Stateville Penitentiary Malaria Study
The Stateville Penitentiary malaria study was a controlled but ethically questionable study of the effects of
Historical context
Demand for malaria research
The circumstances of World War II resulted in an urgent need for the development of new malaria treatments. First, U.S. soldiers were deployed to areas of the Pacific with extremely high rates of malaria infection.[2] The U.S. Army estimated millions of man-hours lost due to malaria throughout the war; thus it was critically important to mitigate the effects of the disease in the interest of the military. Second, the conventional treatment for malaria, quinine, was largely unavailable throughout the war. Japanese control of the Philippines and Indonesia cut off the supply of quinine to the United States, adding to the need for alternate treatments.[2] The new risks of malaria posed by World War II called for experimentation at an unprecedented scale, with a particular focus on human subjects.
Prison as a research center
The prison offered an environment conducive to controlled scientific experimentation on human subjects. The malaria experiments at Stateville Penitentiary are noteworthy for their utilization of this prison environment across all aspects of the experiments. A prison population allowed for researchers to limit extraneous variables across the subjects. Participants of the studies were exclusively white men, of similar age and health, which was the primary demographic of Stateville Penitentiary. The population of prisoners was also inherently homogenous in terms of behavior, due to the restrictions imposed by the maximum-security prison.[3] Follow-up evaluations were possible for virtually all subjects of the study, since all had long-term sentences. Offers of parole reevaluation, as well as financial incentives, typically $25–$100 for an experimental trial (adjusted for inflation, $460–$1,860 in 2021), which yielded an exceptionally high availability of subjects willing to participate.[4]
Malaria Research Project
In 1944, the U.S. Committee on Medical Research formed a contract with the University of Chicago to test novel malaria treatments at the Stateville Penitentiary. Alf Alving, a
The Malaria Research Project was primarily conducted on a floor of the prison hospital in the Stateville Penitentiary. The study aimed to understand the effect of various antimalarial drugs on relapses of malaria, primarily from the
Experiments performed
The study considered the Chesson strain of P. vivax, sourced from a military patient infected in the Pacific.[3] P. vivax, the predominant form of malaria in the Pacific, is associated with milder symptoms and unlike Plasmodium falciparum, it typically is not deadly. This strain was known for its resistance to the standard treatment of quinine, with frequent occurrences of relapse.[4] Subjects at the prison maintained the strain via blood inoculations. For both control and test subjects, a constant number of mosquito bites from infected insects were administered; then, researchers dissected the mosquitoes to determine the intensity of the resultant infection.[3]
The researchers tested patient responses to various potential treatments. The majority of these treatments had not yet been evaluated on humans, and their toxicity and potency was thus unknown. Most were 8-aminoquinoline compounds, analogs of pamaquine, an existing alternative to quinine that was unfavorable due to its higher toxicity. The researchers tested a wide range of doses, including some exceptionally high doses of treatments known to be toxic. The purpose of this was to establish a maximum margin of safety and to observe the manifestation of side effects. Thus, adverse side effects were intentionally caused to subjects, to demonstrate the possible worst-case reaction to extremely high-potency treatments. In one case, a subject died several days after he was injected with a high dosage of SN-8233, a potential treatment considered in the study.[3][4]
Prisoner roles
The prison of the environment of the study created a unique and complex social dynamic, with prisoners involved in many aspects of the study, not only as subjects. A well-known participant of the study was
Legacy of the study
The experiments were widely publicized, though in a controlled manner. In 1944, Life magazine documented the experiments with a photo series. Accounts of prisoner subjects were included, though these were allegedly scripted.[4]
While a series of research publications came out of the Stateville Penitentiary experiments, the results had a minimal long-term impact on malaria treatment methods. The main legacy of the study is instead the ethical contention raised by
Nuremberg medical trial
In the 1946 Nuremberg trials in Germany, the
The U.S. supported Ivy’s claims of fundamental differences and publicized them as a justification for continuing the Stateville experiments. The international Nuremberg Code of human experimentation ethics, which resulted from the trials, contained clauses directly violated by the Stateville experiments. The U.S. never formally ratified the code, however, calling into question the ethics of prisoner experimentation and the Stateville Penitentiary malaria experiments in particular.[4]
Effect on prisoner experimentation
Public opposition to medical experimentation on prisoners was scant during the war. The
See also
- Human experimentation in the United States
- List of medical ethics cases
- Research involving prisoners
- Tuskegee syphilis experiments
References
- S2CID 19593967. Archived from the original(PDF) on 2019-03-01.
- ^ PMID 24769747.
- ^ PMID 16695630.
- ^ PMID 19720327.
- PMID 11368370.
- ^ Clinical Treatment of Malaria, Alf S. Alving, M.D.
- OCLC 69410176.
- S2CID 9950045.
- )