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ABSTRACT During World War II, malaria research was conducted in prisons. A notable example was the experiments at Stateville Penitentiary in Illinois, in which prisoner-subjects were infected with malaria for the purpose of testing the safety and efficacy of novel anti-malaria drugs. Over time, commentators have shifted from viewing the malar ia research at Stateville as a model of ethical clinical research to seeing the experiments as paradigmatic of abusive human experimentation. This essay undertakes a retrospective ethical assessment of the Stateville malaria research during the 1940s in light of basic ethical principles and the Nuremberg Code, as well as contemporary malaria research. In addition to its historical interest, this case study provides a rich context for addressing basic issues of research ethics, including the voluntariness of consent, the justification of risks, and the exploitation of vulnerable subjects.
Examples of abusive human experimentation cast a long shadow over the ethics of clinical research. The prosecution of physician-investigators for brutal experiments in Nazi concentration camps prompted the formulation of the Nuremberg Code in 1947, a beacon of guidance for research ethics. Henry Beecher's 1966 whistle-blowing article describing 22 cases of unethical clinical research aroused considerable public and professional attention. In the United States between the 1940s and the mid-1970s, most research involving healthy volunteers was conducted on prisoners, mainly within penal institutions, but also with prisoners transferred to research sites in hospitals (National Commission for the Protection of Subjects 1976). During the 1970s, professional opinion changed dramatically regarding clinical research involving prisoners, which came to be seen generally as problematic, if not abusive, and was sharply curtailed in the latter half of the decade, such that clinical research virtually ceased to be conducted in this setting (Bonham and Moreno 2008).
In this essay, I undertake a case study of the malaria experiments conducted at the Stateville Penitentiary in Illinois between 1944 and 1946. The research involved deliberate induction of malaria in prisoner-subjects via bites of infected mosquitoes and testing of the safety and efficacy of novel anti-malaria drugs. The change in perspectives on this research over time has been dramatic. On June 4, 1945, Life magazine published an article on the research at Stateville and two other prisons that featured photos of prisoners being bitten...