| In the last decade of the nineteenth century, reports of experiments on hospital patients and the inmates of orphanages and insane asylums provoked an unprecedented public discussion of the ethics of human experimentation. Already committed to legal restrictions on the use of animals in medical research. American antivivisectionists challenged the defenders of unrestricted animal experimentation to account for the medical profession's attitude toward physicians who performed experiments on patients for scientific, rather than therapeutic, purposes. Such experiments, generally undertaken without the knowledge or consent of the patient, antivivisectionists labeled human vivisections.;Acknowledging the importance of therapeutic experiment for medical progress, antivivisectionists formulated a code of ethics for acceptable human experimentation that included provisions for written permission and the protection from experiment for those deemed incapable of granting consent. Although legislative safeguards for human subjects in biomedical research were proposed in several state legislatures and in the United States Senate, these measures were not enacted. Public controversy over a number of human vivisections, including Hideyo Noguchi's development of a diagnostic test for syphilis using orphans and Udo J. Wile's extraction of brain tissue from insane patients, prompted the leaders of the American medical profession to consider adopting a provision for protection of human subjects in the American Medical Association's Code of Ethics in 1916. Their decision not to take such a step reflected the confidence that the practice of human experimentation was not widespread and the conviction that any interference with clinical research would threaten medical progress.;The controversy over human vivisection affords unique insights into medical research at the turn-of-the-century. Systematic examination of four medical research journals provides an assessment of the nature and extent of human experimentation in this period. It reveals that the practice of clinical research was not a rare occurrence in medicine and that a large percentage of human experiments was performed on the class of subjects most recommended by antivivisectionists, namely, physicians themselves, their students and their colleagues. |
