DARK MEDICINE Rationalizing Unethical Medical Research EDITED BY WILLIAM R. LAFLEUR, GERNOT BÖHME, AND SUSUMU SHIMAZONO Dark Medicine Bioethics and the Humanities Eric M. Meslin and Richard B. Miller, editors edited by WILLIAM R. LAFLEUR, GER NOT BÖHME, and SUSU M U SH I M A ZONO Dark Medicine Rationalizing Unethical Medical Research INDIANA UNIVERSITY PRESS Bloomington and Indianapolis This book is a publication of Indiana University Press 601 North Morton Street Bloomington, IN 47404-3797 USA http://iupress.indiana.edu Telephone orders 800-842-6796 Fax orders 812-855-7931 Orders by e-mail
[email protected] © 2007 by Indiana University Press All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher. The Association of American University Presses’ Resolution on Permissions constitutes the only exception to this prohibition. The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI Z39.48-1984. Manufactured in the United States of America Library of Congress Cataloging-in-Publication Data Dark medicine : rationalizing unethical medical research / edited by William R. LaFleur, Gernot Böhme, and Susumu Shimazono. p. ; cm. — (Bioethics and the humanities) Includes bibliographical references and index. ISBN 978-0-253-34872-2 (cloth : alk. paper) 1. Human experimentation in medicine—Moral and ethical aspects. 2. Medicine—Research—Moral and ethical aspects. 3. Medical ethics—History. I. LaFleur, William R. II. Böhme, Gernot. III. Shimazono, Susumu, date IV. Series. [DNLM: 1. Human Experimentation—ethics. 2. Human Experimentation—history. 3. Bioethical Issues. 4. History, 20th Century. W 20.55.H9 D219 2007] R853.H8D3776 2007 174.2′8—dc22 2007000635 1 2 3 4 5 12 11 10 09 08 07 this book is dedicated —To the many people, mostly dead but some alive, who suffered or even perished because inhumane research had been rationalized —To the memory of Hans Jonas (1903–1993), who demonstrated that both history and philosophy give us grounds for putting prudence into our bioethics. Americans were kept in the dark about the effects of what was being done to them . . . for these experiments were kept secret. President Bill Clinton, on October 3, 1995, concerning the Report of the Advisory Committee on Human Radiation Experiments Contents Preface ix Acknowledgments xi Introduction: The Knowledge Tree and Its Double Fruit 1 William R. LaFleur PA R T O N E t h e g ru e s o m e pa st a n d l e s s o n s n ot yet l e a r n e d 1. Rationalizing Unethical Medical Research: Taking Seriously the Case of Viktor von Weizsäcker 15 Gernot Böhme 2. Medical Research, Morality, and History: The German Journal Ethik and the Limits of Human Experimentation 30 Andreas Frewer 3. Experimentation on Humans and Informed Consent: How We