- Wed Jun 28, 2006 12:03 pm
#236184
While promoting the beneficial uses of radiation, the government also wished to continue and expand research on its harmful effects. Three days after the destruction of Hiroshima, Robert Stone wrote two letters to Stafford Warren's deputy, and Stone's former student, Hymer Friedell. The first expressed hope that the contribution of medical researchers could now be made public, so that people would know what they had done during the war.[57] The second letter described Stone's "mixed feelings" at the success that had been achieved and his fear that the lingering effects of radiation from the bomb had been underestimated: "I could hardly believe my eyes," Stone wrote, "when I saw a series of news releases said to be quoting Oppenheimer, and giving the impression that there is no radioactive hazard. Apparently all things are relative."[58]
Friedell and other researchers, including Stafford Warren and Shields Warren, soon traveled to Hiroshima and Nagasaki to begin what became an extensive research program on survivors. The data from that project quickly became and still remain the essential source of information on the long-term effects of radiation on populations of human beings. It was not long, however, before there were additional real-life data on the bomb, from postwar atomic tests. In 1946, the United States undertook the first peacetime nuclear weapons tests at Bikini Atoll in the Marshall Islands. Operation Crossroads, conducted before journalists and VIPs from around the world, was intended to test the ability of a flotilla of unmanned ships to withstand the blast. Since most of the ships remained afloat, the Navy declared Crossroads a triumph.[59]
Behind the scenes, however, Crossroads medical director Stafford Warren expressed horror at the level of contamination on the ships due to the underwater atomic blast.[60] When the ships returned to the West Coast from the Pacific, they were extensively studied to assess the damage and contamination from the atomic bombs. The government created the Naval Radiological Defense Laboratory (NRDL) to study the effects of atomic bombs on ships and to design ways to protect them. "Crossroads," according to an NRDL history, "left no doubt that man was faced with the necessity for coping with strange and unprecedented problems for which no solutions were available."[61]
Hiroshima and Nagasaki, it now seemed, were only the beginning, not the end, of human exposure to bomb-produced radiation. As Crossroads confirmed with the lingering problem of contaminated ships, what the bomb did not obliterate it might still damage by radiation over the course of days or years. It was no longer enough to know about the effects of radioactive materials on American nuclear weapons workers; now there was the urgent need to understand the effects on American soldiers, sailors, and even citizens as well.
Largely invisible to the public, an ad hoc bureaucracy sprang up to address the medical and radiation research problems of atomic warfare. This bureaucracy brought together former wartime radiation researchers, who were joined by junior colleagues, to advise, and participate in, the government's growing radiation research program. Other, already established groups--such as the AEC's Division of Biology and Medicine and its advisory committee--also had important places in the new network.
Beyond considering fallout from the testing of atomic bombs, these groups also looked at how radiation itself might be used as a weapon. During the war, scientists like J. Robert Oppenheimer had speculated on the possibility that fission products (radioactive materials produced by the bomb or by reactors) could be dispersed in the air and on the ground to kill or incapacitate the enemy. In 1946, the widespread contamination of ships at Crossroads by radioactive mist gave dramatic evidence of the potential of so-called radiological warfare, or RW. In 1947, the military created a committee of experts to study the problem. The following year, a blue-ribbon panel of physicians and physicists looked at the prospects, both offensive and defensive, of what the Pentagon termed "Rad War." The work of these panels would lead to dozens of intentional releases of radiation into the environment at the Army's Dugway, Utah, testing grounds from the late 1940s to the early 1950s. The very fact that the government was engaged in RW tests was a secret. Indeed, the records of the RW program--including, as we shall see in chapter 11, the debate on what the public should be told about the program--would remain largely secret for almost fifty years.
In 1949, a military program to build a nuclear-powered airplane led to a set of proposed human radiation experiments. The NEPA (Nuclear Energy for the Propulsion of Aircraft) program had its origins in 1946 as a venture that included the Manhattan Project's Oak Ridge site, the military, and private aircraft manufacturers. Robert Stone, as we shall see in chapter 8, was a leading proponent of experiments involving healthy volunteers, as a key to answering questions about the radiation hazard faced by the crew of the proposed airplane.
The NEPA and RW groups considered important, but still discrete, projects. Where did the "big picture" discussions take place? The Advisory Committee has pieced together the records of the Armed Forces Medical Policy Council, the Committee on Medical Sciences, and the Joint Panel on the Medical Aspects of Atomic Warfare.[62] These three Defense Department groups, all chaired by civilian doctors, guided the government on both the broad subject of military-related biomedical research and the new and special problems posed by atomic warfare.
If the surviving records are an indication, from its creation in 1949 to its evident demise with the reorganization of the Defense Department in 1953, the Joint Panel quickly became the hub of atomic warfare-related biomedical research. The Joint Panel gathered information about relevant research from all corners of the government, provided guidance for Defense Department programs, and reviewed and coordinated policy in the matter of human experimentation using atomic energy.
By charter, the group was to be headed by a civilian. Harvard's Dr. Joseph Aub, a long-standing member of the Boston-based medical research community who had worked with Robley Evans on the study of the radium dial painters and had also studied lead toxicity, served as chair. Those who served with Aub included Evans, Hymer Friedell, and Louis Hempelmann, Oppenheimer's Manhattan Project medical aide. Other government participants came from the AEC, the Public Health Service, the National Institutes of Health, the Veterans Administration, and the CIA. (The charter provided that the Joint Panel should collect information on relevant research conducted abroad, which the CIA evidently provided.)[63]
This bureaucracy provided the venue for secret discussions that linked the arts of healing and war in ways that had little precedent. At one and the same time, for example, doctors counseled the military about the radiation risk to troops at the site of atomic bomb tests, advised on the need for research on the "psychology of panic" at such bomb tests, and debated the need for rules to govern atomic warfare-related experimentation. (See chapter 10.)
The records of the Joint Panel show that, during the height of the Cold War, the resources of civilian agencies were part of the mobilization of resources to serve national security interests. For example, Dr. Howard Andrews, trained as a physicist, was the National Institutes of Health's representative to the Joint Panel, and in the 1950s he worked with the DOD and the AEC in monitoring safety measures and measuring fallout from nuclear tests.[64]
In 1950 President Truman ordered federal agencies, including the Public Health Service and NIH, to focus their resources on activities that would benefit national security needs. On paper, at least, PHS and NIH policymakers sought to direct resources to questions of radiation injury, civil defense, and worker health and safety.[65] For example, a 1952 internal planning memo explained that NIH "will not wait for formal requests by the armed forces . . . to undertake research which NIH staff knows to be of urgent military and civilian defense significance. Limited selective conversion of research to work directly related to biological warfare, shock, radiation injury and thermal burns will begin immediately. . . ."[66] The fragmentary surviving documentation, however, does not show the extent to which PHS- and NIH-funded researchers actually redirected their investigations or merely recast the purpose of ongoing work.
As medical researchers became fixtures in the Cold War research bureaucracy, they assumed roles that, if not entirely new, raised ethical questions with which they had rarely dealt before. The surviving records of the period reveal that frank and remarkable discussions took place among military and civilian officials and researchers, all of whom had to balance the benefits of gaining knowledge needed to fight and survive an atomic war with the risks that had to be taken to gain this knowledge. They had to consider, and even debated, whether human radiation experimentation was justified, what kinds of risks entire populations could be exposed to, and what the public could and should be told.
Whether to Experiment with Humans: The Debate Is Joined
Spurred by proposals for human radiation experiments connected with the nuclear-powered airplane (NEPA) project, AEC and DOD medical experts in 1949 and 1950 engaged in debate on the need for human experimentation. The transcript of a 1950 meeting among AEC biomedical officials and advisers and military representatives provides unique insight into the mix of moral principles and practical concerns.[67]
The participants in the debate included many of the key medical figures in the Manhattan Project and the postwar radiation research bureaucracy. For the Navy, for example, Captain Behrens, the editor of Atomic Medicine, made the point that an atomic bomb might contaminate, but not sink, ships. The Navy would need to know the risk of sending rescue or salvage parties into the contaminated area. There were questions of "calculated risk which all of the services are interested in, and not only the services but probably the civilians as well."[68] Brigadier General William H. Powell, Jr., of the Office of the Air Force Surgeon General, added further questions: How does radiation injure tissue? Can equipment protect against the bomb's effects? Is there a way to treat radiation injury? How should mass casualties be handled?[69]
These questions were hardly abstract. Operation Crossroads had demonstrated that postblast contamination of Navy ships was a serious hazard. The use of the atomic bomb as a tactical weapon, declared Brigadier General James Cooney of the AEC's Division of Military Applications, "has now gone beyond the realm of possibility and into the realm of probability."[70] This meant that "we have a responsibility that is tremendous," Cooney added. "If this weapon is used tactically on a corps or division, and we have, say, 5,000 troops who have received 100 R[oentgens] radiation, the Commander is going to want from me, 'Is it all right for me to reassemble these men and take them into combat?' I don't know the answer to that question."[71] Commanders needed to know "How much radiation can a man take?"[72]
Cooney argued that human experimentation was necessary. He invoked the military's tradition of experimentation with healthy volunteers, dating back to Walter Reed's famous work on yellow fever at the turn of the century. Cooney urged that the military seek volunteers within its ranks--"both officer and enlisted"--to be exposed to as much as 150 R of whole-body radiation.[73]
The AEC's Shields Warren took the other side in this debate. Warren raised two basic points in response to Cooney. First, human experimentation was not essential because animal research would be adequate to find the answers. Second, data from human experimentation would likely be scientifically useless. "We have," Warren declared, "learned enough from animals and from humans at Hiroshima and Nagasaki to be quite certain that there are extraordinary variables in this picture. There are species variables, genetics variables within species, variations in condition of the individual within that species." The danger of failing to provide data had to be weighed against the danger of providing misleading data: "It might be almost more dangerous or misleading to give an artificial accuracy to an answer that is of necessity an answer that spreads over a broad range in light of these variables."[74]
There were, moreover, political obstacles to the program Cooney had proposed. Satisfactory answers, Warren concluded, would require "going to tens of thousands of individuals." But America was not the Soviet Union: "If we were considering things in the Kremlin, undoubtedly it would be practicable. I doubt that it is practicable here."[75]
At the heart of Warren's objections to Cooney's proposal was a concern about employing "human experimentation when it isn't for the good of the individual concerned and when there is no way of solving the problem."[76] To Cooney's invocation of Walter Reed, Warren responded that, in the case of yellow fever, humans were needed as subjects because there was no nonhuman host to the disease.
Cooney did not disagree with Warren "that statistically we will prove nothing." But, he pointed out, "[G]enerals are hard people to deal with. . . . If we had 200 cases whereby we could say that these men did or did not get sick up to 150 R, it would certainly be a great help to us."[77]
Even then, Warren rejoined, the data might not be of great use: "I can think in terms of times when even if everybody on a ship was sea-sick, you would still have to keep the ship operating."[78]
The 1950 debate over NEPA provides clear evidence that midcentury medical experts gave thought before engaging in human experimentation that involved significant risk and was not intended to benefit the subject. On paper, the debate was decided in Shields Warren's favor. Following Warren's and DBM's opposition, Cooney and the military agreed that "human experimentation" on healthy volunteers would not be approved. However, even as this policy was declared, the Defense Department, with Warren's apparent acquiescence, proceeded to contract with private hospitals to gather data on sick patients who were being treated with radiation. The government's use of sick patients for research, as we shall see in chapter 8, raised difficult ethical questions of its own.
Whether to Put Populations at Risk: The Debate Continues
As the medical experts debated the issue of whether to put individual human subjects at risk in radiation experiments on behalf of NEPA, they were also engaged in secret discussions about whether to proceed with the testing of nuclear weapons, which might put whole populations at risk.
It was also in 1950 that the decision was made to carry out atomic bomb testing at a site in the continental United States. President Truman chose the Nevada desert as the location for the test site. Shields Warren's Division of Biology and Medicine was assigned the job of considering the safety of early tests. Like the earlier transcript, an account of a May 1951 meeting at Los Alamos, convened by Warren, provides a window onto the balancing of risks and benefits by medical researchers.
The meeting focused on the radiological hazards to populations downwind from underground testing planned at the Nevada Test Site. Those in attendance realized that the testing could be risky. "I would almost say from the discussion this far," Warren summarized, "that in light of the size and activity of some of these particles, their unpredictability of fallout, the possibility of external beta burns is quite real."[79] Committee members considered the testing a "calculated risk" for populations downwind, but they thought that the information they could gain made the risk worthwhile. According to the record of the meeting, Warren summarized the view of Dr. Gioacchino Failla, a Columbia University radiological physicist: "[T]he time has come when we should take some risk and get some information . . . we are faced with a war in which atomic weapons will undoubtedly be used, and we have to have some information about these things . . . if we look for perfect safety we will never make these tests."[80] Worried about the potential consequences of miscalculation, the AEC's Carrol Tyler observed, "We have lost a continental site no matter where we put it." Still, Tyler argued, "If we are going to gamble it might as well be done where it is operationally convenient."[81] A proposed deep underground test did not take place, and a test evidently considered less risky was substituted. Ultimately, in a summary prepared at the end of the 1951 test series, the Health Division leader of the AEC's Los Alamos Laboratory recorded that perhaps only good fortune had averted significant contamination: "Thanks to the kindness of the winds, no significant activity was deposited in any populated localities. It was certainly shown however," he wrote, "that significant exposures at considerable distances could be acquired by individuals who actually were in the fallout while it was in progress."[82]
The NEPA debate and the advent of nuclear testing confronted biomedical experts with a set of conflicting, and even contradictory, objectives. First, they were called upon to offer advice on decisions that might inevitably put people at some risk. The risk had to be balanced against the benefit, which in most instances was defined as connected with the nation's security. In many cases, the experts agreed, it was better to bear the lesser risk now, in order to avoid a greater risk later. Second, these experts were also called upon, as in the 1951 Nevada test, to provide advice on minimizing risk. Third, as in the Nevada test, these same experts saw the tests as opportunities to gather data that might ultimately be used to reduce risk for all.
Whether and What the Public Should Be Told About Government-Created Radiation Risk
Scientific research had a long and celebrated tradition of open publication in the scientific literature. But several factors caused Cold War researchers to limit their public disclosures. These included, preeminently, concern with national security, which necessarily required secrecy. But they also included the concern that the release of research information would undermine needed programs because the public could not understand radiation or because the information would embarrass the government.
The tension between the publicizing of information and the limits on disclosure was a constant theme in Cold War research. When, in June 1947, the Medical Board of Review appointed by David Lilienthal reported on the AEC's biomedical program, it declared that secrecy in scientific research is "distasteful and in the long run contrary to the best interests of scientific progress."[83] As shown by its organization of the medical isotope program, the AEC acted quickly to make sure that the great preponderance of biomedical research done under its auspices would be published in the open literature.
However, recently retrieved documents show that the need for secrecy was also invoked where national security was not endangered. At the same time that biomedical officials, such as those on the Medical Board of Review, spoke openly of the need to limit national security restrictions, internally they sometimes sided with those who would restrict information from the public even where release admittedly would not directly endanger national security. Thus, as we shall see in chapter 13, Shields Warren and other AEC medical officials agreed to withhold data on human experiments from the public on the grounds that disclosure would embarrass the government or could be a source of legal liability.
A further important qualification to what the public could know related to research connected with the atomic bomb--including the creation of a worldwide network to gather data on the effects of fallout from nuclear tests. In 1949, the AEC undertook Project Gabriel, a secret effort to study the question of whether the tests could threaten the viability of life on earth. In 1953, Gabriel led to Project Sunshine, a loose confederation of fallout research projects whose human data-gathering efforts, as we see in chapter 13, operated in the twilight between openness and secrecy.
Finally, while documents show that medical experts and officials shared an acute awareness of the importance of public support to the success of Cold War programs, this awareness was coupled with concern about the American public's ability to understand the risks that had to be borne to win the Cold War. The concern that citizens could not understand radiation risk is illustrated by a recently recovered NEPA transcript. In July 1949, the nuclear airplane project gathered radiation experts and psychologists to consider psychological problems connected to radiation hazard. To the assembled experts the greatest unknown was not radiation itself, but the basis for public fear and misunderstanding of radiation.
"I believe," General Cooney proposed, "that the general public is under the opinion that we don't know very much about this condition [radiation]. . . . We know," he ventured, "just about as much about it as we do about many other diseases that people take for granted . . . even tuberculosis."[84]
Yet, said the Navy's Captain Behrens, "there are some peculiar ideas relative to radiation that are related to primitive concepts of hysteria and things in that category. . . . There is such a unique element in it; for some it begins to border on the mystical."[85] A good deal of the public's fear of radiation, declared Berkeley's Dr. Karl M. Bowman, a NEPA medical adviser, "is essentially the fear of the unknown. The dangers have been enormously magnified." As Dr. Bowman and others noted, the public's perception was not without reason, for "we have emphasized for purposes of getting funds for research how little we know."[86]
The perspective expressed in the NEPA transcript would lead, as shown in chapter 10, to the use of atomic bomb tests to perform human research on the psychology of panic and, as shown in other case studies, to decisions to hold information closely out of concern that its release could create public misunderstanding that would imperil important government programs.
In the atomic age, Captain Behrens's Atomic Medicine pointed out, radiation research was both the agent and the beneficiary of dramatic developments at the intersection of government and medicine. When ethical questions were raised by these developments, radiation researchers would be on the front line in having to deal with them. The burgeoning government-funded biomedical research, including human radiation research, required a reexamination of the traditional doctor-patient relationship. At the same time, the evolving role of medical researchers as government officials and advisers also posed questions about the place of doctors, and more generally of scientists, in service to government.
Last edited by TheCaptain on Wed Jun 28, 2006 12:30 pm, edited 1 time in total.
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