"The concentration camps were used as a huge laboratory for human experimentation," says Wolfgang Eckhart, professor of Historical Medicine at the University of Heidelberg in Germany. During the Holocaust, Bayer, Hoechst, BASF and other German pharmaceutical and chemical companies combined into a powerful cartel known as Interessengemeinschaft Farbenindustrie Aktiengesellschaft (IG Farben). As well as manufacturing everything from the deadly gas used to kill Holocaust victims, the gasoline used to move war vehicles and the explosives used to bomb enemies and conquer Europe, IG Farben was also trying its best to put a large number of highly profitable new drugs on the market and used concentration camp prisoners as human guinea pigs to do so.
Now, over 60 years after the Holocaust, we'd all like to think that society is above such cruelty, but in reality, human experimentation is still a common practice in modern medicine. Big Pharma operates by many of the same rules and motives as IG Farben did, and the test subjects are still the most vulnerable members of society -- the poor, immigrants, minority groups and children.
"Few doctors dispute that testing drugs on people is necessary. No amount of experimentation on laboratory rats will reliably show how a chemical will affect people," David Evans, et al. writes in the Bloomberg article "Drug Industry Human Testing Masks Death, Injury, Compliant FDA". Doctors have recognized the importance of human experimentation since the days of Hippocrates, though the ancient Greeks used it to benefit individual patients rather than science itself or any profit-driven industry. In 1833, William Beaumont, the army surgeon physician who pioneered gastric medicine with his study of a patient who'd sustained a gunshot wound that left his digestive system permanently exposed, established the importance of human experimentation as long as it is with the subject's consent.
However, sometimes it's difficult to find human test subjects, especially for studies involving pain or high risk. In the 1930s, research scientists discovered a solution to their difficulty in finding willing test subjects: Don't ask for their consent. In the infamous Tuskegee Syphilis Study, the United States Public Health Service diagnosed 200 black men with syphilis and, rather than treating or even informing them of their illness, used them as human guinea pigs to study the symptoms and progression of the disease. Today, as the University of Virginia Health System writes in its online documentary "Bad Blood", "The Tuskegee Syphilis Study has become a powerful symbol of racism in medicine, ethical misconduct in human research, and government abuse of the vulnerable."
During the Holocaust, IG Farben trumped the moral depravity of the Tuskegee Syphilis Study. Why use and abuse only 200 unwilling human test subjects when you can choose from the multitudes imprisoned in Nazi concentration camps? IG Farben callously used concentration camp inmates of all ages for painful, debilitating and often deadly experiments. Because of this, medical experimentation has become synonymous with injustice, cruelty, prejudice and total disregard for human life. Today, few people would try to justify or support IG Farben's medical experiements, but the sad truth is that modern human medical experimentation is in many ways similar to the horrors carried out by IG Farben.
Experimental drug testing centers
During the Nuremberg Trial, Dr. Waldemar Hoven, the Nazi doctor who gave lethal injections to his patients at Buchenwald, gave the following account of the medical experiments he and other concentration camp physicians performed: "It should be generally known, and especially in German scientific circles, that the SS did not have notable scientists at its disposal. It is clear that the experiments in the concentration camps with IG preparations only took place in the interests of the IG, which strived by all means to determine the effectiveness of these preparations. They let the SS deal with the -- shall I say -- dirty work in the concentration camps. It was not the IG’s intention to bring any of this out in the open, but rather to put up a smoke screen around the experiments so that ... they could keep any profits to themselves. Not the SS but the IG took the initiative for the concentration camp experiments."
Like IG Farben, Big Pharma doesn't perform its own experiments. Instead, it doles out the "dirty work" to experimental drug testing centers, some of which confine test subjects for portions of the study. In a Bloomberg article entitled "Miami Test Center Lures Poor Immigrants as Human Guinea Pigs", Argentinian immigrant Roberto Alvarez describes the eight days he spent confined to the Miami-based SFBC testing center: "It can be weird inside. It's like a jail."
In many ways, it is like a jail. In Miami's SFBC, which is the largest center of its kind in North America, test subjects sleep six to a room in double-decker beds. They even have uniforms to wear -- purple drawstring pants and T-shirts, much like the uniforms of concentrate camp victims. Dr. Hoven's criticism of IG Farben's experiments in Nazi concentration camps could easily be directed to Big Pharma's human experiments. In fact, it has. "Some test centers, FDA records show, have used poorly trained and unlicensed clinicians to give participants experimental drugs. The centers ... sometimes have incomplete or illegible records," David Evans, et al. writes.
Even though the FDA has required informed consent of test subjects since 1981, many people believe that researchers often don't fully explain risks and potential side effects, so as not to deter potential test subjects. "Human subjects are in very short supply, so it's not surprising that under the growing pressure to find them, there are sometimes terrible ethical violations," says Marcia Angell, who was editor-in-chief of the New England Journal of Medicine from 1999 to 2000. The centers meet the legal requirements of informed consent by providing an informed consent form, but the form may be written in a language the potential subjects do not fully understand because they are immigrants, who make up a large portion of human test subjects. Even if they are written in the subjects' native language, the forms may be long and dominated by obscure technical jargon. In "Drug Industry Human Testing Masks Death, Injury, Compliant FDA", Argentinian immigrant Roberto Alvarez admits, "The thing I pay most attention to when filling this thing out is this: How much it pays and how long it takes. I don't read them too carefully," while skimming through a 12-page consent form.
The Nazi doctors didn't even bother with consent forms. Why waste time when you can just force-feed concentration camp inmates a pill or inject them with an experimental substance? "I remember one of the SS doctors holding my jaw open and forcing pills down my throat," Auschwitz survivor Zoe Polanska Palmer told BBC Radio 4 reporter Mark Handscomb in It's My Story. Granted, giving potential subjects long consent forms written in language they can't fully understand is better than shoving pills down someone's throat, but it still seems unethical and it can still put human life at risk.
Even Kenneth Lasseter, the executive medical director of the SFBC experimental drug testing center, admitted in the Bloomberg article, "It's clear to me. Perhaps it needs to be explained more." Lasseter was speaking of the consent form for an experimental drug that may treat overactive bladders. "The goal of this study is to determine the highest daily dose of TD-6301 that will not cause an undesired increase in heart rate." Yes, that wording may be clear to Lasseter, but it may not be clear to the average test subject. "They're saying it backwards to a population that may not be of the highest education level. The real purpose of the study is, 'We're going to make you sick in order to find out at what level you get sick when given this drug.' Obviously, they don't want to say that," University of Miami bioethicist Ken Goodman told David Evans, et al..
Preying on immigrants and other poverty-stricken individuals
During the Holocaust, the Nazis confined the marginalized sectors of society -- Jews (including children), gypsies, homosexuals, the mentally ill and the mentally retarded -- into camps that became human guinea pig-filled laboratories for IG Farben's experimental drug studies. Today, marginalized populations still make up a large portion of experimental drug test subjects; however, socioeconomic factors, rather than concentration camp authorities, make them more likely to sell their bodies to Big Pharma.
It's no accident that SFBC, the largest experimental drug testing center in North America, is located in Miami. According to the St. Petersburg Times, Miami-Dade County "is the only county in the country where more than half the residents are foreign-born." After immigrants come to Miami from countries like Cuba, Colombia, Haiti, Nicaragua, Jamaica, Argentina and Mexico, they need money, yet experience the employment limitations that little or no fluency in English, little education, unfamiliarity, prejudice and, in some cases, lack of a work permit brings. With few other options available, these immigrants find one of the few legal jobs that doesn't require any amount of English proficiency or education and may even accept forged social security cards: Professional guinea pig.
Many immigrants participate in multiple, simultaneous drug studies. Combining these experimental drugs is a recipe for disaster "because researchers don't know how the different chemicals interact or what side effects the mix may have on a person," according to the Bloomberg article "Miami Test Center Lures Poor Immigrants as Human Guinea Pigs". However, given the fact that some studies only pay $25 per day, what else are the truly marginalized subjects supposed to do? "It's not the job I would choose, but financial circumstances require you to do it sometimes,'' Venezuelan immigrant Oscar Cabanerio told Bloomberg.
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