"If you are asked to volunteer for an experiment . . . you, the potential subject, should in turn ask the researcher, 'Have you done the experiment on yourself?'
". . . If the researcher says 'No' and can provide no valid reason why he or she has declined to go first, you would be wise to refuse participation unless you can satisfy yourself as to why you should assume a risk the researcher was unwilling to take."
So writes Dr. Lawrence Altman, physician, medical reporter and author of the new "Who Goes First? The Story of Self-Experimentation in Medicine" (Random House, $22.50).
He also quotes Sir George Pickering, professor of medicine at Oxford University, who said: "The experimenter has one golden rule to guide him as to whether the experiment is justifiable. Is he prepared to submit himself to the procedure?"
Dr. John Fletcher, chief ethicist at the National Institute of Health's Clinical Center, disagrees.
"I emphatically don't think self-experimentation is morally required," he says.
"If the study could be very dangerous, I don't think there's any moral obligation for a scientist or physician to take unreasonable and unnecessary risks," any more than it is moral to subject any other human being to unnecessary risks.
In fact, he reports, "Self- experimentation is very rare nowadays."
One reason: most studies are of diseases the investigator does not have, making self-experimentation beside the point.
I've nonetheless talked to a number of researchers who have at least tried undergoing many of the procedures they ask their subjects to undergo, if only to better plan and conduct their experiments.
Dr. Allan Goldstein heads a George Washington University team that has developed a possible AIDS vaccine. He does not yet have federal approval to start a human trial, but when that happens, he says, "I'll be among the first to get it. An experimenter asking another human being to receive an experimental agent should place himself at the same risk." ::
Last week I said that the story of medicine's many self-experimenters is told for the first time in Altman's book. The stories of eight of the self-experimenters were told in 1983 by Jon Franklin and Dr. John Sutherland in their "Guinea Pig Doctors: The Drama of Medical Research Through Self-Experimentation" (Morrow). --