Guatemalan Research Horrors and US Hypocrisy: CIA Unethical Research Ignored

by Stephen Soldz / October 6th, 2010

to top US officials, abusing people in the name of research without
their permission is awful, truly awful. In fact, it is so awful that it
takes two Cabinet officials to apologize. That is, if the
abuses were committed a long time ago, by researchers who are not
around to be held accountable and if there is a friendly foreign
government likely to be outraged about the abuse. However, US officials
have so far been totally silent about horrific, unethical research
conducted by US government researchers within the last decade.

Recently, Secretary of State Hillary Clinton and Secretary of Health and Human Services Kathleen Sebelius profusely apologized
for a study conducted by the US Public Health Service in which nearly
700 incarcerated people and soldiers in Guatemala were, without their
knowledge, deliberately infected with syphilis and other sexually
transmitted diseases in order to test if penicillin could prevent
infection. In a statement the two Cabinet secretaries expressed their
outrage at “such reprehensible research.” In fact, so disturbed is the
US government at this research that President Obama reportedly will
call the Guatemalan president to apologize again.

This research violated the basic ethical principles that were
supposed to guide research done on people — “human subjects research”
in the professional lingo — since World War II. These principles were
codified in the Nuremberg Code internationally and in the Common Rule
guiding most research on people conducted or funded by US government
agencies, including the Department of Health and Human Services of
which the Public Health Service is a part as well as the Defense
Department and the CIA. Fundamental to these and all other recent codes
of research ethics are two basic principles: informed consent and
minimization of harm. Thus, the Nuremberg Code, containing principles
developed for the trials of German doctors who conducted horrific
experiments in the Nazi concentration camps, begins with the principle
of informed consent:

The voluntary consent of the human subject is absolutely
essential. This means that the person involved should have legal
capacity to give consent; should be so situated as to be able to
exercise free power of choice, without the intervention of any element
of force, fraud, deceit, duress, over-reaching, or other ulterior form
of constraint or coercion; and should have sufficient knowledge and
comprehension of the elements of the subject matter involved as to
enable him to make an understanding and enlightened decision. This
latter element requires that before the acceptance of an affirmative
decision by the experimental subject there should be made known to him
the nature, duration, and purpose of the experiment; the method and
means by which it is to be conducted; all inconveniences and hazards
reasonable to be expected; and the effects upon his health or person
which may possibly come from his participation in the experiment.

A little later the Nuremberg Code states the obligation of medical
researchers to minimize harm resulting from experimental procedures:

The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.

No experiment should be conducted where there is an a priori reason
to believe that death or disabling injury will occur; except, perhaps,
in those experiments where the experimental physicians also serve as

The Guatemalan study egregiously violated both these principles and
deserves opprobrium. Rather than informed consent, the purpose of the
study was deliberately hidden from those infected. These individuals
were infected with dangerous, often deadly, illnesses. This research
was awful, reprehensible, even horrific, and should never have been
contemplated, let alone, conducted. I am glad that it only took a short
time since historian Susan M. Reverby of Wellesley College revealed the
abuses in a soon-to-be-published paper — available in preprint form on Reverby’s website — until US government officials vociferously condemned it.

But the US government does not need to look back nearly 65 years to
find horrific research conducted by US government researchers. In June
2010, Physicians for Human Rights (PHR) issued a report, Experiments in Torture: Human Subject Research and Experimentation in the “Enhanced” Interrogation Program,
that documented research and experimentation conducted in this century
by CIA physicians and psychologists related to the abusive techniques
used as part of the CIA’s “enhanced interrogation” torture program.

These researchers observed the torture of CIA prisoners in the
so-called “black sites” and recorded the tortured prisoners’ responses.
They paid special attention to the possibility that the torture would
kill the prisoners. At times they recommended changes in torture
techniques, such as the addition of salt to the water used for the
partial drowning techniques that have come to be known as
“waterboarding” so as to prevent possible death from induced
electrolyte imbalance. This change in procedure allowed the prisoners
to be waterboarded many dozens of times while preventing their escape
into death. As PHR argued, the main reason for this apparent
safety-related research was not the protection of prisoners, but to
provide legal cover for the torturers and torture policy-makers by
allowing them to claim that medical professionals were assuring the
prisoners’ safety.

These abuses were reported by PHR in its peer-review report back in
June. (I am one of the authors of that report.) Secretary of Health and
Human Services Secretary Kathleen Sebelius was notified by letter of
these abuses, abuses that violate the same research ethics principles —
informed consent and minimization of harm — that were violated by the
Guatemalan STD research. But, rather than express her outrage at this
“reprehensible research,” Secretary Sebelius maintained her silence, as
did every government official, other than a CIA press spokesman who
denied our claims without presenting the slightest bit of evidence.
Secretary Sebelius’ department referred an official complaint regarding
unethical CIA research to the very same CIA that had already publicly
denied the charges. So far, no government agency has committed to
investigating these CIA abuses, which occurred far more recently than
the Guatemalan horrors.

In response to the over 60 year old Guatemalan abuses, the
Secretaries of HHS and State announced the creation of a commission
that will undertake to assure that all human subjects research
conducted by US researchers meets the highest ethical standards. As NBC News reported:

In addition to the apology, the U.S. is setting up
commissions to ensure that human medical research conducted around the
globe meets ‘rigorous ethical standards.’ U.S. officials are also
launching investigations to uncover exactly what happened during the

If the purpose of the commission is really “to ensure that human
medical research conducted around the globe meets ‘rigorous ethical
standards,’” there cannot be a double standard. The same rules must
apply to all researchers, everywhere, and to all research subjects,
whoever they are. Ethics are there to protect the despised and
powerless, not just those deemed deserving. Those researchers aiding
CIA or other classified activities cannot get a free pass. We are at an
important juncture, either unethical CIA research is investigated and
those responsible are held accountable or the whole regime preventing
unethical research that has been developed since the world became aware
of Nazi horrors will collapse in hypocrisy. We cannot afford to let
that happen.

Stephen Soldz is a psychoanalyst, psychologist, public health researcher, and faculty member at the Boston Graduate School of Psychoanalysis. He maintains the Psychoanalysts for Peace and Justice web page and the Psyche, Science, and Society
blog. He is a founder of the Coalition for an Ethical Psychology, one
of the organizations leading the struggle to change American
Psychological Association policy on participation in abusive
interrogations.. He is President of Psychologists for Social Responsibility and a consultant to Physicians for Human Rights. Read other articles by Stephen.

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