The development of a cure for
cancer would be as welcome to the human race as the attainment
of world peace. In fact, the United States declared a
"War on Cancer" with the National Cancer Act of 1971 and since
then there's been progress in many fields, though V-C Day has yet
to be celebrated. Cancer is an insidious collection of
diseases and research proceeds in many directions. From 1950
to 1972, a project to develop total
body irradiation (TBI) yielded a spinoff: the U.S. Department
of Defense believed that cancer patients who had received such
radiation treatment -- customarily administered along with
chemotherapy during bone marrow transplant -- bore a similarity to
radiation exposure of troops on a battlefield following the
detonation of an atomic bomb. Military officers especially
wanted to know how quickly a soldier suffering the effects of
radiation could recover and return to action. The Pentagon
even helped fund the studies.
The story of the linkage between a cure for cancer and
preparedness for war has now been detailed in "
Contested Medicine: Cancer Research and the Military", by
Binghamton University history professor Gerald
Kutcher.
The TBI treatment and experiments on human subjects were
conducted at the University of Cincinnati College of Medicine by a
team headed by radiologist
Dr. Eugene L. Saenger. The subjects were unaware of being
surrogates for soliders in an atomic attack, and there was concern
that the radiation received may have been excessive or even
unnecessary, possibly hastening the death of several
patients. Professor Kutcher scrupulously follows the Saenger
experiments, the reaction within his institution and the later
Congressional investigations.
The Cincinnati experiments influenced the creation by
the Federal government in 1994 of the Advisory Commitee
on Human Radiation Experiments (ACHRE). But even after
exhaustive study of Saenger's work (record-keeping was
inconsistent, many documents were lost or had faded and physicians'
scribbly handwriting complicated the studies) ACHRE was unable to
come up with a fixed set of guidelines for bioethics, citing "the
dynamic character of medical research" as well as "community
standards".
Since 1947 and the discovery of sadistic Nazi "medical
experiments", world standards in medical research have been guided
by the Nuremberg
principles -- named for the German city that hosted the German
war crimes trials following World War II. The primary
standard is voluntary patient consent. This was later
supplimented in the United States by rules formulated in 1966 by
the National
Institutes of Health and the Food and Drug
Administration. Kutcher sees the NIH-FDA involvement as
serving primarily to minimize risk (and avoid lawsuits) rather than
enhance patient autonomy.
Gerald Kutcher is singularly prepared to tell about "Contested
Medicine". He is now associate professor of history
Binghamton University and chair of the Department of History, and
holds a Ph.D. in the history and philosophy of science from
Cambridge University. However, prior to turning to the
calling of historian, Kutcher had earned a doctorate in physics and
for twenty years was a radiation physicist and Chief of Service in
Clinical Physics at Memorial Sloan-Kettering Cancer Center in New
York.
Gerald Kutcher
joined Bill Jaker on OFF THE
PAGE to review the development of medical ethics and the social
structures behind ethical standards, and to respond to listeners'
questions about treatment and research. You can still post a
comment to OffThePage@WSKG.ORG.
