危险的药物:人类肝炎实验背后的故事

IF 0.5 4区 社会学 Q4 SOCIOLOGY
Jacob Heller
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引用次数: 0

摘要

Sydney Halpern在《危险医学:人类肝炎实验背后的故事》一书中,对故意感染肝炎(一种使人衰弱、长期甚至致命的病毒性肝病)的研究的压力、行动和结果进行了精心研究和可读的历史分析。按照塔斯基吉梅毒实验的传统,但以历史学家的关注点和更广泛的背景,Halpern记录并加深了我们对20世纪中期健康研究的理解。在从国防部和公共卫生服务局到常春藤盟校和州监督机构等精英组织的指导和监督下,研究人员利用弱势群体,即无法(或能力较弱)拒绝同意参与的群体。这不是一个邪恶科学家的故事,而是一种支持我们现在谴责的做法的制度文化。Halpern依赖于机构记录,并通过报纸报道和对与肝炎实验有关的个人的少数采访得到了加强。本书的前两节重点介绍了武装部队流行病学委员会(AFEB)开展的初步肝炎项目,该委员会确定了对现在被理解为“弱势群体”的研究对象的使用第三部分详细介绍了威洛布鲁克州立学校对智力不健全儿童进行的臭名昭著的实验的开发和实施,以及伊利诺伊州Joliet监狱不太为人所知的实验——这两项实验都得到了AFEB的支持,旨在开发在人群中创造免疫力的方法。Halpern画了一系列详细而引人注目的图片,展示了各种背景:在耶鲁大学的早期实验中,出于良心拒服兵役者的团队精神,为能够在没有夺走生命的情况下帮助对抗德国和日本而感到自豪;宾夕法尼亚大学的工作人员有组织地反对使用精神病患者;努力维护被监禁者参与实验的“需求”利益;最后,机构精英们试图为在威洛布鲁克州立之家的“挑战”测试中使用智力不合格儿童辩护——一些人将其描述为纳粹德国以外最恶劣的不道德研究例子之一。Halpern表明,在有关研究对象权利的伦理规则被编纂和加强的历史时期(从1947年的《纽伦堡法典》到1964年的《赫尔辛基宣言》),这些美国医学研究人员系统地违反了伦理原则,危及和伤害了弱势研究对象。他们将“科学”的目标置于研究对象的权利和健康之上。尽管肝炎是这里的焦点,但这些实践并不局限于肝炎实验。Halpern详细细致的描述始于第二次世界大战期间,士兵中爆发了肝炎,这是由一种开发不良的黄热病疫苗引起的——被污染的242评论
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dangerous Medicine: The Story behind Human Experiments with Hepatitis
In Dangerous Medicine: The Story behind Human Experiments with Hepatitis, Sydney Halpern has written a painstakingly researched and readable historical analysis of the pressures, actions, and outcomes regarding research that intentionally infected people with hepatitis (a set of debilitating, longterm—and sometimes fatal—viral liver diseases). In the tradition of work on the Tuskegee Syphilis Experiment, but with a historian’s focus and broader context, Halpern documents and deepens our understanding of mid-twentieth-century health research. Under the direction and supervision of elite organizations ranging from the Department of Defense and the Public Health Service to Ivy League universities and state oversight agencies, researchers exploited vulnerable populations, groups that were unable (or less able) to withhold their consent to participate. This is not a story of evil scientists, but of an institutional culture that supported practices we now condemn. Halpern relies on institutional records, reinforced by newspaper accounts and a handful of interviews with individuals connected to the hepatitis experiments. The first two sections of the book focus on initial hepatitis programs carried out by the Armed Forces Epidemiology Board (AFEB), which established the use of research subjects who would now be understood as ‘‘vulnerable populations.’’ The third section details the development and implementation of now-infamous experiments on mentally incompetent children at Willowbrook State School, and less-well-known experiments at Joliet Penitentiary in Illinois—both with AFEB support, and conceived to develop ways to create immunity in the population. Halpern paints a series of detailed, compelling pictures that shows the range of contexts: an esprit de corps among conscientious objectors in early experiments at Yale, proud to be helping with the war effort against Germany and Japan without taking lives; organized objections among staff to using mental patients at the University of Pennsylvania; efforts to assert the ‘‘redemptive’’ benefits of participation in experiments for incarcerated individuals; and, finally, the attempts by institutional elites to defend the use of intellectually incompetent children in ‘‘challenge’’ tests at Willowbrook State Home— described by some as among the most egregious examples of unethical research outside Nazi Germany. During the historical period when ethical rules regarding research subjects’ rights were being codified and strengthened (from the Nuremberg Code in 1947 to the Helsinki Declaration in 1964), Halpern shows, these American medical researchers systematically violated ethical principles and endangered and harmed vulnerable research subjects. They prioritized the goals of ‘‘science’’ over the rights and health of their research subjects. Though hepatitis is the focus here, these practices were not limited to hepatitis experiments. Halpern’s detailed and meticulous account begins during the Second World War, with an outbreak of hepatitis among soldiers that was caused by a poorly developed yellow fever vaccine—contaminated 242 Reviews
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