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Reviewed by:
  • Contested Medicine: Cancer Research and the Military
  • David J. Caruso, Ph.D.
Gerald Kutcher . Contested Medicine: Cancer Research and the Military. Chicago, Illinois, University of Chicago Press, 2009. x, 264 pp., $35.00.

In 1993 Eileen Welsome published a series of articles in the Albuquerque Tribune about radiation experiments performed on human subjects in the United States in the mid-twentieth century, unleashing a firestorm of outrage and protest from the American public; within three months, President Clinton established the Advisory Committee on Human Radiation Experiments (ACHRE) to investigate the record of the U.S. government with regard to its participation in such experimentations. ACHRE was charged with uncovering the history of radiation experiments from 1944 through 1974 and with identifying the scientific and ethical standards that could be used to evaluate these experiments so that any wrongdoing that had occurred in the past would not be repeated. One important case under investigation, and the focus of Gerald Kutcher's book, was that of Dr. Eugene Saenger and his cancer therapy/radiation trials at the University of Cincinnati.

For a little over ten years, starting in the early 1960s, Saenger enrolled late-stage cancer patients in a dual-purpose trial to understand the effects of total body irradiation (TBI) on humans: TBI was a potential, though not a proven, therapy for the treatment of cancer, and a majority of the data generated in the study were used as part of research on radiation sickness. Much of this work, however, was funded by the Department of Defense in order to develop a greater understanding of the combat effectiveness of soldiers exposed to radiation while participating actively at war. As Kutcher aptly demonstrates, Saenger's conflation of military-based medicine and treatment-based medicine was hardly an anomaly. Many of [End Page 275] Saenger's peers and many of those who reviewed his studies found that Saenger's research did not vary significantly from their own.

Kutcher's interest in Saenger and his experiments differs markedly from many traditional accounts of the University of Cincinnati experiments that invoke the case to disparage medical research and to question the ethical parameters of researches on human subjects. Instead, Kutcher declares that he is more interested in understanding "the complex and mutually supportive relationship between clinical ethics and medical research practices during the cold war as well as the symbiotic relationship between military medicine and cancer therapy using TBI" (11), opening up the ethical standards of the time to much needed scrutiny. His account neither demonizes Saenger nor defends his form of medical experimentation; it problematizes the whole notion of ethical medical experimentation at a time when most physicians and researchers were trying to figure out the appropriate ways to treat patients while at the same time gathering information for medical science from them. Kutcher shows the reader the ways in which the ethics of experimental work on cancer shaped research practices, the ways in which research practices shaped the ethics of experimental work, and how both were reciprocally changed over time.

Kutcher's attempt to personalize the descriptions of Saenger's human radiation experiments, however, while an interesting approach to the worthy goals of understanding the experiences of the human subjects and making them relevant, fails to deliver on its promises or potential. It is true that, in many accounts of abuses in human subject experimentations, the individuals who are experimented upon often appear simply as impersonal names or dehumanized data points on graphs, denying the reader a broader understanding of the experience of research on human subjects. But although Kutcher "draw[s] on [his] years of experience as a radiation oncology physicist to imaginatively reconstruct from sparse archival sources a 'firsthand' account of [an individual's, namely Maude Jacobs's,] experiences," (16) his reluctance to use social history as a tool to buttress his work does a disservice to his narrative. In telling Jacobs's story, Kutcher often has to rely on assumptions like "[it] is possible that all she remembered [. . .]" (119), "Maude was likely in some state of denial" (121), and "she probably would have tuned out any references to a 'study' [. . .]" (125) without any support other than his experiences...

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