Against Their Will: The Secret History of Medical Experimentation on Children in Cold War America by Allen M. Hornblum, Judith L. Newman and Gregory J. Dober (review)

Allen Hornblum, Judith Newman, and Gregory Dober chronicle the U.S. medical profession's experimentation on children from the 1950s to the 1970s. Doctors targeted children with low IQs, scientifically classifying them as "idiots," "imbeciles," and "morons," occupying an intermediate point between animals and "normal" people. Long rendered invisible in mainstream U.S. society—figuratively in the press as well as literally confined in sanitariums—these children also existed on the margins of Cold War histories. Hornblum, Newman, and Dober seek to bring this shameful story into the larger historical narrative of the Cold War.

The first chapters contextualize eugenics in the twentieth century, showing how the field spread before and during the Second World War. Popular culture in the United States set doctors on a pedestal as heroes pushing the frontiers of medical knowledge. In contrast, the "Nazi doctors" received wide condemnation for their crimes against humanity, and the subsequent Nuremberg Code set forth a list of medical "thou shalt nots" to prevent a repeat of state-authorized human experimentation. However, many within the U.S. medical profession did not feel bound by those standards. The cultural hero-worship surrounding doctors, the precedence of wartime vaccinations, and new concerns about radioactive fallout allowed for a golden age of experimentation on so-called retarded children in the name of patriotism during the Cold War.

The book's account of this dismal era reflects Hornblum's, Newman's, and Dober's backgrounds in medical journalism and human development. The authors use recently declassified government documents pertaining to the experiments; period medical journals detailing the procedures used and the findings; and interviews with surviving children from the experiments and the doctors who conducted them, notably Constantine Maletskos, a specialist in radiation. They effectively summarize the experiments, terminology, and medical context for non-specialists.

The controversial nature of the topic has hindered research, as the authors note. The Iowa state archive, for instance, refuses to allow journalists and "outside researchers" to see records concerning the notorious "Monster Study" (an experiment involving consistent negative criticism to make young people stutter). In detailing the negligence and abuse the children suffered in isolated institutions, the authors express outrage that the profession's Cold War mentality still plagues the field. The book ends with a manifesto: "We, as a society, must be ever vigilant that such paternalistic and utilitarian practices never return, nor be outsourced abroad so that the burden of scientific advancement is relegated to vulnerable populations in lesser developed nations" (p. 228).

Most historians will probably wish the book had offered a deeper analysis of the Cold War context. The heightened American exceptionalism that underpinned the struggle against Communism permeates the text, but the authors seldom directly address the medical profession's role as Cold Warriors. U.S. doctors ignored the Nuremberg Code, believing their work rested on a higher moral plane than Nazi barbarism, and they still adhered to this position decades later. When discussing the exposure of children to radioactive isotopes, Maletskos told the authors, "I feel just as good about it today as the day I did it" (p. 143). In many doctors' view, medical shortcuts were justified if they led to vaccines for polio and other remedies, saving thousands of lives.

The authors could also have said more about the intersection between medicine and politics. As one physician for the U.S. Central Intelligence Agency claimed, "Our guiding light is not the Hippocratic oath, but the victory of freedom" (p. 74). This victory culture, the arms race, and the rapid development of technology and medicine—lobotomy practices, electroshock therapy, and LSD, among others—demonstrate a renewed vigor of wartime mobilization, approaching the status of a garrison state, as various industries cooperated to wage the Cold War. How did medicine fit into this pattern...