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Philosopher Patrick Derr teaches courses on medical and environmental ethics. He is particularly interested in ethical issues surrounding HIV/AIDS and inadequacies in current codes of ethical conduct for medical research. |
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Meet the researchers: Putting the puzzle together
Interview with Gioia Persuitte
Sociology major Gioia Persuitte's interest in HIV/AIDS and medical ethics led her to take on a research apprenticeship with philosophy professor Patrick Derr. Persuitte '06 researched background information on two physicians, Drs. Gerhard Rose and Saul Krugman, who, in the mid-20th century, tested vaccines on people without their consent. Derr is trying to understand why Rose, who participated in studies of typhus vaccines on Nazi concentration camp inmates, was sentenced to life imprisonment, while Dr. Saul Krugman received numerous honors for developing a hepatitis vaccine that he tested on mentally retarded, institutionalized children living in substandard conditions.
In a conversation, summarized below, Persuitte discussed how she became involved in Derr's research.
I understand that you're a transfer student.
Yes. I transferred to Clark at the beginning of my sophomore year. I was looking for a more rigorous, more academic, and more activist school and I'm very happy here. I've met some great people and have a wonderful circle of friends.
Professor Derr has a particular interest in medical ethics. How did you come to work with him?
When I began college, I had many eclectic interests. However, I knew I wanted to be involved in some kind of health care. I am majoring in sociology and minoring in history. I thought that sociology might be appropriate for my career goals as I want to focus on the social aspect of health, with particular interest in public health. I hope to complete the 5th year program here at Clark in Public Administration and then obtain a PhD in epidemiology.
At my previous college I had developed an interest in AIDS and the issues surrounding it and my interest in the subject has continued here at Clark. When I arrived at Clark, I really wanted to take Professor Derr's AIDS class, but unfortunately it was only open to first year students. I was not to be discouraged though, I read the books that were required for the class and was able to learn more information about the subject matter. When Professor Derr's Medical Ethics class was offered, I eagerly registered for the course. This semester I was able to have the opportunity to take a directed study (research apprenticeship) with Professor Derr.
What is your research about?
Professor Derr has asked me to collect background information about vaccination experiments conducted by Dr. Gerhard Rose and Dr. Saul Krugman.
In the 1950s, Dr. Krugman was trying to develop a vaccine for Hepatitis B. He was funded by the U.S. military and did his research at the Willowbrook State Hospital in New York City, a home for severely retarded children. Hepatitis and other diseases were rampant at Willowbrook because the living conditions were deplorable. The institution was poorly maintained, overcrowded, and dirty. Many children were incapacitated and incontinent.
The doctors spent a year doing preliminary studies, and then proposed that the children be used as test subjects for Krugman's hepatitis vaccine experiments. Their proposal was approved by the State of New York, the hospital administration, and New York University. Krugman eventually succeeded in developing a vaccine, and won many awards.
Did Krugman admit to any personal qualms about the ethics of conducting tests on retarded children unable to understand what they were being asked to participate in?
No. Until his death in 1995, he maintained that he was there to help rid these children of a disease that was plaguing the institution. Some parents did sign some consent forms only because their children would not be admitted to the institution unless they would agree to become subjects, but Krugman has always maintained that he was not aware of this. But while Krugman saw himself as trying to help, other people saw him as taking advantage of low-functioning children for selfish ends.
One of the ethical considerations here is whether the end justifies the means. It seems to me that if Krugman had really wanted to help those children, he would have been an advocate for cleaning up the institution so that disease wouldn't be a threat in the first place.
What were the circumstances surrounding the Nazi doctor, Gerhard Rose?
He was convicted of crimes against humanity and given to a life sentence at the Nuremburg Trials for using concentration camp inmates as subjects for typhus vaccine experimentation. Soldiers and camp inmates were dying of typhus, a disease carried by lice. There was a vaccine available, but it was very expensive and not very effective. Doctors were trying to find a better alternative.
My biggest source of information about Rose was the trial record and the associated military tribunal documents from Nuremburg. I initially thought that Rose had been in the concentration camps, actually administering the experimental vaccines. After some research, however, I realized he was more like a distant supervisor who didn't have much control over what was going on. In fact, he knew what was happening and appears to have voiced his disapproval, something obviously risky to do.
Who testitifed against Rose?
There were some inmates, former research subjects, who testified against him. When he was arrested he was in the process of trying to flee Germany for the United States His arrest came as a shock to him.
Dr. Erwin Ding-Schuler was the on-site man actually in charge of the typhus vaccine experimentation. I have an English translation of his diary in which he kept records of the experiments. The diary was recovered after he committed suicide, and was entered into evidence at Nuremberg.
It sounds as if Rose actually had more concern about the ethics of testing than did Krugman.
Yes. I personally feel that Krugman was more responsible for his actions than was Rose. Under the Nazi regime, Rose's hands were tied unless he was willing to put himself at risk—which he actually did, when he protested against using camp inmates as subjects to the SS. Whereas Krugman was not under any type of force or coercion. There was no reason why he couldn't have been an advocate for improved conditions and voice his concerns regarding the environment at Willowbrook.
Both Rose and Krugman tested vaccines on people who didn't consent to being test subjects. Why was Krugman awarded so many honors, while Rose received a life sentence? That's the main question.
Can you comment on the difference between engaging in research and learning in the classroom?
One of the things about doing research that's different from being in the classroom is that you're granted a lot more autonomy. You have the freedom to read what you want, explore what you want. In the classroom you're assigned a text that you have to read. In a directed study you can go in any direction, any way you want. I didn't have to read 50 pages by next Tuesday. But in most cases I wanted to read it right away, because it was so engrossing.
It was fun. I loved it. I love researching. Now that I've gotten my feet wet I just want to do more. It makes me hungrier. I love to learn and explore on my own. I like to put the pieces of the puzzle together, demystify the mystery. It's always a challenge and I really like that.
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Additional Resources
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Goia Persuitte
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Freedom and autonomy