Medical ethics and the military
oolsorters’ disease has a rapid onset. It leads to rigor, rapid respiration, pain in the chest, rapid and feeble pulse, and a high temperature, usually accompanied by cough and bronchitis. Much frothy mucus is produced. Extreme collaps and death occurs in one to three days. The mind usually remains clear.
Woolsorters’ disease is caused by the anthrax bacillus. It used to be a disease of farmers, veterinarians, and slaughterhouse workers. You can also use this bacillus for bacterial warfare.
Bomblets can be packed with billions of anthrax spores. As spore, anthrax becomes easy to handle. Once again in an airy, moist, and warm environment the spore turns back into its deadly old self.
In the spring of 1941, Dr. Paul Fildes of the British Chemical Defense Experimental Establishment travelled to Gruinard Island off the coast of Scotland. He was accompanied by 60 sheep and several small boxes containing anthrax bomblets. The sheep were set free on the island and showered with anthrax bomblets. Within days, all sheep were dead. In other words, the experiment was extremely successful.
Based on this test, the British calculated that 2,690 bomber sorties would be sufficient to eliminate the entire population of Germany, their war enemy at the time.
In December 1941, the United States joined the allied war effort, and the anthrax project slowed down and was replaced by the production of the atom bomb – which was finally used to level Hiroshima and Nagasaki.
However, the anthrax experiment had side-effects that outlived the war. After the end of World War II, the only place in Europe still considered uninhabitable was Gruinard Island. Still anthrax infested today, the island cannot be visited; and it will remain this way forever .
This case is a typical example of the exploitation of medical knowledge for purposes other that its real goal: saving people. But it was a case taking place at a particular time –not necessarily that this excuses or justifies it.
Nevertheless, it is not an isolated case and, even worse, such cases are not limited to periods of war.
Amidst claims of perfect and total control and the intention of defense rather than aggression, there are at present several institutes conducting research for, or in collaboration with, the military.
The example of Gruinard Island shows how it is possible to overlook (or ignore) consequences, whether in the duration and/or use of the effects or in unexpected side-effects.
And how do we feel about cases such as the one just recently made public in the United States, where some fifty years ago medical professionals knowingly injected people, including pregnant women, with plutonium, a toxic radioactive substance, to evaluate what kind of damage it would cause. Once again, these experiments were performed in humans, not in laboratory animals. Nobody asked for informed consent. Nobody seems to have had questions about whether this was ethical. These experiments in humans were not a single case.
Some of those professionals taking part in the experiment, when asked about it today, still defend and justify their actions. They were not punished for it.
Where is the connection to radiology? Most of us in this discipline tend to think that we will never be confronted with such problems. We may believe radiology has little to offer those who are interested in this type of military experiments and so, most likely, we will never be asked to conduct or take part in medical experiments for them. Therefore, we do not need to concern ourselves with these issues.
If you believe that, you may be wrong. After all, radiology provides a window into the body. As it interests some for the sake of preserving life, why would it not interest others who are concerned with damaging and destroying it?
I was recently shaken by a statement from the leader of an NMR research laboratory: “Research funds are scarce and a little prostitution is necessary – and there is always money in military research”.
His laboratory is one of the few involved in the analysis of chemical warfare products. Some other university-based magnetic resonance laboratories are specializing in research on how neurotoxic substances influence cells. Usually such research is performed without knowledge of the local ethical committees. And it is “defense” research.
Both the scientists involved and the people in charge insist that such research is basic research that is scientifically challenging and will result in information which is of importance for the health of the public in general.
Medical research per se has two aims: to improve the life of patients and the career of the researcher. Medical research for companies has three aims: to improve the life of patients, the career of the researcher, and last but not least (in some instances, most important) to increase the profit of the company. Military medical research has military goals: to disable or kill human beings.
I do not mean this as an attack on the military. There is no doubt that armies, sometimes, are necessary to protect the freedom of countries. Furthermore, military research not aimed at the direct destruction of human life has had numerous spinoffs for civilian applications, such as the development of the microwave oven .
Recent history, however, has shown that armies in the hands of unscrupulous, criminal, or incompetent military or political leaders turn wild. It has also shown how in a period of a few years the political situation of the whole world can change.
Those medical researchers involved in experiments for military purposes – and those contemplating it – would be wise to consider questions such as: Who is going to use my results and how? Am I absolutely sure that there will not be any side-effects or abuse of my results? Am I absolutely certain that only those I trust today are the ones who will control my results in the future?
And if these questions are not enough, what about: Would I like to be the guinea pig of such experiments without knowing it?
If the purely moral and ethical answers to these questions are relative and difficult to find, there are national and international laws and treaties that should be easy to comply with. These agreements state that involvement of physicians in biological or chemical warfare research is illegal.
Let’s return to anthrax. For many years, the United States Army has sprayed simulants of this bacillus secretly over populated areas of the United States as part of a military Army research program. Viewed as harmless, the tests were used to assess their survivability and dispersion patterns .
As Leonard A. Cole of Rutgers University in New Brunswick, NJ, points out  the U.S. Army would like to use simulants for such experiments which differ only in one gene from anthrax bacillus. As stated in front of the U.S. Senate, the army reserves the right to perform future vulnerability tests.
Did the medical scientists who developed and prepared these simulants and those who are working in gene technology consider such a scenario?
The personal dilemma between needing research funds and the possible disaster created with “innocent” results is best avoided by not getting exposed to such research.
1. Gordon R: Great Medical Disasters. Hutchinson: London 1983.
2. Alic JA, Branscome LM, Brooks H, Cater AB, and Epstein GL: Beyond Spinoff. Harvard Business School Press: Boston 1992.
3. Subcommittee on Health and Scientific Research, Committee on Human Resources, U. S. Congress: Biological Testing Involving Human Subjects by the Department of Defense. Senate hearings on March 8 and March 23, 1977. U.S. Government Printing Office: Washington, DC 1977. 261-296.
4. Cole LA: Ethics and Biological Warfare Research. in: Mitcham C and Siekevitz P (eds.): Ethical Issues Associated with Scientific and Technological Research for the Military. Annals of the New York Academy of Sciences. Vol. 577. New York 1989. 154-163.