* "Undue Risk: Secret State Experiments on Humans"
By Jonathan D. Moreno
333 pp. $24.95
W.H. Freeman and Company
Early in this book, a United Nations inspector who investigated biological warfare research in Iraq in 1991 describes finding a laboratory chamber big enough to hold "large primates, including the human primate."
Whether Iraq did or didn't conduct tests on "human primates," the use of this term highlights the issue of government-run human experiments. Recruiting human subjects for government research, whether by physical force, coercion or more socially acceptable means, raises daunting ethical challenges.
Jonathan Moreno, who served as a senior staff member of President Clinton's Advisory Committee on Human Radiation Experiments, chronicles decades of abuses in once-secret experiments. He mainly addresses medical tests conducted in the United States and concludes that human subjects were often seen as expendable, secondary to the demands of national security.
The modern debate over the ethics of human experimentation has its roots in Nazi Germany, and Moreno initially focuses on the trial of 16 concentration camp physicians. Seven were hanged for murder despite their protests that experimenting on prisoners was a legitimate part of the war effort. The verdicts helped produce the Nuremberg Code of 1947, whose first sentence reads, "The voluntary consent of the human subject is absolutely essential."
Yet Moreno is not among those who consider the Nuremberg Code a triumph of applied ethics. Instead, he shows how the code was habitually ignored by the Atomic Energy Commission, the Department of Defense and other U.S. institutions. A 1953 policy statement by Defense Secretary Charles E. Wilson on the use of human subjects in Pentagon medical experiments, for example, was treated as a top secret document and rarely given to the scientists it was intended to guide.
"The ethical rules based on Nuremberg were never really embraced by the military-medical establishment, never really penetrated that culture," writes Moreno. This led to a period of human testing in which the ideal of informed consent was frequently trampled, Moreno asserts. While he does not suggest that America's secret tests compare to Hitler's or to the suspected crimes of Iraq, he portrays them as ethical lapses hard to justify:
* Soldiers were placed within a few miles of atomic bomb blasts and then monitored for panic reactions.
* Thousands of unwitting soldiers and even civilians were exposed to such psychoactive substances as LSD to evaluate their potential as mind-control agents.
* Hospitalized cancer patients, uninformed of the risks they were running, were exposed to radiation so scientists could study their reactions.
As details of such tests have come to light, ethical guidelines in human testing have improved. Moreno cites as a gold standard the current policies at Fort Detrick, in Maryland, where the U.S. Army uses volunteer soldiers to develop defenses against biological weapons. Experiments have ranged from benign procedures, such as monitoring injected anthrax vaccine in the blood, to ones that intentionally make the volunteers sick, as in tests of vaccines against diarrhea-inducing bacteria. The volunteers' only compensation is $25 for every blood sample they provide.
"Undue Risk" tackles a broad, complicated subject. Unfortunately, Moreno leapfrogs across the historical landscape. All too often, his basic themes are clouded by diversions that draw the reader away from his main points. But as Moreno makes clear, new weapons and biochemical warfare agents will continue to raise experimental--and ethical--challenges for government research.
Charles W. Schmidt is a writer living in Portland, Maine.