Wolfgang U Eckart (ed.), Man, medicine, and the state: the human body as an object of government sponsored medical research in the 20th century, Beiträge zur Geschichte der Deutschen Forschungsgemeinschaft, Band 2, Stuttgart, Franz Steiner, 2006, pp. 297, €43.00 (paperback 978-3-515-08794-0).

Abstract

After Useful bodies (2003, edited by Jordan Goodman, Anthony McElligott and Lara Marks) and Twentieth century ethics of human subjects research (2004, edited by Volker Roelcke and Giovanni Maio), the present volume is the third collection of essays in a short time that explores the “dark side” of human experimentation in the past century through a range of case studies. As in Useful bodies, the focus is on the social and political contexts that facilitated unethical trials on human subjects, and as in the Roelcke/Maio volume, historical and ethical assessments are often coupled (cf. my reviews in Med. Hist. 2005, 49: 221–2; 2006, 50: 254–5). However, Eckart's collection provides more than just an extension of current knowledge about twentieth-century abuses in human research. Arising from a Heidelberg conference in 2003 as part of a larger project on the history of the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) between 1920 and 1970, this book contains several contributions that investigate in detail the dynamics created by state funding for certain areas of medical research, especially during the period of National Socialism. This applies in particular to Volker Roelcke's paper on the psychiatric genetics of Ernst Rudin, Karl Heinz Roth's essay on German aviation medicine, Marion Hulverscheidt's account of malaria research, Alexander Neumann's discussion of nutritional physiology and Gabriele Moser's article on Kurt Blome and cancer research in the Third Reich. Moreover, the DFG's role in redefining and reconstituting anthropology and human genetics as academic disciplines in Germany after the Second World War is analysed by Anne Cottebrune. Revealing as these discussions are regarding the funding drive behind those research fields and its ethical implications, they would have been more useful to a broader readership if the volume had included a background contribution on the institutional development of the German Research Foundation in the relevant period. Also, the English of some of the papers by German authors would have benefited from more careful copy-editing. Other papers add details of the medical atrocities committed in the concentration camps of Nazi Germany, for example of the experiments in Natzweiler with chemical warfare agents and of the notorious hypothermia experiments in Dachau. This is complemented by a contribution on Japanese biological warfare research on Chinese prisoners in Harbin during the Second World War. Till Barnighausen, author of this latter paper, examines for the Japanese experiments the ethical question that has been discussed in the late 1980s and early 1990s with regard to the Nazi concentration camp trials: whether the immorally obtained data from those experiments may ever be used for scientific purposes. The international dimension of human subject research and abuse in the twentieth century is further highlighted by contributions on vaccination experiments on Sengalese infantrymen in the French army between 1916 and 1933 (Christian Bonah), on metamphetamine tests in the German Wehrmacht (Peter Steinkamp), on the Tuskegee syphilis study (James H Jones), and on American cold war research on flash burn in preparation for a feared nuclear attack (Susan Lederer). The general conclusion that arises from all these papers is obvious: war, racism, and scientific opportunism were the key factors that led, often in combination, to exploitation of human subjects and disregard for consent (even where and when official guidelines on information and consent requirements had been issued, as in the German Reich in 1931). Beyond this insight, what can the future historiography of human experimentation contribute? Paul Weindling's essay, focusing on the victims of Nazi medical experimentation, rightly complains that most of the historical research in this area has been perpetrator-oriented so far. His call for more attention to be paid to the fate of human subjects mirrors, perhaps unwittingly, recent trends in philosophy towards a patient- or victim-centred conception of ethics. Finally, David Rothman, reflecting on the debate of the 1990s about the standards of human trials on AIDS treatment and prevention in developing countries, makes clear that the achievements of ethical codes, such as those of Nuremberg and Helsinki, are under threat in contexts of socio-economic hardship. Historical analysis, one may conclude, may well warn against an ethical relativism that is prepared to compromise on standards of human subject research in situations of poverty and medical need. Eckart's volume has made a significant contribution to this historical enterprise.