Table Of ContentDDAARRKK
Bioethics
William R. LaFleur is E. Dale Saunders LaFLEUR Th e trial of the “German doctors” exposed
Professor of Japanese Studies at the University BÖHME atrocities of Nazi medical science and led to
of Pennsylvania and author of Liquid Life: SHIMAZONO the creation of the Nuremberg Code govern-
Abortion and Buddhism in Japan. Where does one set the limits on medical ing human experimentation. In Japan, Unit
research involving human subjects? 731 carried out hideous experiments on cap-
DD M E D I C I N E
Gernot Böhme recently retired as tured Chinese and downed American pilots.
Professor of Philosophy at the Technical In the United States, stories linger of biologi-
AA
University of Darmstadt. He is a regular cal experimentation during the Korean War.
contributor to European media on questions “By identifying and analyzing how the unethical was justifi ed and RR Are these instances of medicine gone mad
of ethical, bioethical, political, and public rationalized, the authors draw moral and political lessons from or only wartime lapses? What of the claim
this disturbing history that we have not yet really learned.”
policy issues. His books in English include KK that, despite their reprehensible origins,
—Nie Jing-Bao, author of Medical Ethics in China
Coping with Science and Ethics in Context: many discoveries important to mainstream
Th e Art of Dealing with Serious Questions. science and medicine were made? Where
Rationalizing Unethical Medical Research
M
does one set the limits on research involving
Susumu Shimazono is Professor in human subjects?
“Th is collection of essays examines the past and future of evil
the Department of Religious Studies at state-sponsored research. Its multinational authors bring fresh E Th is collection of essays looks at the his-
the University of Tokyo and serves on the perspectives on twentieth century experiments by Germany, tory of the dark medical research that oc-
Japanese Prime Minister’s Advisory Panel Japan, and the United States. Th e book’s second half looks to the D curred during and aft er the Second World
on Bioethics. future. Diverse authors refl ect on how an un-self critical accep- War. Contributors explore this research,
tance of medical risks; new concepts of body, death, and embryos; I
how it was brought to light, and the ratio-
and utopian visions of the cornucopia of science may be obscur- C
nalizations of those who perpetrated and
ing lessons from bitter experiences that we believe would deliver
benefi ted from it. Th ey look at the response
us from evil.” —Steven H. Miles, MD, Professor of Medicine I
to the revelations of this horrifi c research
and Bioethics, University of Minnesota N
and its implications for present-day medi-
cine and ethics. Th ey also look ahead to the
E
lessons that may and may not have been
BIOETHICS AND THE HUMANITIES
INDIANA learned about human experimentation for
Eric M. Meslin and Richard B. Miller, editors
an age of human embryo research and ge-
University Press
netic engineering.
Bloomington & Indianapolis
http://iupress.indiana.edu
1-800-842-6796
INDIANA EDITED BY
WILLIAM R. LAFLEUR, GERNOT BÖHME, AND SUSUMU SHIMAZONO Jacket illustration: “Adam and Eve” by Svetlana Pugachova.
Used with permission of the artist.
Dark Medicine
Bioethics and the Humanities
Eric M. Meslin and Richard B. Miller, editors
edited by
W ILLI A M R . L A F LEU R ,
GER NOT BÖHM E,
and
SUSU M U SH I M A ZONO
Dark Medicine
Rationalizing Unethical
Medical Research
INDIANA UNIVERSITY PRESS
Bloomington and Indianapolis
This book is a publication of
Indiana University Press
601 North Morton Street
Bloomington, IN 47404-3797 USA
http://iupress.indiana.edu
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© 2007 by Indiana University Press
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical,
including photocopying and recording, or by any information storage and retrieval system, without permission
in writing from the publisher. The Association of American University Presses’ Resolution on Permissions con-
stitutes the only exception to this prohibition.
The paper used in this publication meets the minimum requirements of American National Standard for
Information Sciences—Permanence of Paper for Printed Library Materials, ANSI Z39.48-1984.
Manufactured in the United States of America
Library of Congress Cataloging-in-Publication Data
Dark medicine : rationalizing unethical medical research / edited by William R. LaFleur, Gernot Böhme, and
Susumu Shimazono.
p. ; cm. — (Bioethics and the humanities)
Includes bibliographical references and index.
ISBN 978-0-253-34872-2 (cloth : alk. paper) 1. Human experimentation in medicine—Moral and ethical
aspects. 2. Medicine—Research—Moral and ethical aspects. 3. Medical ethics—History. I. LaFleur, William R.
II. Böhme, Gernot. III. Shimazono, Susumu, date IV. Series.
[DNLM: 1. Human Experimentation—ethics. 2. Human Experimentation—history. 3. Bioethical Issues.
4. History, 20th Century. W 20.55.H9 D219 2007]
R853.H8D3776 2007
174.2′8—dc22
2007000635
1 2 3 4 5 12 11 10 09 08 07
this book is dedicated
—To the many people, mostly dead but some alive, who
suffered or even perished because inhumane research had been
rationalized
—To the memory of Hans Jonas (1903–1993), who
demonstrated that
both history and philosophy give us grounds for putting
prudence
into our bioethics.
Americans were kept in the dark about the effects of what was
being done to them . . . for these experiments were kept secret.
President Bill Clinton, on October 3, 1995, concerning
the Report of the Advisory Committee on
Human Radiation Experiments
Contents
Preface ix
Acknowledgments xi
Introduction: The Knowledge Tree and Its Double Fruit 1
William R. LaFleur
PART ONE the gruesome past and lessons not yet learned
1. Rationalizing Unethical Medical Research: Taking Seriously the
Case of Viktor von Weizsäcker 15
Gernot Böhme
2. Medical Research, Morality, and History: The German Journal
Ethik and the Limits of Human Experimentation 30
Andreas Frewer
3. Experimentation on Humans and Informed Consent: How We
Arrived Where We Are 46
Rolf Winau
4. The Silence of the Scholars 57
Benno Müller-Hill
5. The Ethics of Evil: The Challenge and the Lessons of Nazi
Medical Experiments 63
Arthur L. Caplan
6. Unit 731 and the Human Skulls Discovered in 1989: Physicians
Carrying Out Organized Crimes 73
Kei-ichi Tsuneishi
7. Biohazard: Unit 731 in Postwar Japanese Politics of National
“Forgetfulness” 85
Frederick R. Dickinson
8. Biological Weapons: The United States and the Korean War 105
G. Cameron Hurst III
9. Experimental Injury: Wound Ballistics and Aviation Medicine in
Mid-century America 121
Susan Lindee
10. Stumbling Toward Bioethics: Human Experiments Policy and the
Early Cold War 138
Jonathan D. Moreno
PART TWO
the conflicted present and the worrisome future
11. Toward an Ethics of Iatrogenesis 149
Renée C. Fox
12. Strategies for Survival versus Accepting Impermanence:
Rationalizing Brain Death and Organ Transplantation
Today 165
Tetsuo Yamaori
13. The Age of a “Revolutionized Human Body” and the Right
to Die 180
Yoshihiko Komatsu
14. Why We Must Be Prudent in Research Using Human Embryos:
Differing Views of Human Dignity 201
Susumu Shimazono
15. Eugenics, Reproductive Technologies, and the Feminist Dilemma
in Japan 223
Miho Ogino
16. Refusing Utopia’s Bait: Research, Rationalizations, and Hans
Jonas 233
William R. LaFleur
List of Contributors 247
Index 253
viii Contents
Preface
Nations involved today in international competition in biotech research often
behave like drivers in an old-fashioned stock-car race. Each is constantly aware
of others in the race and uses anxiety about relative “position” to rationalize
stepping harder on the accelerator and taking ever-greater risks.
In fact, a kind of raw fear can grip the so-called advanced nations if there
seems to be some evidence, perhaps real but possibly only fabricated, that na-
tions deemed just a few years ago to be underdeveloped in science and biomedi-
cine have not only already caught up but have been sighted as now in the passing
lane. This perception then gets infused into debates about bioethics. For in-
stance, although one can construct a cogent moral argument on behalf of fed-
eral funding of therapeutic stem-cell research, a sizable portion of the “case”
for this, as presented both to the American general public and to the U.S. Con-
gress in 2006, depended on conjuring images of an America no longer able to
be ¤rst among nations in these domains. Although this is utterly dubious as an
ethical argument to justify any program in medicine, in today’s world blatant
appeals to scienti¤c nationalism get imported into politics . . . and even into
bioethics.
Asian societies, taken as monolithic, get cited by speed-enthralled Americans
as now poised to cop the really big prizes of biotech hard-driving. And the pu-
tative reason for this, we are told, is that Asians have no inhibitions in this do-
main. No limit-obsessed God, no heavy-handed church, no sentiment about
life’s sanctity will, we are told, stand in the way of Asians’ rushing ahead of the
West in the domain of what Renée Fox has—tellingly—called “frontier medi-
cine.”
This is a half-truth. It has, if you look, already resulted in some recent wreck-
age on the scene; Korea’s Dr. Woo Suk Hwang, prior to the horrendous 2005
crash of his fraudulent cell nuclear transfer project, had been touting his “Bud-
dhism” as the reason, at least for him, human cloning posed no ethical problems
whatsoever. And, until his big crash, some American scientists and ethicists
publicly expressed envy of Hwang’s perceived advantage.
More fundamentally, however, the problem with the version of an uninhibited
Asia cherished today by some Western scientists is naïve—at least when it is not
craftily manipulating blissful ignorance (plus the “¤ndings” of quickie junkets
to Asia) to rationalize acceleration at home.
This book, at times through studies of the past that may prove downright
painful to some readers, is intended by its editors to put the lie to such naïveté.
For instance, the Japan examined here will not ¤t easily into any facile sketch of
an “uninhibited Asia.” While Japan is probably the world’s most advanced na-
