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.
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.