While completing the Protecting Human Research Participants training module, I immediately recognized the progress mankind has made when involving humans in research. Blatant crimes against humans such as those committed by Nazi war criminals and the Tuskegee researchers would hardly be tolerated today (National Institutes of Health, 2008). Still, while instances such as these do not occur overtly, some argue that problem areas in research, and practices, still exist.
A recent example of human maltreatment is the practice of performing transorbital lobotomies. This was a popular procedure in the United States, during the1950’s, conducted by an American doctor by the name of Walter Freeman. He began utilizing and building upon the technique of Portuguese doctor Alfred Moniz, who used the lobotomy as a source of treatment with severely mentally ill patients (PBS.org, 1998). The transorbital lobotomy, as developed by Freeman, gained popularity during the 1940’s and 1950’s because of the dilapidated conditions of mental institutions and the lack of available treatment for the mentally ill (National Public Radio, 2005).
Freeman used to travel around the country and perform the lobotomy in front of live audiences. This heinous procedure consisted of electroshock treatment to render patients of all ages unconscious (National Pubic Radio, 2005). Following this, a mallet was used to pound a tool similar to an ice pick into the eye sockets. The pick was then moved back and forth blindly to sever nerve fibers in the brain. Freeman claimed this technique could cure schizophrenia, violent behavior, severe depression, and even migraines. The families of many patients complained that the results were less than positive and left patients flat, silly, childlike or helpless. Unfortunately, thousands of these lobotomies were performed before popularity declined and medication was eventually introduced to fight mental illness (Lerner, 2005). Howard Dully, one of Freeman’s victims, describes his painful struggle in a National Public Radio (2005) program entitled My Lobotomy.
While the transorbital lobotomy may seem to be a problem of the past, critics today complain that a pharmaceutical lobotomy is occurring in the United States. Indeed, children are prescribed psychotropic drugs in record numbers. Some argue that children treated with these drugs often lack spontaneity, are flat, mechanized and obsessively engaged in routine behaviors (Breggin, 2002). Breggin (2001) warns that America’s children are being deluged by psychiatric drugs and the problem is growing worse each year. Parents report feeling increased pressure by school officials and teachers to drug their children. It is frightening to note that as of 1998, the United States used 90% of the world’s methylphenidate, a drug commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) (Breggin, 2001). It appears progress has been made in some areas of human research; however, trends such as this give credence to approaching research with great caution.
Another current area of concern regarding children and human subjects is the vaccine debate. Stratton, Gable and McCormick (2001) note that vaccines have been one of the greatest medical accomplishments over the last century (p. 10). As with most medical procedures, it is well known that vaccines do not come without certain risks. For example, anaphylactic shock occurs with some vaccines. Furthermore, some children contract paralytic polio from the oral polio vaccine. Despite these risks, infant mortality has been drastically reduced over the years and immunizations have been a leading factor in this decrease (Stratton et al.).
Still, concerns continue and these concerns center around thimerosal, the increased number of vaccines given to children and the increased instances of autism (Kennedy, 2005). There appears to be indirect evidence that thimerasol-containing vaccines could be associated with neurodevelopmental disorders because of biological plausibility; hence, as of 1999, thimerosal-containing vaccines are not recommended for children under the age of six (Stratton et al.). However, others argue that thimerosal has never been removed from the immunization schedule because 90% of flu shots contain thimerosal; and, children often receive flu vaccinations annually (Generation Rescue, 2007). Additionally, critics of the immunization schedule in the United States note that the number of vaccines given to children has increased from 10 in 1983 to 36 currently. There are fears that ingredients other than theimerosal may also contribute to neurological problems (Generation Rescue, n.d.). Finally, the incidence rate of Autism has risen from 1 in 10,000 in the early 1990’s to 1 in 91 today. One in 58 boys is diagnosed with autism and the ratio of autism in boys and girls is four to one, respectively. Some say this is attributable to the increase in vaccinations (Generation Rescue, n.d.).
These important issues highlight the fact that risks to humans are still an enormous concern when conducting research or recommending treatment. While informed consent and rigorous safety measures may be in place, potential for harm is difficult to remove completely especially when stakeholders don't know what questions to ask. It is hoped that future researchers will not look back to this time in history and declare it a time of grave injustice as far as children are concerned. My hope is that we can learn from victims such as Howard Dully and the Tuskegee participants. We must ask questions and we must listen!
References
Breggin, P. (2001). Talking back to Ritalin: What doctors aren’t
telling you about stimulants and ADHD. Cambridge, MA: Perseus.
Breggin, P. (2002). The Ritalin fact book: What your doctors won’t
tell you about ADHD and stimulant drugs. Cambridge, MA: Perseus.
Generation Rescue. (n.d.). CDC mandatory vaccine schedule
comparison. Retrieved from http://www.generationrescue.org/pdf/cdc_comparison.pdf
Generation Rescue. (n.d.). Autism facts & statistics.
Retrieved from http://www.generationrescue.org/autism-facts-statistics.html
Generation Rescue. (2007). Battling misinformation.
style="font-size:85%;">Retrieved from http://www.generationrescue.org/misinformation.html
Kennedy, R., Jr. (2005). Tobacco science and the thimerosal scandal.
Retrieved from http://www.robertfkennedyjr.com/docs/ThimerosalScandalFINAL.PDF
Lerner, B. (2005). Last ditch medical therapy: Revisiting lobotomy.
New England Journal of Medicine, 353(2), 119-121.
National Institutes of Health. (2008). Protecting human research
participants. Retrieved from http://phrp.nihtraining.com/index.php
National Public Radio. (2005). My lobotomy: Howard Dully’s journey.
Retrieved from http://www.npr.org/templates/story/story.php?storyId=5014080
PBS.org. (1998). People and discoveries: Moniz develops lobotomy for
mental illness 1935. Retrieved March 25, 2008, from
http://www.pbs.org/wgbh/aso/databank/entries/dh35lo.html
Stratton, K., Gable, A., & McCormick, M. (Eds.). Safety review: Thimerosal-containing
vaccines and neurodevelopmental disorders. Retrieved from http://books.nap.edu/catalog.php?record_id=10208
