1947-06-13, #2: Doctors' Trial (late morning)
THE MARSHAL: The Tribunal is again in session.
THE PRESIDENT: The Tribunal desires to announce again that the Tribunal will be in session tomorrow, Saturday, from 1:30 until 12:30, and possibly will be in session tomorrow afternoon. That matter will be determined later when we ascertain how rapidly the cross examinations of the witness progresses, but at least the Tribunal will be in session from 9:30 tomorrow morning until 12:30-on Saturday.
Counsel may proceed.
BY MR. HARDY:
Q: Dr. Ivy, again I wish to ask you to hesitate after I ask a question before you answer, so that the interpreters may have an opportunity to interpret our questions and answers more precisely.
If a collaborator of yours deliberately killed a person in your laboratory, and a colleague reported it to you, what would you do about it?
A: I should make a careful investigation of the report and if the report were true I should report it to the police.
Q: Would you make an attempt to also report it to your superiors if you had people to whom you were subordinated?
A: Certainly.
DR. SEIDL (Seidl for Gebhardt, Fisher and Oberheuser): Mr. President, I object to that question.
THE PRESIDENT: The objection is sustained. The question and answer will be stricken from the record.
Q: As you know, in Document No. 402, this document represents a printed report of Ruff, Romberg and Rascher, which was written the 28 July 1942 and the death occurred in the Rascher experiments in April or May 1942. At that time according to the record Ruff knew that at least three deaths had occurred and Romberg knew of more. Here then we have two scientists joining their names as co-authors with a man whom they regarded either as a murderer or of such culpability that they refused to work with him again; in your opinion as a scientist in matters of a scientific nature of this sort and research problems such as we are concerned with here, which would be the most important thing for the scientist to do, to see that Rascher was apprehended and other deaths prevented, or to take a chance that the scientific results in the joint report might be lost to the world in the instance that the case against Rascher was not pushed.
THE PRESIDENT: The question propounded by counsel to the witness is purely a legal question and should not be answered by the witness.
MR. HARDY: I submit, Your Honor, the questions I am propounding to the witness are problems that will confront scientists all over the World. I am attempting to present a set of facts that a scientist would do if he was the senior scientist in case such a situation arose in his laboratories.
JUDGE SEBRING: Isn't it possible, Mr. Hardy that this Tribunal will, in its opinion, answer that question in such a way scientists in the future will have some landmark to guide them.
MR. HARDY: That is true, Your Honor, but defense counsel have brought up here that six persons died of high altitude experiments in the U. S., I also want Dr. Ivy's opinion on that which coincides with the questions that I have just asked and which the court has stricken from the record.
JUDGE SEBRING: That is a different question. The question propounded by counsel to the witness is objectionable and will not be answered.
Q: Before this Tribunal, Dr. Ivy, we have heard testimony to the fact that in an experiment on high altitude in the U. S. some six persons died. It has also been alleged in experiments in the U. S. that only a sergeant and not a physician was first in charge of the high altitude chamber; do you know anything about that?
A: I know of no deaths which have occurred in the course of real experimentation in aviation medicine in the United States during the war, I know of some deaths which occurred, however, in the course of routine indoctrination of medical officers, pilots, and aviation personnel in the use of oxygen equipment at high altitude these deaths have been thought to be due to the exposure to high altitude, although no real proof of that was forthcoming. When tens of thousands or even hundreds of thousands of people pass through a routine you can expect some to die simply as a matter of course. I don't know how many of these people would have died simply in the course of being examined medically or of natural causes.
Q: Then, in summation you do not know of any deaths which occurred in real experiments in an altitude chamber in the United States?
A: That is correct. In regard to the sergeant, it is true that a sergeant, adequately trained, was in charge of the operation of the chamber, but a medical officer or scientist was always at hand in the room or in an adjacent room.
Q: Well, then you state that in routine altitude training programs, in which hundreds of thousands of persons I presume are routinely indoctrinated regarding the use of oxygen equipment and the symptom of altitude, either four, five or six persons died in the United States?
A: Yes, I can assure you that the circumstances under which these deaths occurred were thoroughly investigated by appropriate commissions or committees.
Q: Then, in the course of experiments in the United States the only death that you know of is the death of Major Dr. Voynden who was killed in an experiment on a free fall from a plane in an altitude chamber?
A: Yes.
Q: If Your Honor please, I have no further questions to put to Dr. Ivy concerning high altitude. If the Tribunal has any questions at this time I will not proceed with my other subjects.
BY JUDGE SEBRING:
Q: Dr. Ivy, I direct your attention, Sir, to Prosecution Document No. 402, which has been received in evidence as Prosecution Exhibit No. 66 and appears in Prosecution Document Book No. 2 at pages 82 to 99, inclusive, the Ruff, Romberg, Rascher report?
A: Yes.
Q: Are you thoroughly familiar with that report?
A: I have studied it quite carefully.
Q: Can you state for the information of the Tribunal whether there is any scientific conclusions or information contained in that report, which could not have been gained solely from the experiments supposed to have been conducted by Ruff, Romberg and Rascher in collaboration?
A: Will you have the question read again, please?
Q: Could you say whether or not there are any scientific conclusions or whether there is any scientific information contained in that report, which could not have been obtained or gained solely from the experiments supposed to have been conducted by Ruff, Romberg and Rascher in collaboration at Dachau. I make a distinction, you understand, between Ruff, Rascher and Romberg and the Rascher experiments, which Ruff and Romberg maintain was conducted by Rascher independently under an order from Himmler.
A: I understand. The conclusions in the report of Ruff, Romberg and Rascher. Document No. 402 could have been made solely on the basis of the findings and data submitted in that report without any knowledge of the results of the experiments purported to have been performed by Dr. Rascher.
Q: Is there anything in the Ruff, Romberg, Rascher report of experiments from which it can be said with absolute certainty either that deaths, permanent injury or extreme pain resulted to the experimental subjects who took part therein?
A: No, but you may recall that I reported that there is a possibility that there may have been some damage to the learning mechanism of them due to long exposure of the brain to oxygen lack.
That was not tested for in the studies of Ruff, Romberg and Rascher.
Q: Is there such a thing as an experimental subject becoming acclimated to the experiments he is undergoing at high altitude so that eventually he reaches the point where the results obtained from the observation of his routine during the course of the experiments would not be the same as it would be for a new subject?
A: No, the matter of adaptation has received considerable attention by investigators in the field of aviation medicine in the United States. I, myself, have studied the matter in relation to the occurrence of bends, which is pains in the region of the joints in the exposure to high altitude. I subjected seven subjects to an altitude of 37,500 feet from 70 to 150 times during the course of 12 to 18 months. One of these subjects became less resistant to exposure to altitude, insofar as the occurrence of bends was concerned. The other subjects showed no change, no adaptation, that is a matter that the subject apparently to individual variations is positive or negative. Adaptation to some extent may occur. By that I mean an occasional individual may become more resistant or less resistant to exposure to altitude.
THE PRESIDENT: Counsel may proceed.
BY MR. HARDY:
Q: Professor Ivy, in the high altitude experiments, as outlined in the Ruff, Rascher, Romberg report, do you consider that those experiments were particularly dangerous?
A: Those experiments which were done with slow descent from high altitude, that is with the parachute opened after bailing out from the plane, associated with a long period of oxygen lack and they were dangerous experiments for that reason.
Q: And would you be reluctant to perform them yourself?
A: I would be reluctant to perform them, yes.
Q: In the course of this trial, Dr. Ivy, we have had considerable testimony concerning experimentation on human beings and problems of medical ethics. At this time, I wish to discuss with you those conditions under which human beings have been used in medical experiments and which conditions are considered to be ethical and legal.
First, I would like to have you explain to the Tribunal in detail the experiments on yellow fever by Dr. Walter Reed as told in the yellow fever compilations on various publications, Document 822, United States Government Printing Office 1911.
DR. SAUTER: Your Honor, I object to the expert witness being examined on these general questions. I remind you of the following. A number of defense counsels have included in their document book experiments from international literature from all the civilized countries in the world. In order to demonstrate what the attitude of the medical profession and medical ethics is to the problem of the permissibility of experiments on human beings.
In almost all these cases the Court has ruled that this problem should be postponed until the conclusion of the presentation of evidence and only then would the Tribunal rule whether and to what extent the experiments from international medical literature are to be accepted in evidence. This attitude on the part of the Tribunal must also be maintained, in my opinion, at the present time where an expert from America is being examined on these questions.
If the defense during the course of the trial and until the conclusion of the trial has no opportunity to put literature then this would be a struggle on an unequal basis. If the prosecution has the opportunity to produce one witness after another and have these witnesses it has chosen answer these questions whereas the defense during the course of presentation of months did not have this opportunity, consequently, I object to this line of questions and ask that it be not permitted.
THE PRESIDENT: Counsel's question to the witness simply referred to a certain publication concerning a certain experiment by a late Dr. Walter Reed. The witness has not been asked concerning his knowledge of this matter. If there is a publication referred to by a counsel that publication would be the best evidence. The witness might testify, if able, from his own knowledge but the mere report itself would be the best evidence of what happened in connection with the matter referred to by counsel's question.
MR. HARDY: Unfortunately, Your Honor, all these reports are not available. I might say that, without exception, most of the defendants have brought up the subject when they were on direct examination about various experiments. I remember, I believe that Mrugowsky mentioned the Reed's experiments. Rose quite strongly mentioned the experiments of Colonel Strong on beri-beri, and plague throughout and Dr. Ivy has considerable knowledge of all these experimental programs; and I think it would be of interest to the Tribunal to hear the information he possesses concerning the circumstances surrounding each experiment.
THE PRESIDENT: Counsel has not shown from the witness that he has knowledge concerning these matters. If the witness has knowledge, of it counsel may propound a question to him concerning them.
BY MR. HARDY:
Q: Dr. Ivy, do you have knowledge concerning the yellow fever experiments by Dr. Reed?
A: Yes, I have a photostatic copy from the report, "Yellow Fever Experiments by Walter Reed."
Q: Do you have any knowledge as to the circumstances surrounding these experiments— that is, whether or not the subjects used were volunteers in the method of procuring the subjects, experimental subjects, and other circumstances which Walter Reed encountered the course of his experiments?
A: I have, as revealed by the publication.
Q: Do you have knowledge of the experiments of Colonel R.P. Strong and Dr. B.C. Crowell on the beri-beri experiments?
A: Yes, as revealed by the publication of their experiments.
Q: What is the date of that publication?
A: The date of that publication was 1912.
Q: Do you have information concerning the experiments of Colonel R. P. Strong on, "Demonstration on the Development of Immunity to the United Living Plague Organisms in Man?"
A: Yes, as published in the Philippine Journal of Science in 1906.
Q: Do you have information concerning the experiments on the Trench Fever made in 1917 as appears in the report of the communication of the Medical Research Committee of the American Red Cross, printed by the Oxford University Press?
A: Yes, as revealed by that publication.
Q: Do you have knowledge of an experiment on pellagra on white male convicts by Joseph Goldberger and Dr. T.A. Wheel.
A: Yes, as revealed by the publication of their work in the Archives of International Medicine in 1920.
Q: Do you have information on the experiment on the Vaccination of Human beings against Exanthematic Typhus by Felix Veintemillas?
A: Yes, as published in the Journal of Immunology in 1939.
Q: Do you have any other knowledge concerning these experiments from discussions with people participating therein or is your knowledge limited to that of publications?
A: I discussed the matter of plague experiments with Colonel Strong, with Dr. B.C. Crowell, his collaborator in the beri-beri experiments.
Q: Have you discussed these matters with any other physicians who participated in or have direct knowledge of the experiments?
A: Not of the experiments which your questions have referred up to the present time.
Q: Are you in a position to tell us the conditions surrounding the experiments on Yellow Fever by Dr. Walter Reed.
A: I can as they are described in the publication.
THE PRESIDENT: Just a moment, Doctor.
DR. FLEMMING: Mr. President, I object to this line of questioning of the expert witness regarding these experiments. The expert witness, according to what he told us yesterday about his career, is a physiologist but he is not a bacteriologist and not a hygienist. For that reason, in my opinion, he is not an expert in this sort of experiments for which only a bacteriologist would be an expert. These are solely exclusively experiments that were carried out with bacteria.
MR. HARDY: I might put one more question to Dr. Ivy to qualify, Your Honor.
BY MR. HARDY:
Q: Dr. Ivy, have you participated in a program covering Medical Ethics and Rules of Medical Experimentation in behalf of the American Medical Association?
A: Yes, and also I am chairman of the committee appointed by Governor Green in the State of Illinois to consider the ethical conditions under which prisoners and penitentiaries may be used ethically as subjects in the medical experiments.
Q: In order to substantially carry out your position in the American Medical Association and in the Committee as appointed by Governor Green of Illinois, did it become necessary for you to exclusively study the conditions surrounding all the other experimental programs and services in medical history in order to ably device rules of medical ethics to be applied in the course of medical experimentation on human beings?
A: Yes, I had to see what the common practices have been.
MR. HARDY: In view of that, your Honor, I submit that the witness is qualified to testify concerning these problems.
DR. SAUTER (Counsel for the defendants Ruff and Romberg): Mr. President, I beg your pardon for interrupting but I should like to draw your attention to the following points: first, if the witness is asked whether he knows something regarding such and such a matter then I should like to know, in order to avoid repeating all these matters, from what date on the witness has this knowledge. In order to evaluate what the witness testifies to, it is important to know whether he has this knowledge from a publication of ten or twenty years ago or whether he acquired this knowledge perhaps a week or two weeks ago in Nuernberg from a defense document book; secondly, if the witness claims to be a member of a committee and in his capacity is a member of that committee to have such and such knowledge, then I think it is necessary for him to state how long he has been a member of that committee how long that committee has been in existence and how long he has had this knowledge; and then, Mr. President, one other point.
If the Prosecution is permitted in this way to take all sort of quotations from medical literature and to submit them and put them to the witness and to examine the witness on them and on what his opinion is as an expert on this literature, which all of us can read and form our opinion on, then the defense must also have that same right; but I am afraid that if we follow this practice of the prosecution we shall have to put the witness on the stand again a week later. I bring this to your attention in order to avoid future difficulties.
DR. FLEMMING: Mr. President, I object to the witness being interrogated in this way because he is not a Hygienist nor a Bacteriologist and, therefore, does not have the necessary specialized knowledge. When Mr. Hardy asked him, the witness stated that he belonged to committee which concerns itself with the question of the ethical problems of experiments on prisoners. I believe that membership in such a committee can never replace the knowledge that Bacteriologists must have, and which alone can be the prerequisite for giving expert testimony here on such medical questions. The witness also stated that he knows of these experiments from literature, but I do not believe mere literary knowledge alone is sufficient for expert testimony here. And, I should like to emphasize what Dr. Sauter has just said, namely, that it must be determined whether the expert witness has his knowledge from our document books or whether he has read any original publications.
MR. HARDY: Your Honor, in this regard, apparently I have not made myself clear. Dr. Ivy is not going to testify as an expert concerning matters of bacteriology. I am merely putting this question to him in the same manner as Professor Lightburn testified. Dr. Ivy, in the course of his career has had ample opportunity to study experimental problems in medical history. He is fully aware of the experimental programs in the United States. He can testify as to the conditions of the experiments, namely, whether or not the experimental subjects were volunteers; whether they were forced in the experiments and so forth, as indicated from the studies, in the same manner as Professor Lightburn did. Professor Lightburn indicated that he knows personally from his own knowledge of the nature of the medical history.
THE PRESIDENT: Propound the witness some further questions to show to the Tribunal his knowledge concerning this matter.
BY MR. HARDY:
Q: From your knowledge of yellow fever experiments, by Dr. Walter Reed, can you tell us how he used experimental subjects?
A: He used volunteers from the U.S. Army, but before that Dr. Carroll permitted himself to be bitten by infected mosquitoes, and another Doctor in experimental tests, was also bitten by a mosquito, Dr. Lazar.
Dr. Carroll and Dr. Lazar died, and in this particular group of experiments, Dr. Carroll and Dr. Lazar were the only ones that died.
Q: Among the experimental subjects were there any deaths, that is, soldiers who volunteered for the experiments?
A: No.
Q: Were the soldiers offered a reward or any inducement to undergo the experiments?
A: As I recall they were, and refused it. I am not certain about that. I have information on that from this report on the yellow fever experiments which I could read, if that is appropriate.
MR. HARDY: If the Tribunal desires to have this report read Dr. Ivy will read it. I do not think it is necessary, Your Honor.
THE PRESIDENT: What is that report; report by whom?
DR. IVY: This is a document from the Government printing office, United States, Washington, D.C., entitled "Yellow Fever, a Compilation of various Publications"; and it is an official document, No. 822. It was from the 61st Congress.
THE PRESIDENT: Contains reports made by officials of the United States Government, Army or otherwise, to the Congress of the United States?
DR. IVY: That is correct, presented by Mr. Owen.
THE PRESIDENT: Well, the witness may testify and analyze that document as briefly as possible for the benefit of the Tribunal.
DR. IVY: The subject of the first experiment was a young private from Ohio, named John R. Kissinger, who volunteered for the service to use his own words:
Solely in the interest of humanity and the cause of science.
When it became known among the troops that subjects were needed for the experimental purposes, Kissinger in company with another young private named John J. Moran, also from Ohio, volunteered their services.
Dr. Reed talked the matter over with them explaining full the danger and suffering involved in the experiments should they be successful; and, then seeing that they were determined, he stated that monetary compensation would be made to them, but both men declined to accept it, making it indeed their sole stipulation that they should receive no pecuniary reward, whereupon Major Reed touched his cap saying respectfully, "Gentlemen, I salute you."
BY MR. HARDY:
Q: What is the date of that publication?
A: The date of this publication is 1911.
Q: In the course of Dr. Reed's experiments, did he use any natives?
A: I am not certain.
Q: Did you ever hear tell whether or not he used natives, and offered them a money reward for undergoing the experiments?
A: No.
Q: Do you know whether or not Walter Reed, in the course of any other experimental program, used natives?
A: No. I might say that when I was asked by the American Medical Association to serve in the capacity as advisor, I did my best to cover the medical literature in situations where human beings have been used, in hazardous experiments in order to inform myself regarding the conditions under which they were used.
Q: We have been informed here that natives were used by Walter Reed in his experiments, but you are unable to enlighten us further?
A: I know nothing about that.
Q: Now, in the experiments of Colonel R. P. Strong and Dr. B. C. Crowell on Beri-beri; where were those experiments performed?
A: They were performed in Manila, Philippine Islands.
Q: Who was used as experimental subjects in those Beri-beri experiments by Colonel Strong and Dr. Crowell?
A, they were prisoners who were condemned to death, but who had volunteered to serve as subjects.
Q: In your opinion, is a person condemned to death in a position to volunteer for a medical experiment?
A: Yes; they can say yes or no, and if the matter is ethically presented to them that there will be no coercion if they say, yes.
Q: How would you approach —
A: Unless they were threatened with punishment.
Q: How would you approach a person condemned to death for use in a medical experiment; would you approach them directly or would you have notices sent out, radio appeal, or what would be the method of attempting to secure the services of a criminal condemned to death?
A: In my opinion they should be approached through a written document sent to them or posted on a bulletin board or by communication by word of mouth in which the purpose of the investigation, medical study, is outlined, in which the hazards of the experiment are indicated; and, where it is pointed out that there will be no punishment or penalty in case the individual does not volunteer.
Q: In these experiments by Colonel Strong and Dr. Crowell on Beri-beri, were these criminals condemned to death offered a pardon or offered a commutation of sentence if they survived the experiments?
A: No, they were not.
Q: They were not offered a pardon?
A: No, they were not offered a pardon or commutation of sentence?
Q: Were they offered any reward?
A: They were offered only extra cigarettes or cigars if they desired them.
Q: Did any of the experimental subjects used by Colonel Strong and Dr. Crowell in their Beri-beri experiments die?
A: No.
Q: When did these experiments take place, Doctor?
A: They took place in 1912.
Q: And, you base your knowledge of these experiments from personal conversation with Colonel Strong, Dr. Crowell, and publications?
A: My knowledge is based on the publications in the American Journal of Science and by personal conversations with Dr. B. C. Crowell who is in charge of Cancer Research of the American College of Surgeons, and resides in Chicago, Illinois.
Q: In the experiments by Colonel Strong on the demonstration of the development of immunity to living organism in the man, do you know whether or not volunteers were used?
A: The article states that prisoners condemned to death were used. I discussed this matter with Dr. Crowell who informed me that these prisoners were exactly in the same category as those used in the Beri-beri experiments; that they were volunteers.
Q: For the moment, doctor, we have discussed the capacity or ability of a criminal condemned to death to volunteer for an experiment. What is you opinion about the ability or capacity of a person incarcerated in a prison to volunteer for an experiment, that is, a person not condemned to death?
A: There is no doubt in my mind that they can freely volunteer to serve as a medical subject, provided no coercion is exercised in getting them to say yes or to volunteer.
Q: Can you tell us whether or not anyone died in the course of the experiments by Colonel Strong and Crowell in the plague problem?
A: No one died.
Q: An experiment on trench fever was made in 1917. Who made that experiment?
A: That was made by a committee working under the auspices of the Surgeon General of the United States Army and of the American Red Cross.
Q: What was the status of the subjects used in that experiment?
A: They were volunteers from the United States Army and before volunteering the purpose of the experiment and the possible hazards were explained to the volunteers.
Q: Who were the volunteers?
A: Soldiers. United States Army.
Q: In the experimental program pellagra with convicts, who conducted those experiments?
A: They were conducted by Dr. Joseph Goldberger as the senior author. They were published in the Archives of Internal Medicine in 1920.
Q: Does that publication give the details of the experiments?
A: It states that the experiments were performed on convicts who were volunteers and other details are not given.
Q: Do you know under what circumstances these convicts volunteered for these experiments?
A: The details are not given in the published article.
Q: Have you ever had the opportunity to talk to Dr. Josef Goldberger or Dr. T. A. Wiehl?
A: No, I have not.
Q: Then your knowledge is limited to the publication in the Archives of Internal Medicine, Volume 25, published in 1920?
A: That is correct.
Q: Do you know whether anyone died in these experiments or suffered a great deal?
A: No one died but some of the subjects developed pellagra.
Q: Did they suffer to a great extent?
A: They suffered to some extent but as soon as the symptoms appeared treatment was instituted.
Q: Was there any comment in the United States at that time concerning the manner in which Dr. Goldberger and Dr. Wiehl and their assistants conducted these experiments?
A: No, and I have never heard the experiments criticized.
Q: In the experiments which were made by the United States Armed forces concerning the testing of various vaccines do you have any information on that subject?
A: Yes. I have in so far as the method of developing and testing the typhus vaccine used on our soldiers in the last War.
Q: What do you base your knowledge on?
A: I base my knowledge on reading a report of this work which is in one of the United States Public Health publications and also from a letter written me by Dr. Toping of the United States Health Service who did this work, the developing of the typhus vaccine that was used on our troops.
Q: Can you tell the Tribunal something about the particulars concerning the development of our typhus vaccine in so far as experiments are concerned and the method of experimentation, the purpose, about the method of curing the subjects, etc., not technical and medical problems concerning typhus itself.
A: The workers in the laboratory of contagious diseases at Bethesda first served as the subjects and then some four hundred volunteers outside of the Research Institute served as subjects. These subjects were injected with the vaccine and the development of the entological responses were followed. None of them were infected with a living virulent typhus virus to see if the vaccine protected against such an inoculation.
Q: Do you have any information concerning the conditions under which prisoners in Federal prisons in the United States served as subjects in medical experimentation programs?
A: Yes. As chairman of the Committee appointed by Governor Green of the State of Illinois to submit a report on the conditions under which prisoners may serve as subjects in medical experiments I investigated that and I have with me a statement which the prisoners were given when they were invited to volunteer and I have the agreement which they signed when they decided to volunteer. I can submit that if it is desired.
Q: Could you outline for the Tribunal the method used in procuring these experimental subjects, first of all, what was the manner of selection?
A: Well, a written statement was posted in the penitentiary in which the importance of the proposed medical investigation was outlined, in which the hazards were indicated, and in some instances without any promise of reward.
Q: Do you happen to have that notice that was posted? Do you have a copy of that?
A: Yes.
Q: Is that too lengthy or could you read it to us?
A: It is not very long. This is entitled "Statement to Prospective Volunteers."
The study we are planning to carry on here and for which we have asked your cooperation is concerned with the testing of new anti-malarial compounds which are being developed by competent investigation for use by the Armed Forces of the United States. The purpose of the testing program is to ascertain whether the drugs are efficient and safe for human beings. The nature of the drugs we propose to use is such that we do not expect serious complications from their use. The toxicity of the drugs is unknown, however, as far as human beings are concerned no drugs will be used which on the basis of extensive animal tests show evidence of severe toxicity.
Persons volunteering to assist in this study will submit to the inoculation into the blood of salivary glands of mosquitos infected with the so-called Chessen strain of malaria which is prevalent in the southwest Pacific area. While the danger to life from this strain of malaria is small there is a strong probability of relapse or recurrent malaria fever for a period up to several years after the infection. Drugs to prevent or treat the infection will be administered by mouth for varying periods and blood tests will be taken. A fee will be paid to each individual who is accepted and who completes the prescribed test. One-half of this fee will be payable within thirty days after the tests are started the other half will be payable after the completion of twelve months of observation.
I might say that the fee was $100.00, $50.00 at the start and $50.00 at the termination.
Q: Is that the entire notice that was published on the bulletin boards at the Penitentiary in Illinois?
A: Yes.
Q: Now what was the response to that?
A: There were more volunteers than could be used.
Q: Were any of these men approached personally or was this noticed published in the bulletin board the only method used to reach the prisoners?
A: No, none were approached personally.
Q: How many subjects were used in these malaria experiments in the Stateville Penitentiary?
A: The exact number I do not know but I know that in the entire program of malaria study eighty compounds were tested on human volunteers who were prisoners in the penitentiaries.
Q: Now, in this connection do you know whether or not any statement was made concerning this by Governor Green of Illinois?
A: Yes, I can read the statement.
Q: Would you read the statement of Governor Green if you please?
A: (reading)
The State of Illinois has regarded these experiments, aimed toward a cure for malaria, as a definite challenge and a definite responsibility. When the project was begun at Stateville Prison, it was a military project. The war against the enemies of the United States was at its height. Malaria research was viewed as another means by which Illinois might help win the war. Now, while still a military project, it becomes a means by which Illinois may help in man's unceasing war against disease. We are proud of the manner in which the inmates of the prison volunteered to submit themselves to tests which required that they actually develop malaria, and then take new drugs in order to test these drugs' potency in the control of the disease. Many more hundreds have volunteered than have been called. Their only complaint has been 'I volunteered; why haven't I been called'.
Q: Do you have the agreement that was signed by the experimental subjects before being subjected to the experiments?
A: Yes.
Q: Could you, in substance, tell us what that agreement is or, if necessary, read some of the portions thereof?
A: One of the points that is made in the agreement is:
I hereby assume all risks of such tests and, acting for myself, my heirs, personal representatives and assigns, do hereby release the University of Chicago
— which I might say were the sponsors for this project.
I hereby assume all risks of such tests and, acting for myself, my heirs, personal representatives and assigns, do hereby release the University of Chicago, all technicians and assistants assisting in said work, the United States Government, the State of Illinois, the Director of the Department for Public Safety of the State of Illinois, the warden of the Illinois State Penitentiary, and all employees connected with the above institutions, from all liability, including claims and suits at law or in equity, for any injury or illness, fatal or otherwise, which may result from these tests. This is to certify that this application is made voluntarily and under no duress.
Those are the essential points of the agreement which was signed by each prisoner volunteer who was accepted for the experiment.
Q: Did you ever hear tell just what the reactions were of the prisoner volunteers?
A: Yes, that was made a subject of a radio broadcast in the United States.
Q: Did the prisoners talk over the radio?
A: That's right.
Q: Do you know what they said over the radio?
A: I have the script of that broadcast and can read what some of them said.
Q: That won't be necessary, Doctor. Was the gist of their statements over the radio that they were volunteers?
A: The gist of their statements made over the radio was that they volunteered in order to help their buddies who were sick with malaria.
Q: Do you have any other circumstances to tell us about which surrounded these malaria experiments at the Stateville Penitentiary in Illinois?
A: No. I might say in the federal penitentiaries the conditions were very much the same, except now, since some prisoners have received some reduction in sentence, it is stated that the prisoner volunteers will receive a consideration of reduction in sentence as a part of the good time reduction in sentence for good conduct.
Q: Do you have information concerning any other experimental programs on human beings which were conducted in the United States or by representatives of the U.S. medical associations or societies or professions?
A: During the war subjects were obtained from the civilian public service agencies. These subjects were known as conscientious objectors. There were two types of conscientious or religious objectors. One type would not cooperate on any program of public service and hence were im prisoned.
The other type of conscientious objectors would cooperate in public service, with the exception that they would have nothing to do with any part of the military effort. These latter conscientious objectors provided public service by serving as orderlies in state hospitals, by serving in forest fire prevention work and similar public service projects. Some of these conscientious objectors were invited to become subjects for medical experiments conducted in university laboratories. In inviting them, a letter was sent to the supervisor of a group of conscientious objectors, outlining the purpose of the medical investigation to be made, how it would be made, the possible hazards. If the conscientious objector volunteered, his transportation to the university would be paid, and while he was at the university, he was given $15.00 a month for pocket money and his maintenance was provided also.
Q: Can you tell us, Dr. Ivy, whether or not you yourself ever experimented on conscientious objectors?
A: Yes, I experimented on two groups of conscientious objectors, one in a high altitude experiment and another in a vitamin deficiency experiment.
Q: In the high altitude experiment did the subjects volunteer as you have outlined?
A: Yes.
Q: Did you talk to each subject prior to using him in an experiment?
A: I talked to the subjects as a group right after they reported and had been subjected to a thorough physical examination, and I told them again the purpose of the experiment, its nature and the possible hazards. I also explained that, when any symptoms of a mental or physical disturbance became manifest, therapy would be instituted.
Q: Did any of them withdraw, at that time, after you had warned them yourself?
A: No.
Q: Did any of them ask to be relieved of the experiments during the course of the experimental program?
A: No.
Q: Did any of them die in the course of your experiments?
A: No.
Q: Did you always remain with the patients or did one of your physician assistants remain with the patients while they were being subjected to the experiments?
A: They were under the constant supervision of either a physician or a medical scientist, depending upon the nature of the work.
Q: In your experiments on diet did you, at that time, also address the experimental subjects?
A: Yes.
Q: Did you warn them of the hazards of the experiments?
A: Yes.
Q: Did any of the experimental subjects become ill?
A: They developed some symptoms of vitamin B complex deficiency, yes, and the therapy was started as soon as these symptoms appeared.
Q: Did these experimental subjects, conscientious objectors, receive any pay?
A: None other than that which I have indicated, $15.00 a month for pocket money.
Q: Was that their regular allowance for pocket money as a conscientious objector, or was that given to them merely because they submitted to these experiments?
A: No, that was the amount that was regularly allowed them.
Q: I see. In your opinion, Doctor, what should be the rules followed by a physician before experimenting on a human being? In other words, do you have a set of principles — medical ethics — concerning experimentation on human beings? If so, would you outline to the Tribunal what you deem to be the ethical manner in which experimentation on human beings should be conducted?
A: Having been appointed by the House of Delegates of the American Medical Association, and since in my advisory capacity in these trials, I made a study of the conditions under which human beings have been used as medical subjects in cultured and civilized nations throughout the world.
I formulated a set of ethical principles which I believe represented common practice in this regard. I submitted this set of ethical principles to the House of Delegates of the American Medical Association for consideration.
MR. HARDY: Anticipating an objection, Your Honor, I might add that this is the opinion of Dr. Ivy concerning what experimentation principles should be followed when working on human beings. I have asked each defendant that same question when they have taken the stand and they have given their opinion. I am now asking that of Dr. Ivy.
DR. FLEMMING (Counsel for the defendant Mrugowsky): Mr. President, it is my opinion that this is a question which only the Tribunal can decide. The opinion of an individual, of a man who is even a medical expert, is not, in any way, designed to further the trial or to deny the Tribunal the right to make its own decision. For this reason, I object to this question and ask, if possible, that it will be stricken from the record.
THE PRESIDENT: Objection will be overruled.
I will ask the witness the date of these experiments in the penitentiary in Illinois, or approximate date.
THE WITNESS: As I recall, they started about 1942 and they are still in progress.
THE PRESIDENT: Witness will answer the question propounded to him after the noon recess.
The Tribunal will now be in recess until 1:30 o'clock.
(A recess was taken until 1330 hours, 13 June 1947.)