Cold War Radiation Test on Humans To Undergo a Congressional Review
By KEITH SCHNEIDER,
Published: April 11, 1994
levels help treat the patients’ cancers?
*Did top University of Cincinnati administrators conceal reviews by top medical faculty members who criticized how the experiment by one of their leading researchers was done?
These issues will receive their first Congressional public airing on Monday at a House Judiciary subcommittee hearing here in Cincinnati.
Dr. Saenger has acknowledged that the high radiation levels may have contributed to the death of 8 of the 88 patients. He did not agree to be interviewed for this article. But in previous statements and reports, he has asserted that the experiment’s primary purpose was to treat the patients’ cancers and, incidentally, to provide data to the Pentagon. Full Story Is Not Out
Dr. Saenger’s lawyer, R. Joseph Parker, also says that so far the only material that has been made public — Dr. Saenger’s annual summaries to the Pentagon and two proposals to expand the research — primarily reflects the Pentagon’s interest in the experiment. He said documents that would exonerate Dr. Saenger, the patient charts, had yet to be released.
But a 1972 report by three University of Cincinnati junior faculty members who evaluated the experiment said that as many as a quarter of the patients died from the radiation.
Dr. Saenger and his colleagues failed to get money to continue the experiment that year. At the same, the details of the work were widely reported, and Senator Edward M. Kennedy, Democrat of Massachusetts, started investigating.
At the time, the University of Cincinnati defended Dr. Saenger, as did the American College of Radiology, which called his research “validly conceived, stated, executed, controlled and followed up.” But a full inquiry was never completed.
Tomorrow’s hearing will consider a wealth of new evidence on the experiment, including thousands of pages of files released in March by the university as part of a Governmentwide review of cold war human radiation experiments.
Dr. Saenger, now 77 and retired, has not spoken publicly about the experiment since December but is expected to testify at the hearing.
Last year, when he testified as an expert witness in an unrelated radiation court case in Cincinnati, he said he was proud of his experiment. “These people were sick,” he said. “They had far-advanced cancer. And we gave them this treatment to see whether we could improve their condition.”
But some researchers and the families of the patients who died said there was scientific evidence as early as 1959 casting doubt on the use of whole-body or partial-body radiation to treat the types of malignant tumors these patients had. The families of some of the patients recently filed four lawsuits against Dr. Saenger, his colleagues and the university. Sought to Develop Test
The university experiment began in 1960, when the Pentagon accepted Dr. Saenger’s proposal to study changes in the blood, urine and mental alertness of terminally ill cancer patients after all or part of their bodies had been exposed to high-dose radiation.
Dr. Saenger, who was 43 at the time and director of the university’s radioisotope laboratory, hoped to develop a blood and urine test that would quickly and easily indicate a person’s radiation exposure level. He told the Pentagon that such a test would be useful on the nuclear battlefield.
Most of the 88 patients chosen for the experiment over the next 11 years had breast, lung or gastrointestinal malignancies, known as solid tumors. Though their cancers were inoperable, the patients were judged physically strong enough to withstand intense radiation.
The participants, most of them patients at Cincinnati General Hospital, a public hospital, did not start signing releases until 1965, when the Government directed universities to tighten procedures for human experimentation. Over time, the consent forms became more rigorous, but as was common practice at the time, they never disclosed the name of the experiment’s sponsor, which in this case was the Pentagon.
After knowledge of the experiment became public, university officials said patients were told orally during the study’s final months in 1970 and 1971 of the Pentagon’s involvement. 20,000 Chest X-Rays
Most patients were exposed to radiation once for roughly an hour with up to 300 rads, equal to 20,000 chest X-rays and enough to cause 48 of the 88 patients to develop nausea, vomiting, anorexia, abdominal pain and mental confusion, documents show.
Last month, in response to public pressure and a request from the Pentagon, Dr. Joseph A. Steger, the university’s president since 1984, released thousands of pages of documents on the study.
“We have nothing to hide here,” he said. “We are a public institution and these are public documents.”
Included among them are internal memorandums and private reports from members of a faculty committee in the 1960’s that reviewed clinical research involving human subjects. The papers make clear that committee members had argued privately for years about the safety and morality of exposing terminally ill cancer patients to high doses of radiation.
“The problem was the amount of radiation they were giving to patients was enough to do a lot of damage to normal cells, but it wasn’t the kind of dose normally given for treatment,” said Dr. Edward P. Radford, a retired environmental medical specialist.
In an April 1967 memorandum, Dr. Radford, a former University of Cincinnati faculty member who served on the committee in the mid-1960’s, questioned the experiment’s therapeutic aims. The papers indicate that the National Institutes of Health had also expressed doubts in 1967, rejecting Dr. Saenger’s proposal to expand his experiment for ethical reasons.
The newly disclosed papers also shed light on the 1971-72 investigation by the American College of Radiology, which defended Dr. Saenger and his colleagues. A memorandum by Dr. Saenger in December 1971 indicates that he set up appointments for the investigators and may have chaperoned them. At the time, he sat on five of the organization’s subcommittees and commissions. Dr. Robert W. McConnell, the group’s president, was a fishing buddy and signed the investigative report.
If there was this much skepticism, why was the study not stopped? Dr. Radford said his panel was a little intimidated by Dr. Saenger. “We hadn’t thought through the whole moral morass quite as thoroughly as people have now,” he said. “And Dr. Saenger was irate. He said, ‘Who are these guys telling me how to do my research?’ He was still living in the period when the doctor was God.” Reputation Not Harmed
Dr. Saenger survived the investigations with his reputation intact. He was the founder of the radioisotope laboratory there in 1950 and turned it into a leading research center by becoming a Government consultant on radiation and health. In 1978, the university named the laboratory in his honor. In November, the American College of Radiology awarded him a gold medal for his career achievements.
But the Government’s new interest in cold war radiation experiments, with the recent release of documents, has again brought Dr. Saenger and the university under fire. Congress has now picked up where it left off more than 20 years ago.
“In January, I was told one thing by the university — that they’d been through this once before and there was nothing more to say,” said Representative David Mann, an Ohio Democrat and member of the House Judiciary Subcommittee on Administrative Law and Governmental Relations who had called for Congressional hearings. “Later, in a lot of different ways we learned there were more questions to be asked. In no way was I ever advised by the university that there had ever been any internal questions or disagreements.” Was Information Hidden?
One issue is the propriety of concealing information about the effects of high-dose radiation from patients. In summaries to the Pentagon, Dr. Saenger said patients were not to be informed. “The patient is told that he is to receive treatment to help his sickness,” he wrote in 1961. “There is no discussion of subjective reactions resulting from the treatment. Other physicians, nurses and ward personnel are instructed not to discuss these aspects with the patient.”
By subjective symptoms, he meant vomiting, abdominal pain, diarrhea, weakness and mental confusion. “Do not ask the patient whether he has these symptoms,” Dr. Saenger wrote.
Dr. Saenger’s lawyer, Mr. Parker, said, “There was a genuine belief that the patients would benefit from the study and, by the way, there could be information developed for the Department of Defense.” He said Dr. Saenger’s critics were reading only reports prepared for the Pentagon. “The Pentagon was not interested in cancer treatment,” he said.
But Dr. David Egilman, a former instructor in family medicine at the University of Cincinnati and now clinical assistant professor of community health at Brown University, said that even in the 1960’s, whole-body radiation had been largely discounted for treating colon, stomach, lung and breast tumors.
“The study was designed to test the effect of radiation on soldiers,” said Dr. Egilman, who has studied Dr. Saenger’s experiment and is scheduled to testify at the Congressional hearing. “It was known when the study began that whole body radiation wouldn’t treat the types of cancer these patients had. What happened here is one of the worst things this Government has ever done to its citizens in secret.”
Photo: Dr. Eugene Saenger, a retired radiologist who conducted radiation experiments on humans in the 1960’s at the University of Cincinnati. A Congressional panel will begin reviewing his work today. (Michael Snyder for The New York Times)