Useful bodies Humans in the service of medical science in the twentieth century
Authors: Susanna Cunningham
Journal: Journal of Clinical Investigation (2004)

In September 1998 a group of papers was presented at the Wellcome Institute for the History of Medicine in London. This collective work was presented as a workshop on the history of experimentation on humans. Now, Jordan Goodman, Anthony McElligott, and Lara Marks have edited these eight papers into the new book Useful bodies: humans in the service of medical science in the twentieth century.

The opening essay, “Making human bodies useful: historicizing medical experiments in the twentieth century,” makes two key points: first, that there is very little historical information available on the history of human experimentation; and second, that the focus for the papers in the book is the role of the state in nontherapeutic human experimentation. The authors argue that during the period from 1900 to 2000, the state held the position that it could use the bodies of individuals to meet its needs without explicit consent. This chapter is hard work for the lay reader who is not a historian. In fact, many readers would probably find it more interesting to return to the essay after reading the rest of the book. The following essays are grouped according to three questions: What is a human experiment? Who performs the experiments? Whose body is experimented on? Unfortunately, these questions are not specifically addressed within the essays, so, for the casual reader, the organizing principle is rather obscure.

Four of the eight chapters deal with infectious agents, focusing on the study of germ warfare methods in Great Britain; the study of jaundice in mentally retarded children or in persons with rheumatoid arthritis in the United States and England, respectively; and the use of malaria to treat neurosyphilis in the United States. The remaining essays discuss experiments involving some form of radiation, ranging from atom bomb testing by Great Britain in Australia to the development of radiation therapy and the use of radioisotopes in the United States. As individual case studies, these chapters make fascinating reading. It would, however, have been helpful to include a brief summary essay that made explicit how the themes presented in the introductory essay were supported by the case reports.

Useful bodies could have been titled Beyond Tuskegee, as it describes other less-well-known cases of highly debatable human research done in the last century. Aside from medical historians and fans of biomedical history, I can see this book being of interest to either journal clubs or teachers of science, ethics, and/or research methods. The well-documented essays cite a rich body of sources, though the inclusion of an index would have made the book more user friendly. There is some discussion of the research done in Nazi Germany in the initial essay, but the remainder of the book is devoted to studies in Great Britain, the United States, and, in one case, Australia (although that research was performed by the British Ministry of Defense). It would have been useful to include information on what nontherapeutic research was being done by states in the rest of the world during the same period.

One issue that readers of the book will confront is how to evaluate the research that it documents from an ethical point of view. There is no doubt that the studies discussed in Useful bodies would never have been approved in the year 2004. Even though the focus of the book is history, not ethics, the approaches taken by the essayists — all academicians from diverse fields including science policy, science and medical history, internal medicine, and humanities — clearly range between judging the science according to the time in which it was done and judging it by current-day standards. Each reader must decide for him- or herself which standards to use. How will our work be judged by those who follow us?