the head dropping rather toward the shoulder or chest, and the upper eyelids drooping."[1]