A conference on Eugenics in November 2010 at René-Descartes Paris V medical school studied the “effective acting in medicine” in the light of history and genetics. The speakers are worried faced with the evolution of biomedical techniques and called for vigilance, particularly for the experiment on the most vulnerable human beings.
From impotence to arrogance
Pr. Axel Kahn, chairman of the René-Descartes Paris V University, explained why medicine, humanist discipline by excellence, was so often inhuman. We can distinguish three steps in the history of medicine: the step of “prudent impotence” which corresponds to the period of the Hippocratic wisdom; the step of the “conceited ignorance” marked by scientists like Harvey or Brousset; and finally that of the “arrogant knowledge” during which the medicine has the means of its ambitions and which is based on the certainty that in medicine, the man is like master and owner of the human nature.
It is this arrogance which is the wellspring of medical inhumanity, which explains the succession of eugenics projects during this period. At Brooklyn Jewish Hospital, homogenate of cancerous tumours was injected to elderly people, elsewhere several hundreds of autistic children were contaminated with serum of hepatic patients. Recently, an American study in Guatemala led to inoculate syphilis to local populations in order to test penicillin-based treatments. There is no lack of examples, without mentioning the horrors made by Nazis physicians.
In all cases, recurrent “corrupting icons” seduce the scientist. This is the same for the scientific passion which blinds the scientist, or even of a general underestimation of humanity level of experiment subjects (disabled, elderly, condemned to death, immigrant people, etc.) which prevent from retaining the investigator act. Axel Kahn states that at the same time, the expected benefits which are used as an excuse for medical experimentation are systematically overstated. Finally the financial interest is often arising from these inhuman projects.
Informed consent and inhumanity
Today the emergence of the ethical criterion of “informed consent of the person” reveals a new form of medical inhumanity. According this one, considering this principle as the “final point” of ethics leads to dehumanising indifference and medical formalism. In fact, the equality of duties and rights of the physician and of the patient, presupposed by the informed consent, does not erase their difference of situation: the patient remains vulnerable which implies for the physician a solidarity and reciprocity right.
Pr Patrick Berche, dean of René Descartes Medical School showed by a retrospective that the medical experiment could have three objectives: to protect the patient, understand the disease or destroy individuals. Tuskegee study, conducted in Alabama between 1932 and 1972 to understand the development of syphilis is emblematic. This study consisted in contaminating several hundreds of African-American people with syphilis without administering them treatment in order to observe if they were better without the toxic treatments administered at this time. The study gives no results and was carried on after we discovered the efficiency and the safety of penicillin to cure syphilis in 1947: thus it did not have any reason to exist. Moreover, researchers carried out this experiment while totally ignoring the then-scientific literature which particularly reported two Norwegian studies giving all the required results through most ethical means. President Bill Clinton officially apologized to the surviving victims in 1997.
This study shows how some experiences, carried out under the guise of medical purpose without taking into account the alternative ethical methods which would allow a greater scientific advance, are not legitimate.
Transgression and psychological well-being
Pr Maurice Corcos, head of adolescent psychiatry department at the Institut mutualiste Montsouris, began with an analysis on the Nazis horrors in Auschwitz to assess the current risks of biomedical drifts. Nazis policy against mentally ill and disabled patients was an efficient solution for a society in the midst of an economic crisis. This is reminiscent of the current context of crisis in which elderly people are as costly for the society as mentally ill patients were for Germany. It warns against a medicine which has not only the technical means for its ambitions, but also the legality for it: “when we have the technical means and we are told: ‘you can go ahead, we are going very fast and very far. “This way, Nazis physicians did not simply meet the objectives politicians set them, but they widely overall them.
Finally Pr Corcos underlined the mental consequences of the transgression in medicine: “when we take liberties with ethics […] it is the whole mental well-being which is disturbed.” “When we go beyond the point of no return, we are not the same“, he stated before explaining that then we entered a relentless gearing of continuous escalation to justify.
Finally, Pr Jessica Zucman-Rossi, (Inserm) mentioned a latent eugenics in the choice of access criteria to care.