American Journal of Public Health article calls for compensation for Guatemala Syphilis Experiment Victims

Last month, the American Journal of Public Health (AJPH) published an article directly related to the Guatemala Syphilis experimentation scandal, where the US Public Health Service killed at least 83 people in the process of purposely inoculating Guatemalan hundreds of subjects with venereal diseases. Even more egregiously, this was done without the informed consent of the subjects, who were mostly poor, or prisoners and insane asylum inmates.

Leading members of a Presidential Commission for the Study of Bioethical Issues that looked at the scandal harshly criticized U.S. researchers for covering up the research and its horrific outcome. John Donnelly at the official blog for the Presidential Commission said researchers did more than fail to get consent, they used "intentional deception" in their recruitment of the Guatemalan subjects.

The AJPH article, by Glenn Cohen (Harvard Law School and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics) and Dr. Eli Y. Adashi (Warren Alpert Medical School, Brown University), proposes that U.S. apologies for the affair are "insufficient" and the authors "call for a restitution program directed at the aggrieved parties."

"Surviving family members should also be made whole for harm incurred, whether direct (e.g., disease transmission) or indirect in nature," the authors contend. But "contrition is not enough and [the fact] that compensation and remediation are expected may obviate gross violations of research ethics in the future." I imagine the statute of limitations for these crimes are likely expired, or those guilty, who I suppose could be arraigned for murder, are all now dead.

But as Cohen and Adashi note, "Instead, history appears littered with misdeeds characterized by drawn-out, grudging acceptance of responsibility by the alleged perpetrator."

In March 2001, seven Guatemalans, "former soldiers, orphans, prisoners, and mental health patients in Guatemala who were purposefully infected with the venereal disease syphilis, or their heirs and the family members who were also impacted by the disease," filed a complaint (Garcia v. Sibelius) in the U.S. District Court for the District Of Columbia. Their attorneys note, "The class action lawsuit names several U.S. Government entities and addresses the despicable human rights violations that took place in the course of non-consensual human medical experimentation on Guatemalans in Guatemala by U.S. health authorities beginning in 1946." (See PDF of filing, or Spanish summary of the case.)

Cohen and Adashi contend that establishing a government compensation program "would allow Congress to end the pending litigation," and cite precedents for this.

Recognizing its responsibility in the face of a failed class-action lawsuit (Allen v United States),11 Congress passed the Radiation Exposure Compensation Act of 199012 to make “partial restitution” to eligible individuals “for the burdens they have borne for the nation as a whole."

Cohen and Adashi see this kind of result as "a swifter and surer form of resolution that can benefit a larger swath of possible victims rather than merely those who bring suit or are represented in the class action."

I don't know. While the Presidential Commission did a lot of investigative work, it's possible that discovery in the process of a suit could bring up more vital information. On the other hand, the victims have been waiting for decades. As Cohen and Adashi point out, a class-action lawsuit brought on behalf of the Tuskegrhee experiment victims was settled out of court for $10 million dollars.

In any case, the article and its subject matter deserve wider circulation and discussion. For more on the Presidential Commission, see Cheryl Welsh's article at Daily Censored, "Bioethics Commission Failed Obama’s Mandate in New Report."

A selection from her article:

The Commission issued a report last December 14th and concluded that current U.S. rules are adequate and would prevent such abuses from happening again. 

However, the Commission disregarded the lack of legal reforms for nearly half a million victims of unethical Cold War government research. The Cold War research was often conducted in secret and without consent. The ethical consensus today is that a person must agree to participate in any research and must be informed about the possible risks, known as informed consent. But bureaucratic roadblocks prevented crucial legal reforms from being implemented, including the requirement of informed consent in classified research. Today, U.S. law still allows for a waiver of informed consent.... 

The Common Rule is found at 45 U.S. Code of Federal Regulations (CFR) 46. CFR 46.101(i) allows a director of a federal department or intelligence agency to waive any of the Common Rule requirements, including the informed consent requirement and to do so in secret. The waiver effectively nullifies the regulations, and as happened in past Cold War experiments, allows for a complete lack of protections for human subjects in classified research, at the discretion of top officials. 

The endnotes of Obama’s Commission report briefly mentioned the current rules that cover classified research; an Institutional Review Board (IRB) must include a nongovernmental member and must review classified research, and expedited review is not allowed. However, without the consent requirement, U.S. rules still fail to meet even the minimal standards for adequate human subject protections today. 

Nonconsensual human experimentation is a violation of the Fourth, Fifth and Eighth Amendments of the U.S. Constitution. The U.S. government has acknowledged as much in a U.S. Department of State report and past presidential commission reports.... 

It is true, most experts believe that the ethical standards and U.S. rules in place today would prevent the large numbers of Cold War experiments from happening again. While that may have been the thinking of the Commission, this disregards the overwhelming evidence that the legal requirement of informed consent in classified research is essential for adequate human subject protections.

83 Died in U.S.-Guatemala Syphilis Experiments: "We’re talking about intentional deception."

It made headlines when historian Susan M. Reverby of Wellesley College discovered a decades-old program run from by the U.S. Public Health Service’s studies in Guatemala from 1946 to 1948. That's because the researchers deliberately inoculated subjects with syphilis in order to study sexually transmitted disease, and they did so without informed consent for the procedure.

Subjects were "not told what the purpose of the research was nor were they warned of its potentially fatal consequences." Furthermore, "U.S. government researchers must have known they were contravening ethical standards by deliberately infecting mental patients with syphilis."

The researchers, led by U.S. doctor John Cutler, who had also been involved in the infamous Tuskegee syphilis experiments on African-American men that ran from 1932 to 1972, utilized mental patients, prostitutes, prisoners and soldiers as their guinea pigs. Today, the Presidential Commission for the Study of Bioethical Issues issued their findings of a study undertaken in the aftermath of the scandal.

According to news reports, at least 83 Guatemalans died after being infected with both spyhilis and gonorrhea. Over 1,300 were exposed to the venereal diseases.

AFP reports:

Commission president Amy Gutmann called it an "historic injustice," and said the inquiry aimed to "honor the victims and make sure it never happens again."

"It was not an accident that this happened in Guatemala," Gutmann said. "Some of the people involved said we could not do this in our own country."

The U.S. researchers "systematically failed to act in accordance with minimal respect for human rights and morality in the conduct of research," she said, citing "substantial evidence" of an attempted cover-up.

John Donnelly at the official blog for the Presidential Commission, tells the story of one of these victims, a Guatemalan woman.

Berta, said Dr. John Arras, the Porterfield Professor of Biomedical Ethics and Professor of Philosophy at the University of Virginia, was a patient on a psychiatric ward who was injected with syphilis and not given treatment for three months after her initial exposure.

Arras noted the observations of the principal investigator for the study, Dr. John Charles Cutler, of Berta on one summer’s day. Arras said that Cutler wrote that it appeared Berta “was going to die. He did not specify why.”

That same day, Arras said that Dr. Cutler “put gonorrhea puss [sic] on her eyes, urethra and rectrum.”

Soon after, Berta died....

Arras said he brought up this single case because he was wrestling with the “distinction between blame and wrongdoing for some time...."

“I, for one, have been extremely reluctant to bring the moral hammer down with full force on the question of moral blame,” he said. “However, the issue of informed consent is not the only question. I’m not talking about just the failure to inform. We’re talking about intentional deception. … I really do believe that a very rigorous judgment of moral blame can be lodged against some of these people.”

“The most powerful argument,’’ he said, “is to repeat a story."

As I wrote on this subject last October, "These revelations are only the latest in an ongoing series of scandals regarding government illegal and unethical experimentation.... There are plenty of other underreported and important stories out there on the terrible scandal that has been U.S. illegal experimentation."

The list of such illegal experiments is quite long (government radiation experiments, Navy experiments with chemical agents on sailors, the Edgewood Arsenal experiments with LSD and other drugs (with the help literally of ex-Nazi scientists), the MKULTRA experiments, and allegedly, but awaiting fuller documentation, CIA and DoD experiments on "enemy combatants" in the "war on terror." I don't know if the current commission intends to discuss this history, giving context to the Guatemala atrocity, or not. But if not, they should be.

Only total transparency and an end to secrecy on these issue will bring an end to this kind of illegal experimentation and the human tragedies that result. "National security" for too long has been a shibboleth to justify the worst violations of human rights. If that finally hits home as a result of the Guatemalan scandal, then those people will not have died in vain. But I'm afraid it will take much more before we get to where we need to be.

From Past to the Present-day: Guatemala Revelations & CIA/DoD Experimentation

Headlines were made last week concerning revelations of a 64-year-old scandal only recently discovered by historian Susan M. Reverby of Wellesley College. Reverby discovered that a key researcher who was part of the infamous Tuskegee Syphilis experiment had also headed a project in Guatemala that deliberately infected prisoners and insane asylum inmates with various venereal diseases, ostensibly in order to study how the diseases were transmitted and if they human contagion could be blocked.

Inoculation was difficult, the researchers found, and they had to result to making abrasions and dripping rabbit-infected pus on the genitals of human beings, some of whom had no idea what was being done to them, to try and get the desired results. The study was inconclusive, and ended after only a few years, but not before more than 700 individuals had been inoculated. The human subjects were supposed to be treated with penicillin if they contracted any disease, but record keeping and controls on the project were poor. None received adequate informed consent. Moreover, the researchers involved, working for the U.S. Public Health Service, knew the experiment would never pass muster if done in the United States. A similar experiment in U.S. prisons in 1911 was shut down because of controversy over the unethical experimentation upon prisoners. See Reverby's preprint version (PDF) of her academic article for a much fuller discussion of what occurred.

These revelations are only the latest in an ongoing series of scandals regarding government illegal and unethical experimentation. Earlier this year, investigative journalist H.P. Albarelli detailed the many activities of the government its decades-long mind control project, as well as the use of drugs in clandestine operations in his book A Terrible Mistake: The Murder of Frank Olson and the CIA's Secret Cold War. (Albarelli was also a guest at FDL Book Salon last January.) Albarelli's book also covered the LSD poisoning by the CIA of the entire French village Pont-St.-Esprit in August 1951, a story picked up only a few months ago by BBC.

There are plenty of other underreported and important stories out there on the terrible scandal that has been U.S. illegal experimentation. The Department of Defense experimented on over 7000 soldiers at its Edgewood Arsenal, part of "a secret testing program in which U.S. military personnel were deliberately exposed to chemical and biological weapons and other toxins without informed consent." Troops were tested with "nerve gas, psychochemicals, and thousands of other toxic chemical or biological substances and perhaps most gruesomely, the insertion of septal implants in the brains of subjects in a ghastly series of mind control experiments that went awry." The program ended in 1976 after approximately twenty years. Remarkably, a lawsuit by veterans is still alive and wending its way through the courts.

It was approximately only ten years ago when another DoD experiment scandal became big news. Project Shad was a DoD experiment that exposed at least 4,000 Navy men to various chemical agents and decontaminant chemicals, "including Bacillus globigii (BG), Coxiella burnetii [which causes Q fever], Pasteurella tularensis [which causes tularemia or 'rabbit fever'], Zinc Cadmium Sulfide, Beta-propriolactone, Sarin, VX, Escherichia Coli (EC), Serratia Marcescens (SM), Sodium Hydroxide, Peracetic acid, Potassium hydroxide, Sodium hypochlorite, 'tracer amounts' of radioactivity and asbestos, [and] Methylacetoacetate." So outrageous were these experiments, denied by the government for 35 years, that there were Congressional hearings (PDF) in 2002, and major news reports by CBS Evening News. Today, the story has dropped off the radar, though thanks to some Congressional pressure, and the activism of some of the Shad victims, veterans and the government can get more information on Shad and its land-based twin experiment, Project 112, at this Veterans Administration webpage.

The government use of drugs and other experimental torture techniques during the Bush administration has led to a number of studies and reports. Most recently, the DoD Inspector General concluded an investigation on the drugging of detainees, or so-called "unprivileged enemy combatants" in DoD custody. But the results of the review remain classified, and the fact the report was even ever concluded was kept from public knowledge for many months. In 2008, now-Vice President Joesph Biden had been one of three senators asking for an investigation into the drugging charges. Biden's office at the White House refused to reply to questions for comment on the report's existence or what have been revealed by the investigation.

Finally, we have the ongoing question of human experimentation by the CIA as part of the construction of and operations concerning their "enhanced interrogation" torture program. Earlier this year, Physicians for Human Rights released a peer-reviewed white paper detailing some of the CIA actions. As the following press release by PHR explains, there is a direct line of scientific malfeasance and unethical behavior that runs from the Guatemala experiments of the 1940s to the CIA and DoD illegal experimentation of our era. In an excellent article on the topic by one of the PHR report authors, psychologists Stephen Soldz, explains:

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.

The letter denying the complaint and referring it back to the CIA was signed by Howard Koh, Assistant Secretary of Health at the U.S. Public Health Service, the same agency that conducted the Guatemala experiments decades ago (and conveniently never published the results).

What follows is a press release from Physicians for Human Rights (courtesy Stephen Soldz's website):

Physicians for Human Rights Decries Obama Administration’s Double Standard on Illegal Human Experimentation; 1946 Guatemala Case and Alleged CIA Experimentation on Black Site Detainees Both Deserve Equal Justice

Cambridge, MA–In the wake of revelations about America’s experimentation on unwilling human subjects in Guatemala in 1946, Physicians for Human Rights (PHR) calls on President Obama to equally investigate credible evidence of illegal human subject research on detainees in CIA custody during the Bush administration.

“What was done to 700 Guatemalans 64 years ago without their consent is appalling,” said Physicians for Human Rights CEO Frank Donaghue. “But President Obama’s apologies for the Guatemala case ring hollow when the White House refuses to investigate similar crimes that allegedly occurred in the past decade. The credible evidence of illegal human experiments by the CIA on black site detainees deserves equal attention and justice.”

PHR’s June 2010 report, Experiments in Torture: Human Subject Research and Evidence of Experimentation in the ‘Enhanced’ Interrogation Program, was the first peer-reviewed analysis of evidence indicating that the Bush administration allegedly conducted illegal human research and experimentation on prisoners in US custody. The research was apparently used to insulate interrogators from potential prosecution and to standardize the use of torture.

“The conduct of health professionals in both cases—Guatemala and the CIA black sites—makes a mockery of bedrock principles of medical ethics and the law,” stated Scott Allen, MD, lead medical author of the PHR report. “Human subject research protections mean nothing if they don’t apply to all people all of the time—regardless of politics.”

CIA physicians and psychologists collected and analyzed data on the physical and psychological impact of the “enhanced” interrogation tactics, analysis which became the basis of Department of Justice memos justifying the torture program. This alleged program of illegal human subject experimentation violates medical ethics, federal law, and international research standards, including the Nuremberg Code and the Common Rule. These practices could, in some cases, constitute war crimes and crimes against humanity.

“While the proposed federal commission on the abuses in Guatemala is welcome, the American people must also learn the truth about what was done in our name over the past decade to detainees in CIA custody,” said Nathaniel Raymond, Director of PHR’s Campaign Against Torture and lead author of the PHR report. “The Departments of Justice and Health and Human Services must investigate these credible allegations of human experimentation on detainees by the CIA with the same mandate as the Guatemala case.”

PHR calls on President Obama, working with Congress, to appoint a federal commission to investigate what American physicians and psychologists did to people subjected to torture in US custody. John Durham, the Department of Justice prosecutor tasked with investigating the destruction of CIA interrogation videotapes as well as interrogations that went beyond what was authorized by the Department of Justice memos, should also be given a clear mandate to probe allegations of illegal research at the black sites, Guantanamo and elsewhere.

Also posted at FDL/The Seminal

Bill Moyer on "The Secret Government"

PBS, 1987

I doubt it would even be aired today.

"The history of our secret government.... 'National Security' was invented in 1947...."

A truly remarkable documentary and fascinating viewing. I'm proud to present it here.

Gingrich's Long History as Bully-Boy for the CIA

Ex-House Republican Speaker Newt Gingrich has been apoplectic about current Democratic Speaker Nancy Pelosi's claim that the CIA lied about briefing her about the use of torture ("enhanced interrogation techniques") at a meeting in September 2002. Like a diminutive Zeus, thundering from the heights of Mt. Lilliput, Gingrich railed against what he called Pelosi's "despicable, dishonest and vicious political effort," and called for investigations.

Whatever Pelosi's ultimate political fate on this matter -- and she appears to have backed off a little on Friday, shifting her emphasis from the lies of the CIA to the lies of the Bush administration in general, after a letter from CIA Director Leon Panetta to his troops -- a person would have to be totally obtuse not to see Gingrich's attack as cover for the CIA and its torture crimes. It is also a fiercely partisan attack, laying down a smokescreen for the real criminals, Cheney, Bush, Tenet, Rumsfeld and their ilk.

But this is not the first time we've seen Newt play this role. In 1995, then-Democratic Representative Robert G. Torricelli received information from a State Department whistleblower, Richard Nuccio, that a long-time Guatemalan CIA agent, Colonel Julio Roberto Alpirez, was responsible for the controversial killing of an American innkeeper living in Guatemala, as well as the murder of a leftist guerrilla leader married to an American citizen, Jennifer Harbury. The guerrilla leader, Efrain Bamaca Velasquez, was ordered killed at the end of his interrogation by Alpirez, who also was a Guatemalan military intelligence officer. Both the State Department and the National Security Council knew the identity of the killer, but withheld the information, even as Harbury was conducting hunger strikes to get the government to pursue what then appeared to be her husband's disappearance.

Torricelli, who was a member of the House Intelligence Committee, released the name of the CIA agent and announced in a letter to President Clinton:

The direct involvement of the Central Intelligence Agency in the murder of these individuals leads me to the extraordinary conclusion that the agency is simply out of control and that it contains what can only be called a criminal element..."

Torricelli's bombshell caused a huge scandal, coming in the wake of revelations of a bloody U.S.-backed Guatemalan counter-insurgency campaign that killed over 100,000 civilians, led by the Guatemalan military and intelligence services. According to a New York Times article in March 1995, Alpirez had been a CIA informer since the 1980s, and then trained at the U.S. Army-run School of the Americas in 1989.

By the time of the 1990 murder of Michael DeVine, "an American citizen who ran a hotel in the Guatemalan rain forest and apparently had stumbled onto a smuggling operation involving the Guatemalan military," Alpirez was a contract agent for the CIA. The controversy over DeVine's murder forced the Bush I administration to cut off military aid to the Guatemalan regime, all the while, according to the UK Independent, secretly channeling $7 million a year to the Guatamalan government through the CIA.

The mid-90s scandal grew uglier and uglier. From the NY Times article:

The role of Guatemala's military and intelligence services in death-squad killings has long been suspected. In 1993 that role was confirmed by two Guatemalan soldiers, who linked many such killings to the military high command.

The C.I.A.'s station in Guatemala has had close links to the military since 1954, when the intelligence agency led a coup that overthrew the nation's President, Jacobo Arbenz Guzman, and helped install a right-wing junta.

The stage was set for Speaker Newt to spring into action. He called Torricelli's disclosures "explicitly inappropriate," and called for the House Intelligence Committee to expel the New Jersey congressman. "I think he just decided it was better to go ahead and cause a public embarrassment to the United States," Gingrich said.

In the end, Gingrich did not get his way, as supposedly "not wanting to make the Democrat a martyr," the Republicans backed down and Torricelli stayed on the committee. Meanwhile, the next year found Gingrich mixing it up with fellow Republican Arlen Specter, as Gingrich fought to increase the CIA budget for covert operations against Iran from $4 million to $18 million dollars ($19 million was already set aside for destabilization operations against Iraq). And then it seems only yesterday (2007), when Newt attacked then-Senator Biden's call for a special prosecutor in the case of the destroyed CIA torture tapes.

According to a Jeff Stein interview with Nuccio in 1997, published at Salon, the Torricelli disclosures led to a change in Clinton-era CIA hiring policy, which now was to exclude hiring agents who were implicated in human rights abuses. Even further, then CIA-director John Deutch ordered an internal review of current agents involved in such abuses, and approximately 100 agents fitting such criteria were fired.

The denouement was not so pretty, however. The CIA rank-and-file mutinied -- "poor morale," don't you know -- and got Deutch kicked out and a new CIA director appointed. Before Deutch was gone, two senior CIA officials were also let go for lying to Congress. Meanwhile, the CIA saw to it that Nuccio lost his security clearance, thereby wrecking his career. Torricelli won the New Jersey Senate seat, only to bow out after one term because of financial scandal. Gingrich went on to even bigger game, helping impeach President Clinton for lying about a blow job, only to fall in disgrace himself a few years later. Deutch was replaced by George Tenet.

The CIA and the U.S. government's policy over prisoners did not fall from the clouds. Nor did it come from the original sin of Dick Cheney, as guilty as he may be in this instance. All these "secret cabals" (Lawrence Wilkerson's term, not mine) within the government are incubated in the attitudes and crimes of normative government/military functioning. Just ask the 100,000 dead Guatemalan civilians, predecessors to the 100,000s thousands of dead in Iraq. Or ask Jennifer Harbury... or Abu Zubaydah.

Newt Gingrich's charges against Nancy Pelosi are not motivated by a desire for truth, but to cover for the crimes of the CIA. This is his M.O. This is his job. If only the press had a memory they would not report the fulminations of this shill for torturers and murderers. They might report this, from a story by Jeremy Scahill on the "extrajudicial terror squad" still active at Guantanamo, published in Friday's AlterNet:

As the Obama administration continues to fight the release of some 2,000 photos that graphically document U.S. military abuse of prisoners in Iraq and Afghanistan, an ongoing Spanish investigation is adding harrowing details to the ever-emerging portrait of the torture inside and outside Guantánamo. Among them: "blows to [the] testicles;" "detention underground in total darkness for three weeks with deprivation of food and sleep;" being "inoculated … through injection with 'a disease for dog cysts;'" the smearing of feces on prisoners; and waterboarding. The torture, according to the Spanish investigation, all occurred "under the authority of American military personnel" and was sometimes conducted in the presence of medical professionals....

The force is officially known as the the Immediate Reaction Force or Emergency Reaction Force, but inside the walls of Guantánamo, it is known to the prisoners as the Extreme Repression Force. Despite President Barack Obama's publicized pledge to close the prison camp and end torture -- and analysis from human rights lawyers who call these forces' actions illegal -- IRFs remain very much active at Guantánamo.

Or they could do the kind of digging Jason Leopold did in his latest article, Documents Describe Prisoner Abuse Photos Obama is Withholding. Besides describing a number of the photographs Obama does not now want the U.S. public to see, the article demonstrates how widespread the abuse and torture of prisoners actually was, a horrific combination of official policy, and an army brutalized by its own leadership, inured to the idea of prisoner abuse by observing the policy of the higher ups:

Another photograph that was set for release at the end of month that is now being withheld was taken in December 2003 and was found on a government computer. The image shows three soldiers at the St. Mere Forward Operating Base posing with three Iraqi detainees “zip-tied to bars in a stress position, fully clothed, with hoods over their heads.”

One female soldier in the photo is pointing a broom "as if I was sticking the end of a broom stick into the rectum of a restrained detainee," she testified to Army investigators in April 2004....

One soldier said they “kept the detainees awake by holding them up or by playing the loud music,” the report noted. The soldier said Special Forces instructed soldiers that prisoners who were “violent or had information” were “flex-cuffed on their hands, heads covered and not allowed to sleep"....

Most of the soldiers interviewed in all of the incidents stated that they were not aware of any set policy on the treatment of detainees, and did not realize at the time that their actions were wrong nor did they believe it was inappropriate. A sergeant stated that he had also seen pictures on Army computers of detainees being kicked, hit or inhumanely treated while in U.S. custody.

Another soldier said he had “seen a few pictures of this nature before but thought nothing of it since these people are the ones that are trying to kill us.”

On Wednesday, Obama told reporters that the photographs “are not particularly sensational.”

Also posted at Firedoglake