Medical Experimentation, Ethics, and Experts

Question 1

What firs promoted experimentation on humans?

Answer 1

The program of experiment that suggested human trials as a logical step in developing therapeutics

Question 2

Who is Robert Boyle?

Answer 2

Introduced program on experimentation first on science and then medicine.

Question 3

What were blood transfusions extrapolated from?

Answer 3

the idea of blood-letting

Question 4

How were blood transfusions considered in relation to patients?

Answer 4

beneficial

Question 5

Who believed “medical art at the patient’s bedside”?

Answer 5

Hippocrates

Question 6

What two major things did Hippocrates believe?

Answer 6

1) physicians had to address specific symptoms as specific individuals
2) Physicians classified different kinds of diseases –> map

Question 7

What was the general plan of ht pathological work like? What did this lead to?

Answer 7

• like a map

- classificatory medicine (anatomo-clinical method) (structure and function)

Question 8

Where did the healing art have its original foundation?

Answer 8

in experiment

Question 9

What did accident at first make know?

Answer 9

the virtue of a remedy in some particular disease

Question 10

What did the practices of the “healing art” become possible in?

Answer 10

A teaching hospital

Question 11

What were the 4 important points on teaching hospitals? (when, state control over what, problems (2))?

Answer 11

• 19th century clinic –< scientific coherence and social utility
• state control over the ‘production of health’
• moral problematics: therapy + research on patients
• ambiguous domain of the hospital beside the laboratory

Question 12

What was there a small step from therapeutic method to what?

Answer 12

experimentation

Question 13

What was there no boundaries between in teaching hospitals?

Answer 13

experimentation and therapeutic method

Question 14

What was medical electricity used for in: 
1799?
1824?
1862?
1910?

Answer 14

1799- medical electricity (2 scientists invented it)
1824- patient suffers
862- use of electricity for purely scientific purposes
1910- used to treat chancer

Question 15

Why did we need codes/

Answer 15

to distinguish between therapy and experimentation

Question 16

Who is Thomas Percival?

Answer 16

• One of the first to introduce need for codes
• Believed that no such trials should exists without a previous consultation of the physicians or surgeons according to the nature of the case. IOW, physicians and scientists had to cooperate.

Question 17

How was industrialization and epidemics related to experimentation?

Answer 17

For example, cholera was very tough to find a treatment that works.

• Epidemics repeated
• Related to industrialization

Question 18

What two things did Max Simon believe?

Answer 18

1) “…the experimenter is obliged to bear in mind the immediate interest of the human subject whatever his scientific concern and passion for finding a solution to a fundamental question or for enriching material medical might be…
2) “…the experimenter should mentally take the position of the human subject and try the suggested unproven course of action on himself.”

Question 19

Who believed that moral norms that restrained physician’s latitude of action secured the pride of place for the hospital as an appropriate institution for carrying out human experimentation?

Answer 19

Max Simon

Question 20

What wer the chloroform experiments?

Answer 20

Self-experimentation with substances

-Drank liquid chloroform

Question 21

Why did people experiment on themselves?

Answer 21

Experimented on themselves to prove that their practices were of upmost ethical value.

Question 22

Who was Claude Bernard?

Answer 22

Pioneer of experimental medicine

Question 23

What were Bernard’s 3 practices of experimental medicine?

Answer 23

1) pathology
2) therapeutics
3) physiology

Question 24

What is significant about pharmaceutical/chemical laboratory?

Answer 24

-Layout much more sophisticated

Question 25

What is the mass production of medicaments?

Answer 25

• Pharmacy shops

- New technologies to produce new forms of drugs

Question 26

What was the clinic seen as with the germ theory of disease?

Answer 26

as a laboratory for human experimentation.

Question 27

What is the germ theory of disease?

Answer 27

Every disease can be treated with a unique medicine and the medical profession must find all these treatments.

• There was something behind every disease
• They could all be treated
• Demand on medical professionals to find drugs

Question 28

How did the germ theory of disease work?

Answer 28

Intensification of testing of novel therapeutics, and old drugs for new purposes.

Question 29

What is advertising drugs/

Answer 29

Various forms of medicines; tablets, capsules, potions, etc.

Question 30

What were the two human diseases that defied animal experimentation?

Answer 30

• STIs

- Syphilis

Question 31

What was the dilemma with STIs and Syphilis since animal experimentation was not applicable?

Answer 31

How to make a toxic substance tested inhuman subjects ethical

Question 32

Who is Paul Ehrlich?

Answer 32

• Salvarsan (1909)- a synthetic drug produced to treated syphilis
• ‘a magic bullet’
• -synthesized the drug

Question 33

What were the ethical issues associated with syphilis?

Answer 33

How to treat people because it was so widespread

Question 34

What was the Tuskegee Syphilis Study?

Answer 34

• 1932-1972
• African men
• In exchange, promised 3 meals, free medical services, etc.
• Men were inoculated, not treated
• Natural progression of syphilis
• Not about a new drug or way to treat it
• Even though there were drugs to treat sufferers doctors ignored them because they wanted to know how the disease evolved.

Question 35

What is the Declaration of Geneva?

Answer 35

• 1948
• A declaration on ethics about practicing the profession with dignity, respecting the human life, the health of the patients is of upmost importance.

Question 36

What is the date that the Declaration of Geneva was adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland?

Answer 36

September 1948

Question 37

What is the Thalidomide Scandal (1960-1962)?

Answer 37

-Thalidomide synthesized in West Germany
-Marketed internationally
-“wonder drug”
-1961 suspected cause of birth malfunctions
1962- public outcry

Question 38

What wer ehe results of the thalidomide scandal?

Answer 38

1) medical decision making came open public debate

2) institutionalization of procedures for determine investigational drug efficacy

Question 39

What was the declaration of Helsinki (2 principles and date)?

Answer 39

• Human Experimentation: Code of Ethics of the World Medical Association (1962-1964)
• Clinical research must conform to the moral and scientific research based on laboratory and animal experiments
• Doctor should obtain consent after full explanation

Question 40

What has created rationals for medical experimentation that have been judged at one moment necessary and at another unethical?

Answer 40

Historical context and cultural circumstances

Question 41

In human subjects, drug is tested for few conditions to confirm what?

Answer 41

that it is not very toxic (no mutations or death)

Question 42

What have experts in therapeutic experimentation been produced by?

Answer 42

the conditions in which they have existed

Question 43

What has the culture of medical ethics been?

Answer 43

more localized than universalized