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Wednesday
Feb162011

The Vanderbilt Experiment: Pregnant Women as Radiation Test Subjects

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By Emjaybee


Those of us who fight for better choices in birth have a fair amount of experience with the shockingly casual and dismissive approach some caregivers and institutions have towards the rights and wishes of their patients. Whether it’s a midwife who breaks a woman’s water or strips her membranes without permission, attendants who threaten and scold a woman who wants to move or eat during labor, or an OB who threatens to call CPS on a woman who wants to refuse a cesarean, it’s clear that pregnant women’s basic human rights are disrespected far too often.

We know all that; we talk about those stories all the time on this blog. But every now and then, something new comes along that reveals how deep that disrespect can go and has gone.

While reading a NY Times book review, one line leapt out at me:

“The Revenge of the Radioactive Lady” was inspired in part by actual medical experiments that were conducted at a prenatal clinic at Vanderbilt University. Several hundred pregnant women were given cocktails of radioactive iron, apparently to discover whether radiation could cross the placental barrier. It could.

Wait, what?

Well, I did know that the use of radiation such as x-rays during pregnancy was once considered safer than it is now. That’s one thing. But using pregnant women and their fetuses as test subjects for ingested radiation experiments? Does that only seem insane now, or did the scientists and doctors who did this know it was bad then?

It’s very hard to ascertain. The study in question, the Vanderbilt study, is linked here (you will need to scroll down as several other studies are listed on that page). Vanderbilt worked with the Tennessee State Department of Health, and the research was partly funded by the Public Health Service. The study included 820 “poor, Caucasian” women and lasted from 1945 to 1949.

We only know about this experiment and others like it thanks to President Clinton’s nomination of Hazel O’Leary as Secretary of Energy in 1993. O’Leary declassified many Cold War-era records, which showed the U.S. Government had used American citizens as guinea pigs in human radiation experiments. As a result President Clinton issued Executive Order 12891, which created the Advisory Committee on Human Radiation Experiments (ACHRE) to prevent any more such abuses of power.

Thanks to that release, the Vanderbilt experiment came to light, as did other government-sponsored studies of radiation on vulnerable, and it seems, completely unknowing people, including mentally disabled children in orphanages.

Following these revelations, three ex-test-subjects filed suit against Vanderbilt; one woman maintained that her daughter’s death of cancer at 11 was caused by the experiment, and the others believed their own ongoing health problems were related to radiation exposure. Eventually the case gained class-action status and came to include 200 claimants.  It was settled in 1998 for 10 million dollars.

For those of us familiar with stories of being offered unidentified medications or treatments, this paragraph had a sadly familiar ring:

There is at least some indication that the women neither gave their consent nor were aware they were participating in an experiment. Vanderbilt study subjects, expressing bitterness at the way they believed they had been treated, testified at an Advisory Committee meeting that the proffered drink, called a “cocktail” by the investigators, was offered with no mention of its contents. “I remember taking a cocktail,” one woman said simply. “I don’t remember what it was, and I was not told what it was.”

Now there are several tacks we could take if we wanted to defend the researchers and doctors involved (although actual testimony from those persons is not something I could find online).  The nurses giving the cocktails may have had no idea what was in them. Given that the study was classified, not telling the women might have been justified as some sort of national security issue. And at least some medical opinion at the time did not think that long-term harm would come from radioactive doses of that size.

The danger in taking that tack, of course, is that it erases the women, their bodies, and their health and that of their children. Whatever the benefits may be, we are still right to shy away from endangering human beings without their knowledge or consent in the name of research, especially pregnant women. 

We now have highly detailed rules for conducting human research on pregnant women and fetuses, and the Vanderbilt study would not have passed the test.

It is interesting that Vanderbilt originally defended itself by saying that the doses in question were safe, a defense that failed; perhaps their lawyers decided this was not likely to fly in court. Perhaps this is because, as the ACHRE study comments:

In 1963-1964, a group of researchers at Vanderbilt found no significant differences in malignancy rates between the exposed and nonexposed mothers.  However, they did identify a higher number of malignancies among the exposed offspring (four cases in the exposed group: acute lymphatic leukemia, synovial sarcoma, lymphosarcoma, and primary liver carcinoma, which was discounted as a rare, familial form of cancer). No cases were found in a control group of similar size, and approximately 0.65 cases would have been expected on Tennessee state rates, compared to which the three observed cases is a marginally significant excess. This led the researchers to conclude that the data suggested a causal relationship between the prenatal exposure to Fe-59 and the cancer. The investigators also concluded that Dr. Hahn’s estimate of fetal exposure was an underestimation of the fetal-absorbed dose.

Which makes this passage even more chilling:

We did establish that the Vanderbilt study was not the only experiment during this period to expose fetuses in research that offered no prospect of medical benefit to them or their mothers. While the Committee did not conduct an exhaustive review of the scientific literature, we did find twenty-seven human radiation studies that included pregnant or nursing women as subjects between 1944 and 1974.

 

 

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Reader Comments (11)

I find this shocking! It seems to me that there continues to be a lack of informed consent right through the medical system especially for birthing mothers.

February 17, 2011 | Unregistered CommenterAlison Longley

I first learned of this a few years ago when helping some students look for materials for a project on these studies - I'm at the medical library at Vanderbilt, and we also keep the archives/historical collections.

February 17, 2011 | Unregistered CommenterRachelW

Disgusting. No surprise that the subjects were poor. Makes you wonder how many of these Tuskegee-style studies are out there. Thanks for this informative post.

February 17, 2011 | Unregistered CommenterAnother Rachel

Have you ever read about the cervical cancer experiments in N ew Zealand? I'm sure I have an old post on it somewhere-long story short, women weren't even told they had cancer or precancerous cells, had colposcopies that were for research, not care, etc. Ugh.

February 17, 2011 | Unregistered CommenterRachelW

We, as women, are appalled when strangers on the street as well as friends and loved ones take to a pregnant woman as if she is a punching bag. Offering up insults about her weight and girth whether it be too small or big, making emotional jabs about parenthood if its her first or 10th, and telling horror stories that frighten even the most experienced mothers. Is it any wonder they do such things when those hired to care for us are doing far worse? I do think there is a connection, perhaps a cultural bias against pregnant women in western society, that they are viewed as being lower class than most animals. Perhaps why America fought so hard to keep abortion illegal was so they could have more test subjects.

February 17, 2011 | Unregistered CommenterMichelle

@Michelle: I want to object to your last sentence about America keeping abortion illegal so there could be more test subjects. I am pro-life; I fight to limit abortions because I believe abortion kills a human being made in God's image. Since I believe that, I also think these experiments were reprehensible, disrespectful of the dignity due to every human. I highly doubt that many of the people in America who were pro-life before Roe v. Wade wanted abortion to be illegal so more "experiments" could be done. Perhaps a few people--those who knew of these experiments (acts of tortue and sadism would be a better description)--but not the majority. And if anyone did want to keep abortion illegal so they could experiment, it would certainly not have been for logical reasons that follow from typical pro-life views like mine described above.

February 17, 2011 | Unregistered CommenterBecky

Beginning in 1954 New York researchers injected cancer cells into unknowing patients and prisoners. In August of 1963, 3 residents, aware of the Nuremberg Code and Nazi atrocities, refused to inject the cancer cells into patients. The were told the were too sensitive--they were Jewish. As late as 1965, the AMA said the Code did not apply to American doctors. Informed Consent is first used in a 1957 lawsuit. Remember that American Medicine is hierarchal, built on the belief that they know better than anyone, and should not be questioned. For decades it was considered ethical to withhold information and make decisions for patients--who aren't educated enough to know what is good for them.

February 17, 2011 | Unregistered CommenterD'Anne

Reminder to self: stop bitching about how tedious IRB submissions are.

Rebecca (PHD)- I agree! The IRB system isn't perfect, but I'm glad that human subjects protection is moving in a positive direction, and I hope that it can continue to do so inclusively of childbearing women. I am also very very glad that women themselves are becoming aware of these issues and the folks here are willing to advocate with/for them.

Pregnant women are (equally) entitled to the human right to enjoy the benefit of scientific progress. After all, sick women get pregnant and pregnant women get sick. It has been too long that women have been ignored altogether or treated like they were in this "study"-- like bodies without rights used for the purpose of experimentation without therapeutic benefit.

February 17, 2011 | Unregistered CommenterRebecca S

The article was a wee bit dramatic but is otherwise well-written and appears well-researched. The focus is necessarily specific but it may be of interest to know as well that radiation testing in ways that we perceive stupid and brutal today were not limited to the Vanderbilt study. The US Army assembled soldiers and gave them nothing but sunglasses before standing them in formation in front of a nuclear blast and this was solely to observe the effect on them.

These types of outrages give examples of science run amok but it's concerning that all science will be dismissed as useless and dangerous. People tend toward hysterical these days so it's good to see a level-headed article on this topic.

February 18, 2011 | Unregistered CommenterSilas Scarborough
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