Ethics are important part of research

When a professor from another university recently discovered journals outlining how former Pitt… When a professor from another university recently discovered journals outlining how former Pitt faculty member Dr. John Cutler infected Guatemalan prisoners with sexually transmitted diseases and didn’t tell them, people around the world were appalled.

But Pitt officials say times have changed. All agree that something like the Guatemalan experiments won’t happen again.

The study — conducted by Cutler in the late 1940s and documented in journals recently found in Pitt’s archives— infected about 700 Guatemalan prisoners with syphilis and gonorrhea. Cutler wanted to study the effectiveness of antibiotics in fighting the diseases. The prisoners were unaware that they were infected.

Dr. Gary Fischer, associate professor of the University of Pittsburgh Medical Center’s division of Palliative Care and Medical Ethics, said that it is obvious these experiments would be considered unethical today. Back then, however, researchers felt differently.

“These experiments were conducted under a completely different ethical mindset. Around the same time were the studies conducted by the Nazis in Germany. There are obvious differences between the generally accepted ethical regulations, as well as the lawful regulations, that were in place then and now,” Fischer said.

Remember.org, an online library devoted to providing information about the Holocaust said, “the practice of medicine by the doctors of the Third Reich is egregious, outrageous, and shocking. The Nazi doctors violated the trust placed in them by humanity.”

The website detailed the experiments conducted on prisoners of several concentration camps, which included testing of the human body’s ability to endure hypothermia. Scientists froze patients to the point of death and then used various methods to resuscitate the body.

Other experiments were conducted on sets of twins to further understand genetics. These experiments typically consisted of examinations and tests in which doctors thoroughly examined the rectal, prostate and gastrointestinal areas of the patients through extensive and painful methods, according to Remember.org.

Similarly, journalist Jean Heller discovered in 1972 that experiments conducted by the U.S. Public Health Service on syphilis-infected African-Americans of Tuskegee, Ala., posed fatal risks to the patients. Cutler was also involved with the experiment.

From 1943 to 1972, syphilis-infected African-Americans were refused treatment for their illness with the pretense that a cure could be found through the study of the progression of its symptoms, according to the University of Tuskegee’s website.

These subjects did not benefit from the experiments and were not given the choice to opt out of participation.

“[The Nazi] experiments and those conducted in Tuskegee, Ala., were the catalysts for the enactment of more astute regulations regarding ethical standards,” said Dr. Scott Curry, a current member of the Institutional Review Board at the University of Pittsburgh.

The Institutional Review Board monitors experiments involving humans to ensure that they meet ethical standards.

Educational institutions created organizations, like Pitt’s IRB, across the country in response to both the Tuskegee experiments and those conducted by the Nazis.

Curry explained the IRB review process: “A research study is reviewed thoroughly, detail by detail. There is a checklist that investigates how the scientific world would view the experiment and how the community would view the experiment.”

That checklist holds all necessary components of an ethical study. Some questions include: “Are the risks to subjects reasonable in relation to the anticipated benefits, if any?” and “Will informed consent be sought from each prospective subject?”

Fischer said, “The current concept of medical ethics today is that no research can be conducted on human subjects without informed, noncoerced and voluntary consent. The feeling now is just different. These are generally accepted rules.”

These rules were formed to address public concern. All of the researchers interviewed said that ethics have developed because researchers value the input of the community.

Dr. David Barnard, member of the Center for Bioethics and Health Law at Pitt, said that researchers have more concern for the public view of current medical standards and how it can affect confidence in medical research.

“This is a huge reminder to the scientific community that the future of science relies heavily on the general public perception of trustworthiness,” Barnard said. “Without trust in the work that we researchers conduct, nothing can move forward. These discoveries have caused an enormous setback.”

The public should be comforted to know, however, that the current regulations make it highly unlikely for anything like the Guatemalan experiments to occur in the future, he said.

Curry agreed.

“I would like to think that the scientific reviewers of the IRB would immediately catch the various discrepancies in the experiment, but if they didn’t the community reviewers absolutely would,” Curry said. “There is no possible way that any government-funded experiment would ever be conducted under unethical contexts like those in Tuskegee or Guatemala. It is impossible.”