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A DELICATE CALCULATION ONLY A BALANCE BETWEEN SCIENCE AND ETHICS CANPROMOTE THE HEALTH OFHUMANKIND
Plain Dealer, The (Cleveland, OH)
- November 16, 1998The ethical and procedural questions raised by the work of U.S. medical researchers abroad defy pat answers.As recent articles by Plain Dealer reporters Bill Sloat and Keith Epstein point out, ethics rules regularly are broken;patients involved in research often are unaware of the implications of participating; and host countries' social,economic and technological conditions often are ill-suited to maintaining ethical purity.
Edition: 
FINAL / ALL
Section: 
EDITORIALS & FORUM 
Page: 
6B 
Column: 
EDITORIALS 
Record Number: 
09820005 Copyright 1998, 2002 The Plain Dealer. All Rights Reserved. Used by NewsBank with Permission.
UGANDAN TB STUDY REFLECTS ETHICAL DILEMMA
Plain Dealer, The (Cleveland, OH)
- November 22, 1998Once again, the United States had the opportunity to exercise moral and ethical leadership in its internationalconcerns. And once again, we failed to step up to the plate. I am referring to the recent Plain Dealer article on thetuberculosis research in Uganda.Inexcusable reasons were given for allowing the participants to believe they were receiving treatment, only to begiven vitamin C, an innocuous placebo. I believe that, no matter what the foreign researchers and officials felt aboutthe efficaciousness of the prevention efforts, as international leaders, we have a responsibility to do no less to protectthe health of the citizens in Uganda than we would in this country. The question is not whether there are differentethical standards in a socioeconomic rather than in an epidemiological setting. These researchers are from theUnited States, which opposes unethical research protocols.
Caption:
PHOTO BY: MIKE LEVY / PLAIN DEALER PHOTOGRAPHER A bedridden woman rests in Rubaga Hospital inKampala, Uganda.
Edition: 
FINAL / ALL
Section: 
EDITORIALS & FORUM 
Page: 
4D 
Column: 
LETTERS 
Record Number: 
09826156 Copyright 1998, 2002 The Plain Dealer. All Rights Reserved. Used by NewsBank with Permission.
VA DID STUDIES WITHOUT CONSENT PSYCHIATRIC PATIENTS USED IN EXPERIMENTS
Plain Dealer, The (Cleveland, OH)
- February 16, 1997
Author: 
BILL SLOAT and KEITH C. EPSTEIN PLAIN DEALER REPORTERS 
Psychiatric patients at the nation's Veterans Affairs hospitals have been subjected to experiments in which theirmedication was withheld without telling them of the risks, according to the sworn statement of a senior VAresearcher.Not disclosing the risks of withdrawing medication was "the norm and practice" during the 1980s, Jack Hirschowitz,chief of psychiatry at the VA hospital in the Bronx, N.Y., testified in an affidavit filed in an Ohio lawsuit.
Edition: 
FINAL / ALL
 
Section: 
METRO 
Page: 
1B 
Record Number: 
09047057 Copyright 1997, 2002 The Plain Dealer. All Rights Reserved. Used by NewsBank with Permission.
CLOSING CHAPTER ON EXPERIMENT CINCINNATI HOSPITAL OFFERS A SETTLEMENTTO PATIENTS' SURVIVORS
Plain Dealer, The (Cleveland, OH)
- February 21, 1997
Author: 
BILL SLOAT and KEITH C. EPSTEIN PLAIN DEALER REPORTERS 
John Stillwell had skin cancer.He checked into Cincinnati's University Hospital for help and wound up participating in a Cold War radiationexperiment sponsored by the Department of Defense in 1971.
Caption:
PHOTO: ASSOCIATED PRESS Maryann Vaughn, Rose Mary Roesch, Charles Stillwell and Mary Ann Houchins -relatives of cancer patients used in military radiation experiments in Cincinnati - want assurances such researchwon't happen again.
Edition: 
FINAL / ALL
Section: 
OHIO 
Page: 
5B 
Dateline: 
CINCINNATI 
Record Number: 
09052037 Copyright 1997, 2002 The Plain Dealer. All Rights Reserved. Used by NewsBank with Permission.
LIVING PROOF UGANDANS IN AMERICAN-RUN STUDY EXPECTED TREATMENT, BUTSOME PILLS WEREDUMMIES
Plain Dealer, The (Cleveland, OH)
- November 9, 1998
Author: 
BILL SLOAT and KEITH EPSTEIN PLAIN DEALER REPORTERS 
Her husband lay dying, his spirit draining away into the earth as silimu consumed his body.Joyce Namugenyi knew she would never see him again on this side of life.
Caption:
PHOTO (COLOR) BY: MIKE LEVY / PLAIN DEALER PHOTOGRAPHER Joyce Namugenyi, 41, a widow infectedwith HIV, with the form letter she got from Case Western University, waits her turn at a tuberculosis clinic at RubagaHospital. PHOTO (COLOR) BY: MIKE LEVY / PLAIN DEALER PHOTOGRAPHER (Page 8A) A bedridden womanrests in a tuberculosis ward at Rubaga Hospital. TB, the world's most deadly infectious organism, is particularlydeadly for HIV patients because each disease speeds the other. PHOTO (COLOR): NO CREDIT (Page 8A) A coffinstrapped to the back of motorbike is a common sight in Uganda, deadly crossroads of tuberculosis and AIDS.PHOTO (COLOR): NO CREDIT (Page 8A) A health care worker checks X-rays at a tuberculosis clinic at RubagaHospital in Kampala. PHOTO (COLOR): NO CREDIT (Page 8A) Soldier Dominic Lusiba displays his medical cardfrom the research project. PHOTO (COLOR) BY: MIKE LEVY / PLAIN DEALER PHOTOGRAPHER (Page 9A)Efurance Ndibarekera, 36, with her 3-year-old daughter, Caroline, is among the Ugandans who signed up for aU.S.-sponsored research project. PHOTO (COLOR): NO CREDIT (Page 9A) Efurance Ndibarekera returns homeafter attending a clinic at St. Francis Hospital. BOX: Yesterday: Although the United States has strict safeguards toprotect people involved in medical research, the country has flouted its own rules in dozens of nations. Today:American researchers' use of an untreated control group is at the heart of a debate extending from Uganda tomedical centers around the world. BOX: FACTS ABOUT UGANDA Location: Eastern Africa, west of KenyaComparative area: Slightly smaller than Oregon National capital: Kampala Population: 20,604,874 (July 1997estimate) Life expectancy: Total population: 36.69 years Male: 39.3 years Female: 40.1 years (1997 estimate)Telephones: 54,900 (1989 estimate) Tevevisions: 193,000 (1992 estimate MAP: New York Times Uganda BOX BY:PLAIN DEALER (Page 9 A) Tuberculosis ... Kills 2 million to 3 million people each year, more than any otherinfectious disease, according to the World Health Organization, which declared the disease a global emergency in1993. - TB FACTS Tuberculosis (TB) is a contagious disease that spreads through the air when infected peoplecough, sneez talk or spit. Someone in the world is newly infected with TB every second. One-third of the world'spopulation is infected with TB. Five to 10 percent of people infected with TB become sick or infectious at some time
 
during their life. The TB bacilli can lie dormant for years, contained by the immune system. Someone who is infectedwith TB and HIV-positive is 30 times more likely to become sick with TB because of a weakened immune system. TBis the leading cause of death among people who are HIV-positive, accounting for almost one-third of AIDS deathsworldwide. Up to 50 million people may be infected with drug-resistant strains of TB. 1996 INCIDENCE COUNTRYRATE PER 100,000 The Congo 333 Uganda 300 Phillippines 280 Afghanistan 278 South Africa 250 Peru 250Nigeria 222 Bangladesh 220 Indonesia 220 India 220
Edition: 
FINAL / ALL
Section: 
NATIONAL
Page: 
1A
Series: 
SECOND OF TWO ARTICLES 
Dateline: 
KAMPALA, UGANDA
Record Number: 
09813100 Copyright 1998, 2002 The Plain Dealer. All Rights Reserved. Used by NewsBank with Permission.
U.S. MEDICAL RESEARCHERS FLOUT RULES AROUND WORLD
Plain Dealer, The (Cleveland, OH)
- November 8, 1998
Author: 
KEITH EPSTEIN and BILL SLOAT PLAIN DEALER REPORTERS 
A legacy of medical exploitation, from secret Cold War radiation experiments to notorious syphilis studies on unwaryblacks, has led the United States to adopt some of the world's toughest protections for people on whom scientists testnew drugs, devices and vaccines.So firm is the underlying presumption that patients in experiments must be treated fairly and honestly that theprotections of federal law apply not just to Americans but to any person, anywhere in the world, used in U.S.-financedresearch.
Caption:
PHOTO BY MIKE LEVY / PLAIN DEALER PHOTOGRAPHER This was the main office for the Case WesternReserve University study at Mulago Hospital in Kampala, Uganda. Uganda is one of the countries where the Centersfor Disease Control and Prevention failed to obtain written assurances meant to safeguard patients. CHART: Theseare the countries where the Centers for Disease Control and Prevention failed to obtain written assurances thatsafeguard patients involved in medical research SOURCES: Centers for Disease Control and Prevention GRAPHICBY PLAIN DEALER
Memo:
Today: Although the United States has strict safeguards to protect people involved in medical research, the countryhas flouted its own rules in dozens of nations.Tomorrow: American researchers' use of an untreated control group is at the heart of a debate extending fromUganda to medical centers around the world.
Edition: 
FINAL / ALL
Section: 
NATIONAL
Page: 
1A
Series: 
FIRST OF TWO ARTICLES 
Dateline: 
WASHINGTON 
Record Number: 
09812059 Copyright 1998, 2002 The Plain Dealer. All Rights Reserved. Used by NewsBank with Permission.
RESEARCHERS LINK ANTIDOTE TO GULF WAR SYNDROME `INVESTIGATIONAL' DRUGDISPENSED TO SOLDIERS BEFORE HUMAN TESTING
Plain Dealer, The (Cleveland, OH)
- March 30, 1998
Author: 
BILL SLOAT and KEITH EPSTEIN PLAIN DEALER REPORTERS 
It was meant to help protect American troops. Instead, it may have helped harm them.Federal officials find it plausible that an experimental nerve gas antidote given to thousands of soldiers without theirconsent may have contributed to the mysterious ailment known as Gulf War Syndrome.
Caption:
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