Book Review – Against Their Will: The Secret History of Medical Experimentation on Children in Cold War America
It’s been 15 years since author Allen Hornblum’s landmark book on unethical human experimentation in U.S. prisons, Acres of Skin, was published. His new book, written with co-authors Judith L. Newman and Gregory J. Dober, is a worthy follow-up to the earlier book. Against Their Will: The Secret History of Medical Experimentation on Children in Cold War America should become a standard work in the fields of medical ethics and history of science. It has received favorable reviews by the Associated Press, the Boston Globe, the Spectator,” and other publications.
Against Their Will is an extraordinary work, a plea for humanist ethics in science and medicine as against political and economic expediency. It takes us into even darker places than Hornblum’s earlier book as it examines the long history of unethical experiments done on children in America. Hornblum and his co-authors trace the hideous practice of using children, even infants and pregnant women, as guinea pigs, back to the ideology of the eugenicists in the early 20th century.
Ostensibly practicing science in the heroic mold — science was to cure all of mankind’s ills — doctors and scientists turned to the youth warehoused in orphanages, children’s homes and hospitals as apt subjects for medical and other experiments. The children, who could not make any informed consent, were often labelled “feeble-minded,” or were children with Downs Syndrome or cerebral palsy, or were just too poor and illiterate to make any fuss. Their parents often were not notified of the experiments, or they were overtly or subtly coerced to give consent.
The result was a series of experiments in hospitals and children’s homes — like Vineland, Willowbrook, or Wrentham — seeking cures or treatments for pellagra, ringworm, hepatitis, diphtheria, and any number of ills. But the experiments wreaked untold and possibly still unreported havoc on the young children involved. One child subject the authors interviewed years later in adulthood insisted that some victims at Fernald State School in Massachusetts were “buried out there in paupers’ graves… They killed them” (p. 146). Some of the experiments involved treatments for birth control, including use of forced sterilization and castration.
The children used as experimental subjects were often deliberately infected with diseases, and then given experimental treatments (many quite dangerous), or even no treatment at all, the better to observe the natural course of the disease for science’s sake. Dr. Albert Kligman, a key figure in Hornblum’s Acres of Skin, reappears in this new book, deliberately introducing ringworm fungus into experimentally induced wounds on retarded children, and withholding treatment to observe the course of the disease.
Between the early negative eugenics inspired experiments and the later use of children as experimental subjects, the monstrous example of Nazi science and bizarre and deadly medical experiments cast a shadow across the subsequent decades. Hornblum et al. describe the rise and rapid fall of the Nuremberg protocols, which were generally ignored by U.S. doctors and scientists. These professionals eviscerated the ethical commands around informed consent. One doctor, associated with the Army Epidemiological Board, is quoted as criticizing “the Nuremberg specter”, which drives out “rational approaches” to using children as human subjects in medical research (p. 66).
But as the title of the book suggests, it was Cold War exigencies that gave medical and scientific researchers seeming carte blanche to conduct experiments on children (and prisoners, and elderly patients, and even prostitutes’ clients), and all in the name of national security and protection from communism. Hornblum and his co-authors do an excellent job in explaining this complex history, and showing how the Department of Defense, the Atomic Energy Committee and the CIA funded experiments, including use of electric shock and LSD.
The book describes the work of noted child researcher Lauretta Bender, known for her famous Bender Gestalt Test, taught to generations of psychologists, who used both electric shock and LSD on children deemed schizophrenic or behaviorally disordered. Many of these experiments were reported in medical or psychological journals, discussed at public conferences. (Hank Albarelli and I explored some of this history as well in a 2010 article at Truthout.) In the Cold War environment that prevailed, few saw any problem with using children this way. Few objected they represented a vulnerable population.