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2011-08-31

As Grim Details Emerge, Guatemalan Victims Seek Justice for U.S. Medical Experiments in 1940s

Guests

Anita Allen, member of the Presidential Commission for the Study of Bioethical Issues. She is the Henry R. Silverman Professor of Law and Professor of Philosophy at the University of Pennsylvania Law School.

Piper Hendricks, an associate at the Conrad & Scherer law firm in Washington. She is helping to prepare a class action lawsuit against the U.S. government on behalf of the 700 Guatemalans who were unknowingly infected with syphilis from 1946 to 1948 as part of a secret U.S.-led medical experiment. She is collaborating with lawyers in Guatemala on the case.

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A White House bioethics commission has revealed gruesome new details about venereal disease experiments from 1946 to 1948 in which U.S. medical officials intentionally infected Guatemalan sex workers, prisoners, soldiers and mental patients with syphilis in order to study the effects of penicillin. The commission concluded that nearly 5,500 Guatemalans were subjected to diagnostic testing — without their consent — and more than 1,300 were exposed to venereal diseases by contact or inoculations. At least 83 died over the course of the experiments, which were approved by the Guatemalan government. President Obama has apologized for the program, and Guatemalan President Álvaro Colom has described it as a "crime against humanity" and ordered his own investigation. We discuss the commission’s findings with one of its members, Dr. Anita Allen, a professor of law and philosophy at the University of Pennsylvania Law School. We are also joined by Piper Hendricks, an attorney collaborating with Guatemalan lawyers on a class action lawsuit against the U.S. government on behalf of 700 Guatemalans who were unknowingly infected with syphilis. Since the case was filed in March, one victim has passed away. "This is something that happened many, many years ago, and people have been waiting for decades to see justice," notes Hendricks. "Time is of the essence to address the horrifying things that people went through back in the late 1940s." [includes rush transcript]

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: A White House bioethics commission has revealed gruesome new details about American-run venereal disease experiments on unsuspecting Guatemalans from 1946 to ’48. The testing focused on sexually transmitted diseases and involved U.S. medical officials intentionally infecting Guatemalan sex workers, prisoners, soldiers, mental patients—without their permission—in order to study the effects of penicillin. The New York Times reports, quote, "When some of the men failed to become infected through sex, the bacteria were poured into scrapes made on the penises or faces, or even injected by spinal puncture."

President Obama personally apologized to Guatemalan President Álvaro Colom for the experiments last year, after they were discovered. Since then, the Presidential Commission for the Study of Bioethical Issues has studied 125,000 pages of documents and sent investigators to Guatemala.

On Tuesday, the commission concluded nearly 5,500 people were subjected to diagnostic testing in Guatemala, and more than 1,300 exposed to venereal disease by contact or inoculation. President Álvaro Colom has described the experiments as a "crime against humanity" and ordered his own investigation.

The Guatemala program was discovered by Wellesley College Professor Susan Reverby while she was researching the infamous Tuskegee experiments. Professor Reverby spoke to Democracy Now! last year and described how much U.S. officials knew about the practices the program’s architect, Dr. John Cutler, was engaged in.

SUSAN REVERBY: It’s too easy to say, OK, this was a period when there wasn’t research norms or any of the kind of regulations we’ve had in place since the mid-'70s. But Cutler's bosses at the Public Health Service knew this was sort of really on the edge. And the quote that I found that just really knocked me off the chair was one from the surgeon general himself, who said—and this is secondhand, but it was in a letter to Cutler, where one of his colleagues said, "The surgeon general says, 'Well, we couldn't do this in the United States.’" And that’s just a stunning, absolutely stunning, acknowledgment of what was going on.

AMY GOODMAN: That was Wellesley College Professor Susan Reverby speaking last year on Democracy Now!

Members of the bioethics commission investigating the venereal disease experiments say they recalled Nazi experiments on Jews. They argue that Dr. Cutler, who died in 2003, must have known from the Nuremberg doctors’ trials, underway by 1946, that his work was unethical. Panel members endorsed the idea of creating a compensation fund for subjects who are harmed in the future, or requiring researchers to buy insurance for that purpose. Some countries require these steps; the United States does not.

For more, we go to Philadelphia. We’re joined by Dr. Anita Allen, a member of the Presidential Commission for the Study of Bioethical Issues. She is a professor of law and philosophy at the University of Pennsylvania Law School.

We welcome you to Democracy Now! Talk about what you found and what you were most surprised by, Dr. Allen.

DR. ANITA ALLEN: Good morning. Thank you for having me.

We found many of the details of the experiments, which had not been uncovered by Dr. Susan Reverby, whom you briefly quoted a few minutes ago, and we also found some of the explanations for why this heinous research was able to continue for so long.

AMY GOODMAN: Explain the scope of these experiments. What exactly happened?

DR. ANITA ALLEN: Well, the original intent of the experiments was to determine whether or not there could be a prevention for the transmission of sexually transmitted diseases such as gonorrhea, syphilis and chancroid. And this was the great question throughout the world. In a time of war, there’s a great concern about the extent to which sexually transmitted diseases can affect troops. And so, there was a great interest in finding a way to increase military readiness in the United States for our World War II efforts, but then, generally, to protect, as a public health matter, the population against unnecessary illness and even death caused by sexually transmitted diseases.

So, everyone agreed this was an important area of scientific, medical research to pursue, but there was only so much you could do. It was deemed ethically impossible in the United States to, for example, deliberately infect adults with a disease in order to treat them—or to not treat them, to track the course of the illness. But yet, the doctors involved, Dr. Cutler of the United States Public Health Service and his colleagues, decided that they could do this offshore and took the experimental protocol to Guatemala, where, as you noted, more than 6,000 people were involved in this research.

AMY GOODMAN: And again, explain just who Dr. John Cutler was. He was a U.S. government employee working for the National Health Service, right?

DR. ANITA ALLEN: Yes. So, at the time of the Guatemala experiments, which took place between 1944 and 1946, John Cutler was a 30-year-old scientist, researcher, who was employed by the United States Public Health Service. He was employed in their Venereal Disease Research Laboratory, which was headquartered in Staten Island, New York. And he and his colleagues had been working on STD research for many years. Cutler had been associated with Doctors Mahoney and Dr. Arnold in a U.S.-based project in a prison in Terre Haute, Indiana, where they had attempted to infect 241 U.S. prisoners, with their consent, informed consent, in a similar research protocol. That research protocol failed miserably. They were unable to reliably create infection in U.S. prisoners. But they didn’t give up. They really wanted to try to see if they could infect human subjects and to then attempt to see whether various prophylaxis medications would work to prevent the contraction of the disease or work to cure the disease.

AMY GOODMAN: The current issue of Harper’s Magazine features excerpts of letters written by John Cutler, who oversaw the medical experiments in Guatemala—

DR. ANITA ALLEN: Yes, yes, yes.

AMY GOODMAN: —he was a surgeon, as you said, with the U.S. Public Health Service—

DR. ANITA ALLEN: Yes.

AMY GOODMAN: —to doctors at the Marine Hospital on Staten Island, New York. I want to read an excerpt of Culter’s letter dated January 7th, 1947. He writes, quote, "So far as the work in the prison goes, to increase the number of exposures we shall bring in the source of infection along with some not infected so as to allay fears and suspicion. In that way, we shall be able to avoid political repercussions."

In another letter, Dr. Cutler characterizes his explanation of the experiments to the patients as, quote, "double talk."

Cutler was later involved with the Tuskegee syphilis experiments, which monitored the progression of the disease in African-American men who believed they were receiving healthcare from the U.S government. This is a remarkable story here.

DR. ANITA ALLEN: Yes, what the commission uncovered was that Dr. Cutler and his colleagues knew that they would not be able to get informed consent, believed that in fact if you went to Guatemala, and you’re working with prostitutes, mental patients, prisoners, soldiers, people who are ill, you don’t have to get informed consent. And they didn’t even attempt to get the informed consent. Instead, they attempted to conceal the exact nature of their work with the research subjects. As a result of that, there were many reluctant participants or those who, for a pack of cigarettes or some other small amenity, were willing to undergo lumbar punctures, cisternal punctures to the base of the brain, or blood sticks. And this was not something which, again, could have ever been approved in the United States, It was absolutely outside the scope of what was legitimately considered ethical and humane conduct in the United States.

AMY GOODMAN: I wanted to bring our next guest into this discussion. She’s in Washington, D.C. Her name is Piper Hendricks. She’s an associate at Conrad & Scherer law firm there. She’s helping to prepare a class action lawsuit against the U.S. government on behalf of 700 Guatemalans who were unknowingly infected with syphilis from 1946 to 1948 as part of this American medical experiment. She’s collaborating with lawyers in Guatemala.

Talk about who you represent, Piper Hendricks.

PIPER HENDRICKS: Good morning, Amy. Thank you.

We represent an entire class of people who were impacted by the experiments. And that class includes everyone who was directly impacted—the soldiers, the mental patients, the prostitutes who were used, the orphans—and their family members. Something that’s important to remember here is that the treatment of the people who were impacted was not a top priority. Some people were left untreated completely. Those who received treatment may not have received enough to actually cure them of the disease with which they were infected. And so, they then passed that along to their spouses, to their children. And so, this is much bigger than just those who were involved in the experiments, which, as you’ve already mentioned, is a very large number, to begin with.

AMY GOODMAN: I wanted to turn for a minute to a clip of Dr. Cutler himself. This is a clip that comes from a documentary called Deadly Deception. It was done years ago by WGBH. Now, here, Dr. Cutler is talking about the Tuskegee experiments that he went on to do in the United States after leaving Guatemala.

DR. JOHN CUTLER: The Tuskegee study has been grossly misunderstood and misrepresented this way. And the fact was that it was concern for the black community, trying to set the stage for the best public health approach possible and best therapy, that led to the study being carried out. My regret is—in terms of the study, I have none, as a scientist, and say, one would like to have seen an ideal scientific study, but we’re dealing with human beings over a long period of time, and this is impossible.

AMY GOODMAN: That was Dr. Cutler. Before we go back to Piper Hendricks, Anita Allen, can you comment?

DR. ANITA ALLEN: Well, it’s a shame that, many years later, Dr. Cutler experienced no remorse. As you know, he left his research notes from Guatemala in an archive for the University of Pittsburgh in 1990. So, even in 1990, he did not understand, I think, that history would not forgive him or would not come to see that this scientifically unvalid research, which violated human rights, was not somehow worthwhile. So we have, again, a tragic example of someone who engaged in horrendous research in at least two contexts and felt no remorse about it.

AMY GOODMAN: We’re going to go to break, and then we’re going to come back to this discussion. Dr. Anita Allen is a member of the Presidential Commission for the Study of Bioethical Issues. Piper Hendricks is with the law firm Conrad & Scherer, representing Guatemalan families who were affected by the U.S. experiments in Guatemala in the 1940s. This is Democracy Now! Back in a minute.

[break]

AMY GOODMAN: In October of 2010, Guatemalan President Álvaro Colom called the experiments conducted by the U.S. government in Guatemala on hundreds of unsuspecting Guatemalans as a "crime against humanity."

PRESIDENT ÁLVARO COLOM: [translated] It’s an incredible violation of human rights. But there it is. We must face it. We’re going to do whatever is necessary so that we can find out quickly the effect on people, because what we’re interested in is the victims. Obviously indignant. And if there were officials from the past who were involved in this, that also needs to be told.

AMY GOODMAN: That was the Guatemalan president. Piper Hendricks, can the Guatemalan government bring this case to an international court?

PIPER HENDRICKS: They could. We have not been working directly with the Guatemalan government. We’ve been filing—we filed our own case here in the United States. But given the crimes involved, that would be a possibility, were they—should they want to pursue it.

AMY GOODMAN: I wanted to turn right now to President Obama. In 2010, State Department spokesperson P.J. Crowley said the Obama administration had apologized to the Guatemalan president, Álvaro Colom.

P.J. CROWLEY: Yesterday afternoon, Secretary Clinton called President Colom of Colombia sic to express both her shock at the discovery of the details of this research and also to apologize on behalf of the American people. During the course of the conversation, she also invited Guatemala to participate fully in the investigation that we will carry out to determine the facts behind this research.

AMY GOODMAN: Anita Allen, professor at University of Pennsylvania Law School, also serving on the U.S. bioethics commission that has just revealed even more of the gruesome details of these U.S. government tests on unsuspecting Guatemalans from 1946 to 1948, how will your commission, the bioethics commission, findings be used by the Obama administration? Will there be reparations recommended for the victims?

DR. ANITA ALLEN: Let me point out something that has not come out this morning so far. The Guatemalan government was completely on board with this research. The Guatemalan government and the U.S. government entered an agreement about the research. Guatemalan Doctor Juan Funes brought the idea of bringing research on STDs from the United States to Guatemala after he had spent a year working with Dr. Cutler and his colleagues in Staten Island. The health ministers of Guatemala approved the research. So that when we talk about liability and about responses, we need to look at all of the culpable parties, that include not just the United States and its doctors, but also the Guatemalan government and its physicians and researchers, who helped with the protocol and knew about the details of the protocol. So, while we may need to look, and we are going to be looking, very carefully at the question about U.S. responsibility and culpability as far as reparations or compensations is concerned, we have to look at those issues. We’re looking at the question not just in terms of U.S. liability and responsibility, but also Guatemalan liability for complicity with the horrible research protocol that affected its own people.

AMY GOODMAN: Piper Hendricks, your response?

PIPER HENDRICKS: I would agree with Professor Allen on that. I think something that’s very important to remember is, when we’re looking at the recommendations of the commission, it’s encouraging to think that, going forward, we will not make these mistakes again. However, it’s very important that the research team involved not depend entirely on the community. There are some recommendations that you be involved with the community, and I agree. However, in this example we have in Guatemala, as Professor Allen mentioned, the institutions were complicit in these experiments. They were not seeking consent of the people involved. Instead, you sought consent of the mental institution. And so, there were Guatemalan officials who were—whether they knew exactly what was going on is not clear, but it’s something that’s very disturbing, that—you know, there may be some very murky areas still in international law, but one thing that is absolutely without question is that non-consensual human medical experimentation is beyond the pale. And so, to have that going on in the time when we had Unit 731, when we had Nuremberg, there is just no doubt that what was going on was extremely problematic. And to seek the consent of the orphanages and of the institutions, rather than the people themselves, is, without a doubt, absolutely illegal.

AMY GOODMAN: I’m looking at a piece in the New York Times called "Panel Hears Grim Details of Venereal Disease Tests," and it talks about the most offensive case, [per] a colleague of Anita Allen on the White House presidential commission, John Arras, a bioethicist of the University of Virginia and panelist, was that of a mental patient named Berta, he described. "She was first deliberately infected with syphilis and, months later, given penicillin. After that, Dr. John C. Cutler of the Public Health Service, who led the experiments, described her as so unwell that she 'appeared she was going to die.' Nonetheless, he inserted pus from a male gonorrhea victim into her eyes, urethra and rectum. Four days later, infected in both eyes and bleeding from the urethra, she died." I mean, these are gruesome details, Professor Allen. How—

DR. ANITA ALLEN: They really, really are.

AMY GOODMAN: So, at this point, what are the plans of the Presidential Commission for the Study of Bioethical Issues? Now you have gone through the fact-finding phase.

DR. ANITA ALLEN: Thank you, yes. We intend to issue a report. It will probably be in the neighborhood of 180, 200 pages in September. This report will reveal all of our historical research that will describe the case of Berta and other similar patients who were affected and their situations. And then we’re going to also have a forward-looking study that will look very carefully at the question of what can we do to make sure this kind of thing doesn’t happen again.

We’re also—right now we’re surveying all the federally funded human subject research around the world, so we can understand how much of it’s going on. We’re looking at all the standards, the ethical standards in place, the government standards, the private standards. We’re looking comprehensively at what are the governing ethical norms today that will ensure that these kinds of things won’t happen again. All that’s happening.

I think, you know, one of the—for me, personally, one of the greatest tragedies of Guatemala was that the experiments happened at a time when Guatemala was experiencing a degree of freedom. It had been a country ruled by dictators for many, many, many years, since its independence from Spain in 1821. There was a great emphasis on labor unions, on free speech, political parties, and attempt to bring together the ethnic groups, the native, indigenous Guatemalan Indians and the Latinas. But this project sort of came at a time when concern about health, ironically, caused Guatemalan doctors to welcome U.S. researchers to try to help them with their STD problem, probably not realizing the full extent of what would be done, but being complicit to a tremendous degree in efforts to use vulnerable populations who could not give consent in controversial research that could not be done in the first world.

AMY GOODMAN: Piper Hendricks, the U.S. presence in Guatemala at that time was, to say the least, very controversial, as well.

PIPER HENDRICKS: Yes, it was. It was. And one thing that I’d like to note, Amy, is that as we’re waiting for the report, our case has been put on hold for a bit, waiting for the commission’s report to be released. And I think now that there’s no question that—and there never has been. I mean, there was the apology that you mentioned last October, with the U.S. admitting that there was culpability there. In the time since we filed our case in March, we’ve already had one of our victims pass away. I mean, this is something that happened many, many years ago, and people have been waiting for decades to see justice. So, we have a hearing this Friday in the case. I’m hoping that it can move forward, before we—the final report is released, because really time is of the essence to address the horrifying things that people went through back in the late 1940s.

AMY GOODMAN: I want to thank you both very much for being with us. Piper Hendricks, at Conrad & Scherer law firm in Washington, helping prepare a class action lawsuit against the U.S. government on behalf of hundreds of Guatemalans, over 700, unknowingly infected with syphilis from ’46 to 1948 in this American medical experiment. And I also want to thank Anita Allen, a member of the Presidential Commission for the Study of Bioethical Issues, the Henry R. Silverman Professor of Law and Professor of Philosophy at the University of Pennsylvania Law School. We will speak again as this case and others are investigated.

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