Human Guinea Pigs: Medical Experimentation Before World War II

In 1884, J. Marion Sims, considered by some to be the “father” of gynecological surgery, published an autobiography that recalled his early experiments on slave women. Among his first efforts was to develop a surgical technique to repair vesico-vaginal fistulas, a hole in the vaginal wall that virtually incapacitated women, causing them to lose control of their bladders. He recalled that his interest in this procedure developed after a fellow physician told Sims that “‘one of my servant girls, Betsey,’” was unable to retain her urine. The next month, in 1845, a local slave owner approached Sims about another slave girl who was also incapacitated with the same condition. Before long, seven slave women had been identified in the area as suffering from vesico-vaginal fistulas and Sims made their owners a proposition: If the owners would allow him to perform surgical experiments on these women—in the hope of developing an intervention that would possibly return them to health and, hence, to use—Sims would provide room and shelter for the period of experimentation and recovery.

The first patient Sims operated on was Lucy, a slave girl who had a hole two-inches in diameter. She “bore the operation with great heroism and bravery,” Sims remembered, despite the fact that the operation was performed “before the days of anesthetics” or antisepsis. ¹ Sims established a “hospital” for six to twelve slave women by adding an extra story to his clinic and proceeded to experiment on these women for four years, performing hundreds of experimental operations and going so far as to take the women with him when he traveled. “There was never a time that I could not, at any day, have had a subject for operation,” he wrote, despite the fact that, until 1849, “my operations all failed.” ²

Susan Lederer’s book is a bold attempt to provide a voice to the many women, children, prison inmates, elderly, minority, and others who served as “human guinea pigs” and were “subjected to science.” It is also a penetrating social and intellectual history of the development of an ethical consciousness among physicians, the American public, and the patient population about the boundaries between ethical and unethical research, legitimate human experimentation, and abuse of patients’ rights and bodies. In the decades between 1890 and World War II, Lederer maintains, a growing sensitivity among a broad public forced the legions of medical experimenters to develop informal and formal guidelines that would distinguish between legitimate research, unethical experimentation, and barbarous exploitation. Despite a decline of power among animal and childrens’ rights advocates who spurred the movement, the questions they raised in the interwar years were the basis for all later discussions of informed consent, patients’ rights, and ethical behavior within medicine.

Lederer directly addresses some of the spoken and unspoken assumptions of bioethicists (and some apologists for past abuse) who maintain that today’s ethical standards are far more exacting than those of previous eras. She illustrates that concerns about the rights of patients preceded the post-World War II revelations at Nuremberg of German death camp experiments. Rather, the concern over patients’ rights grew out of a conjoining of antivivisectionist sentiments, urbanization, and developments in scientific medicine in the final decades of the last century and the early decades of our own.

Virtually from the beginning, animal and human experimentation were closely linked. Shortly after the Civil War the American Society for the Prevention of Cruelty to Animals (ASPCA) was established, in part to protect from abuse the hundreds of thousands of horses that had provided every form of transportation and power in the growing cities of the nation. Shortly thereafter, in 1875, the New York Society for the Prevention of Cruelty to Children (SPCC) was formed in order to protect children from exploitation as cheap labor in the growing industrial nation. The ASPCA and SPCC shared both a common goal and a...