Subjected to Science: Human Experimentation in America Before the Second World War

The Henry E. Sigerist Series in the History of Medicine

by Susan E. Lederer

Long before the U.S. government began conducting secret radiation and germ-warfare experiments, and long before the Tuskegee syphilis experiments, medical professionals had introduced—and hotly debated the ethics of—the use of human subjects in medical experiments. In Subjected to Science, Susan Lederer provides the first full-length history of biomedical research with human subjects in the earlier period, from 1890 to 1940.

Lederer offers detailed accounts of experiments—benign and otherwise—conducted on both healthy and unhealthy men, women, and children, including the yellow fever experiments (which ultimately became the subject of a Broadway play and Hollywood film), Udo Wile's "dental drill" experiments on insane patients, and Hideyo Noguchi's syphilis experiments, which involved injecting a number of healthy children and adults with the syphilis germ, luetin.

Genres: History, Nonfiction, Science, Medicine, Academia, History Of Medicine

216 pages, Paperback

First published December 1, 1994

Reviews

[CHAIRity_Owner · Rating 2 out of 5]

Although an important book in the history of human experimentation, it often feels repetetive, where Lederer reuses concepts and words quite often during this short book. It would have been better if Lederer spent an extra one hundred pages or so delving deeper into the history of these experiments and why they are important in the first place.

[Emily · Rating 2 out of 5]

Picked up this book hoping for a better understanding of the historical lead up of experimentation within the American eugenics movement and later the Belmont Report. Unsurprisingly, this text was dense and dry, but the worst part was that continued repetition of information interrupted any understanding of historical timeline in the book

[Meredith · Rating 4 out of 5]

I initially read this in college, and re-read it because...well, I was trying to productively procrastinate on my epi and environmental health midterms.

It's an excellent investigation into debates over human experimentation before World War II. Perhaps the most surprising feature -- aside from the fact that it was controversial at all -- is that animal rights and welfare proponents lead the charge against human experimentation. As one of the antivivisectionist slogans at the time put it, "[i]t's not your dog or your baby -- it's your dog and your baby."

It's one of those works of history that demonstrates the more things change, the more things stay the same. From the turn of the century, medical researchers have been criticized for failing to fully inform study participants about the risks and benefits, using populations such as prisoners and military personnel who have no real ability to object to participating in the study, conducting research that has no therapeutic benefit for the individual participant, etc.

There are only two notable flaws in her argument. The first is that she presents experiment opponents' argument as a slippery slope fallacy, when the distinction in experiment opponents' minds appears to have been (and still is) more binary. The evidence she presents suggests that the more accurate interpretation is that anti-experiment activists fought for both animals and children because they saw the issue as fundamentally being about who's Them and who's Us. While American society generally viewed "Us" as human and "Them" as animals, experimentation opponents tended to make the distinction along consciousness lines: "We" are anything capable of emotion and vulnerable to exploitation from those with social and political power. While anti-vivisectionists did employ "slippery slope" arguments, those arguments appeared primarily in advertisements geared towards persuading non-committed Americans -- not in their private writings and internal letters about their opposition to experimentation. The only difference anti-vivsectionists appeared to see between research subjects and themselves was one of vulnerability tied to social status. Yet that increased vulnerability didn't push orphaned children and animals into the category of "Them"; rather, their vulnerability is precisely what made them one of "Us."

Not coincidentially, this division is echoed in the relationship between the modern animal rights and abortion debates. Pro-lifers frequently comment on how a disproportionate percentage of animal rights activists support reproductive rights, while reproductive rights activists note how many pro-lifers approve of the death penalty. If you dissect their writings pro-lifers tend to view "Us" as anything with the secular -- but still sacred -- soul of human DNA and "Them" as everything without such a soul or permanently tainted by their immorality. (For more on DNA as a secular soul, see The DNA Mystique.) Conversely, most animal rights activists justify their position on abortion rights on consciousness grounds.

Second, she glides over possible differences in how each camp viewed the purpose of medical care. Today, physicians tend to view medical care as fundamentally being about disease, while many patients view medical care as fundamentally being about illness. (See The Illness Narratives: Suffering, Healing, and the Human Condition.) Although Lederer briefly mentions a couple of sources alluding to a similar distinction at the turn of the century in pro- and anti-experimentation groups, she does not examine it in detail. Given how central this different emphasis in objective is in current experimental ethics discussions, it would have been interesting to see whether similar conversations existed at the turn of the twentieth century -- and, if so, how they shaped the modern discussion.

For me, this book ultimately supports my suspicion that the biggest problem is that medical research professionalization cements this divide between researchers and subjects. To be fair, Lederer's work illustrates how self-experimentation does not entirely eliminate research abuses. This is particularly true in situations with "true believer" scientists dedicated to proving their theories, like Brodie. But most scientists aren't zealots. I have to wonder whether institutional practices heightening researchers' solidarity with research subjects would be more effective in preventing research abuses than IRBs. After all, would the wealthy, well-educated, and (presumably) white researchers leading the lead abatement study in Grimes v. Kennedy Krieger have conducted the research if they had to raise their children in one of the homes with minimal lead abatement? I doubt it.

Or maybe this is just a very abstract rationalization of how I know I'd feel if I pursue one potential career path. Frankly, I wouldn't be able to live with myself if I tested a new therapy on someone's mother/brother/daughter only to discover that the therapy's fatal. I don't know how most medical researchers can.

[Ashley]

Important topic and interesting stories. Descriptive and dissertation-like style. But this book was as dry was a water cracker to read… guess I’ll need to give it another fighting champs for comps.

[MargCal · Rating 3 out of 5]

"Subjected to Science" by Susan Lederer (read November 2013)
When it comes to experimentation on humans, we're accustomed to thinking of "those dreadful Nazis" - and without a doubt they took it to a new level. But prior to WWII, experiments were being done on humans across Europe and in the US, probably elsewhere as well. This book shows how it was done in the US with reference to a few of the experiments in other places. The book details how concern for human subjects of medical experimentation grew out of concern for animal welfare. Shocking reading - for example, children from foundling homes were cheaper to use than animals.
It's surprising how new the concept of informed consent is.