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Contested Medicine
By Gerald Kutcher

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Contested Medicine
Cancer Research and the Military
By Gerald Kutcher
Read How You Want, (2011)
EasyRead Large Print, in 16 Point Font
(Originally Published in Standard Print by University Of Chicago Press)
ISBN: 978-1459627536
Genre: History, Health, Bioethics

Reviewed by Boris Segal - November 23, 2011

There have been many reports of unethical experiments conducted on 'patients' without their consent or without full knowledge of what is to be done to them. Some, such as the Tuskegee syphilis experiments have gained widespread notoriety and the ensuing publicity has made these experiments rather well know. However, there were other equally unconscionable experiments that while no longer secret, are not so well known. One of the better-known cases was Dr. Eugene Saenger's cancer research experiments. Saenger experiments were carried out at the University of Cincinnati College of Medicine in the 1960's. At the time he was under contract with the Department of Defense. In his experiments, Saenger subjected cancer patients to full body radiation - not to so much to see if it would cure them, but rather to test the effects of total-body irradiation (TBI). Seen under the veil of the Cold War, the Military 'needed' this information so that they could predict how radiation would affect military readiness and efficiency in the event of a nuclear war or attack. Saenger was not the only doctor who worked on radiation experiments since the advent of the nuclear bomb. Such experiments took place across the country and they took various forms including feeding mentally disabled children radioactive oatmeal...

In Contested Medicine: Cancer Research and the Military, Gerald Kutcher uses Saenger as a prism from which to view these Cold War radiation experiments, and help judge if there were any benefits to these experiments - for the patients, for the military, or for humanity as a whole. Kutcher examines the question, were these human experiments, at the time they were carried out - normal? I.e., did they meet the ethical standards of the time, or were they as egregious as they appear? Kutcher also examines the rise, after World War II, of well financed medical research programs into subjects such as cancer, that saw the development of new technologies and changes in how clinical research was carried out. The main focus of this book is Eugene Saenger radiation experiments and how they were eventually stopped in 1971 after they became public knowledge. If you are interested in reading a general overview of all the full extent of the radiation experiments that were sponsored by the U.S. government, I recommend The Plutonium Files by Eileen Welsome. Unfortunately, The Plutonium Files is not available in large print at this time.

Divided into three parts, Contested Medicine. The first part details medical research practices in postwar America, including the various TBI studies that were conducted and the ethical regulations under which they were conducted. Within the scope of this first part, Kutcher also examines work carried out by some of Saenger's compatriots such as Bernard Fisher, James Shannon, and Donnal Thomas. Part two deals almost solely with Saenger's activities in Cincinnati, ranging from when he began his radiation experiments through to their closure in the early 1970's. Details on what Saenger and his co-investigators did to their patients is explored in detail. In this section, Kutcher shows us the impact of Saenger's research by following the treatment regiment of one of his patients, Maude Jacobs. Kutcher uses his experience as a radiation oncologist to give the reader a chilling account of what Jacobs endured during her 'treatment'. The final section in this book deals with the question on why a consensus on the nature of Saenger's human experimentation has never been reached.

A respected doctor, radiologist, and pioneer of nuclear medicine, Saenger (1917-2007) did much good during his career. The value, if any, of his radiation experiments, are in question. During his experiments he used patients with advanced forms of cancer, and he claimed that his goal in irradiating them was to cure them of their cancer. He further claimed that his military research was always secondary. Reviews of his research, conducted after the fact, never came to a clear decision on the questions, "Did he treat his patients ethically?" and "What was his main priority doing research for the military or trying to cure his patients?" No matter the answer, his used of full-body radiation on 'his' cancer patients did not effect any cures. Most telling, Kutcher examines the reason why a clear consensus on the ethical implications of Saenger's experiments have never been reached, despite extensive study, investigation, and contemplation. Kutcher also examines the implications of the unresolved ethical dilemma that still exists today in the form of double-blind human trials. Is it moral to deny a potentially life-saving treatment from a patient because they have been selected to receive a placebo? And, is it moral to keep doctors in the dark about how a given trial is going? Without information about the ongoing results of a clinical trial, doctors are still encouraged to continue to enroll patients in these studies, without having any idea of the effectiveness or harm being caused by a given treatment.

Contested Medicine: Cancer Research and the Military is an eye-opening exposť on this divergent issue surrounding medical and scientific experimentation on human subject, and the question of how well informed these subjects are about what is going to happen to them - if they are informed at all. Kutcher's book also points out that once enrolled in a clinical study, many patients lose all rights to control their treatment, or to be informed of the consequences of the treatment - or even if they are being treated at all. In the process, Kutcher provides a compelling look at the role that human experimentation played in American medicine during the Cold War and the legacy that we are still living with today.

Contested Medicine is available from Read How You Want, an on-demand publisher that makes books available in a variety of formats including Braille, DAISY, and five different large print formats. This range of formats makes this, and other books, available not only to visually impaired individuals, but also anyone with a reading or physical disability that makes reading standard print books difficult.

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