The Ramazzini Institute
for Occupational and Environmental Health Research   

Who Are We?

The Need for Openness and Informed Consent

Undue Risk:  Secret State Experiments on Humans
By Jonathan D. Moreno, W.H. Freeman, 2000, 320 pp.
Reviewed by Arthur C. Upton

    In his book Undue Risk, Jonathan Moreno has drawn on his investigative experience as a senior staff member of the presidential Advisory Committee on Human Radiation Experiments to produce a revealing account of government-sponsored experiments on human subjects.  Although he makes no attempt in the book to document such experiments comprehensively, the many experiments he describes comprise a historically significant and illuminating series. They include, among others, experiments on human volunteers that were conducted by Walter Reed and the Yellow Fever Commission at the beginning of the twentieth century; the Tuskegee syphilis study; experiments that were conducted for the purpose of protecting soldiers against mustard gas in world war II; experiments for protecting soldiers against chemical and biological weapons in the Gulf war; and experiments during the intervening years on the effects of penicillin, nitrogen mustard, anti-malarials, mescaline, plutonium, whole-body ionizing radiation, and various other agents.  The subjects in such experiments included patients, retarded children, volunteers, servicemen, and prisoners, many of whom were recruited without informed consent, some unwittingly.  In the latter context, the book discusses the U.S. government’s failure to inform uranium miners, servicemen, and members of the public about the risks that they may have incurred as a result of exposure to radiation during the nation’s development and testing of atomic weapons.  The book also cites NASA’s recruitment of Nazi experts into its space program in spite of the knowledge of Nazi atrocities, including horrific experiments by Nazis on concentration camp prisoners. Other egregious human experiments that are discussed in the book include those which were conducted by Shiro Ishii on Chinese and Russian victims in Manchuria and those which were conducted by the Iraqi government on Kurds and other populations in Iraq.

     In recounting details of these state-sponsored experiments, the book provides penetrating insights into the circumstances surrounding them, the personalities of those who were involved, the issues that were a stake, and the personal, professional and public attitudes prevailing at the time. In the process, the book chronicles the need for, gradual evolution of, and eventual acceptance of an ethical framework for research on human subjects that embodies the principles of voluntary participation and informed consent, as exemplified in the Nuremberg Code. At the conclusion of the book, the author expresses the view that experiments on human subjects will undoubtedly continue to be necessary throughout the foreseeable future, not only for the pre-market testing of newly developed pharmaceuticals and other products but also for the protection of potentially exposed populations against the threat of attack by atomic, chemical, and biological weapons.  Hence, in order to help ensure that such experiments meet ethical standards of openness and informed consent, the author recommends that a “research ethics court” should be developed by the international community.

     In going behind the scenes to describe many struggles over the ethics of human experimentation that have occurred in recent decades among government officials who were concerned with national security, Jonathan Moreno shows vividly how a policy of secrecy that seemed justifiable to those who were directly involved proved ultimately to be corrosive to democracy and to cause serious violations of human rights.  From these lessons, he argues persuasively that although research on human subjects for military and medical purposes can be expected to continue indefinitely, such research should be confined to defensive rather then offensive purposes, should meet ethical standards of openness and informed consent, and should expose none of the involved participants to undue risks.  His call for establishment of an ethical review process to help ensure that investigators meet such standards consistently in the future merits the serious attention of citizens and governments everywhere.

     Undue Risk deals with the aforementioned issues in a balanced, scholarly way, documenting each of the relevant sources of information with appropriate references. Although the book was written for general readership, it is a book with a timely and important message, and it should be interesting and informative to all who are concerned with military preparedness, defense, and the ethics of human experimentation.