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(USA) The Philadelphia Experiments – Quillette (Allen M. Hornblum | December 2022)

Posted by Connar Allen in Human Research Ethics on December 25, 2022
Keywords: Beneficence, Conflicts of interest, Human research ethics, International, Medical research, Merit and integrity, Protection for participants, Researcher responsibilities

The Linked Original Item was Posted On December 10, 2022

A greyscale image of prison bars.

How an enterprising doctor, an elite university, and negligent public officials turned a city prison system into the largest human research factory in America.

When La Salle University student Priscilla Morris first came across the 1971 portrait of Dr. Albert M. Kligman in Philadelphia’s Woodmere Museum, she says she found it “eerie. I really thought the portrait quite ominous.” For Morris, a criminal justice major doing a deep dive into Kligman’s controversial career, the portrait confirmed her opinion of the renowned University of Pennsylvania researcher as “menacing.” The woodblock print by Kligman’s second wife, Mitzi Melnicoff, divides his face into red and yellow, marked by bold, slashing black lines. The result is dramatic. Some consider it unsettling and off-putting. Melnicoff said she wanted to emphasize her husband’s “powerful force of character,” but she may have gone too far. Morris is probably not alone in finding something sinister about the picture—a quality familiar to those, both free and behind bars, who had the dubious pleasure of meeting its infamous subject or being used as his research material.

In the past, we have played a direct role in the design and delivery of HREC member professional development for the NHMRC.  We are now not proud of that involvement because it embedded poor practice into the conduct of research ethics review in Australia.  Cases like this are shocking and such research practice needs to be blocked from ever happening again.  But the use of an egregious case of medical research from US is unlikely to be considered relevant outside of the health sciences in Australia.  Rather than using such cases for shock value or as justification for research ethics review and combative review decisions, it should be used as an opportunity to discuss, vulnerability, conflicts of interest, researcher responsibilities and clinical trial monitoring.  That approach might seem to be a less shocking or engaging way to go, but it should result in better review decisions.

Melnicoff’s portrait was painted at a time when her husband was riding high. A one-time enfant terrible of the medical/academic arena, he was now comfortably ensconced at a prestigious Ivy League University, the author of dozens of medical journal articles and several books, and the go-to scientist for numerous pharmaceutical companies conducting Phase I drug trials. By the early 1970s, he was well on his way to being recognized as one of the world’s most influential dermatologists.

Dr. Kligman would die in 2010 at the age of 93. His New York Times obituary described his many accomplishments and the critical role he played in bringing a “scientific base to dermatology.” It mentioned his “innovative” and “very charismatic” personality, his coinage of new terms such as “photoaging” and “cosmeceuticals,” and his wildly profitable commercial products, Retin-A and Renova. However, the Times also mentioned my book, Acres of Skin, which illuminated Kligman’s darker side—his use of vulnerable populations for medical research and the many “ethical questions that dogged his career.” In fact, the last 10 years of his life would be, in some respects, a bulwark action in defense of his scientific contributions as he fended off attacks that cast him as a modern day Mengele, who used institutionalized black men as grist for his research mill and personal enrichment.

Kligman’s reputation and the research empire he created had already taken a number of hits when, on October 6th, 2022, Philadelphia became the first city in the nation to apologize “to those who were subjected to the inhumane and horrific abuse” in the county’s correctional system. Recognizing “the historical impact and trauma of this practice of medical racism” and the “deep distrust experiments like this have created in our communities of color,” Mayor Jim Kenney “formally and officially” extended “a sincere apology” for this “deplorable chapter” in the city’s history. That apology, which recalled President Bill Clinton’s 1997 apology to the survivors of the infamous Tuskegee Syphilis Study, received widespread media coverage, including in publications in the United Kingdom, France, and China.

The Philadelphia Experiments
How an enterprising doctor, an elite university, and negligent public officials turned a city prison system into the largest human research factory in America.

Related Reading

(US) This Researcher Exploited Prisoners, Children, and the Elderly. Why Does Penn Honor Him? – The Chronicle of Higher Education (Alexander Kafka, | November 2019)

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