EXPERIMENTS IN PAIN

How Medical Researchers Subjected Volunteer Prisoners To Pain, Isolation
And Shocks In 20 Years Of Secretive Tests

Michel Lambeth, National Archives of Canada / The Kingston
Penitentiary was the site of numerous tests carried out on prisoners
throughout the 1960s and into the 1970s. The tests included
experimental drugs, electric shock therapy and sensory
deprivation.

Michel Lambeth, National Archives of Canada / Dr. George Ducolon Scott
is shown here in 1964 administering a sodium pentathol injection to an
inmate at Kingston Penitentiary prior to treatment. Assistant Jack
Burk looks on.

For more than a decade, Canadian prisoners served as guinea pigs in
the name of commerce and medical science.

A Citizen investigation has discovered that federal inmates were test
subjects in numerous questionable experiments, including trials of
unproven pharmaceuticals, sensory-deprivation research and pain
studies employing electric shocks.

The tests, conducted quietly behind prison walls throughout the 1960s
and well into the 1970s, involved hundreds of male and female convicts
across the country.

The research -- sponsored by drug companies, universities and the
federal government -- has received scant attention over the years,
despite a public furore more than two decades ago about similar
experimentation in the United States.

Until now, it has been widely assumed that such experiments were
restricted to prisons south of the 49th parallel.

The Canadian government is currently facing a lawsuit from an inmate
subjected to a 1960s LSD-25 experiment aimed at rehabilitating addicts
at the Prison for Women in Kingston. Dorothy Proctor says federal
officials, the prison and its staff were "callous and reckless" in
administering the drug to her.

Archival documents, journal articles and correspondence show the LSD
trial was just one of many experiments in which prisoners made their
bodies available to researchers. Inmates took part in clinical trials
of pharmaceuticals including penicillin products, sedatives and
anti-bacterial agents. Some ingested pesticide traces to better
understand how the body processed them.

The protocol for 1963 tests of a new drug listed only as W-327 noted
subjects could expect diarrhea, dizziness, nausea and vomiting.

Academic investigators saw prisoners as useful subjects for exploring
the nature of various addictions, homosexuality, genetic makeup and
social isolation.

In particular, the cluster of institutions in and around Kingston
piqued the interest of several researchers.

In one sensory-deprivation study, 10 Kingston Penitentiary inmates
spent seven days in dark isolation cells to help researchers determine
the effects on their desire for visual and auditory
stimulation.

One prisoner began to panic after four days. Another hallucinated
during the final two days, seeing spiders and the face of his dead
brother.

In another test, inmates experienced terrifying shocks through
electrodes attached to their forearms to see if the jolts would
discourage smoking.

Records indicate that prisoners volunteered for the experiments, but
some ethicists question whether people locked behind bars can truly
offer informed consent to such tests.

"You have to be extra careful when you're in these circumstances,"
said Michael McDonald, a University of British Columbia professor who
recently helped develop a new national policy for human
experimentation.

Beginning in late 1963, researchers and prison officials were
expressly forbidden from promising inmates rewards, such as reduced
sentences, for taking part in studies.

But Mr. McDonald questions whether prisoners would take such a
declaration at face value: "Are there pressures to participate that
can't be seen?" he asked after reviewing records of the Canadian
prison studies. "I do have real concerns about some of the
intrusiveness of some of the (experimentation), worries about the
voluntariness of it, and the protections given to people to avoid
exploiting their institutionalized circumstances."

The use of prisoners to test pharmaceuticals appears to have petered
out in the mid-1970s as the ethical storm in the United States reached
a crescendo. The Canadian penitentiary service issued medical policy
guidelines in early 1978 banning clinical trials and other
investigative procedures unrelated to specific health needs of
Canadian inmates.

Many of the medical directors who planned trials for drug companies in
the 1960s have retired or died, said Robert Dugal, director of
university and scientific affairs with the Pharmaceutical
Manufacturers Association of Canada. But Mr. Dugal said current
medical directors of member companies feel clinical testing of drugs
on prisoners is unethical.

"We can say, in general terms, that it was seen as being acceptable at
the time and no longer is, as many things are today," he said. "The
science of ethics is a new one, and has evolved considerably in the
last 20 years."

Mr. Dugal said association members do not test pharmaceuticals in
prisons today, an exception being voluntary trials of new AIDS drugs
designed to treat HIV-positive inmates.

Mr. McDonald, director of UBC's Centre for Applied Ethics, says
Canada's new guidelines for tests on humans would effectively rule out
performing tests on prisoners: "I think research ethics boards would
be loath to pass something where a pharmaceutical trial was done on
those populations."

In the 1960s, federal prisons were fertile testing grounds for both
U.S. and Canadian branches of large drug companies. Fifty inmates from
Collins Bay penitentiary in Kingston took part in an October 1967
study by Bristol Laboratories of Syracuse, New York, to compare the
pain caused by different intramuscular injections of Rolitetracycline,
an antibacterial drug.

The test "evidently caused considerable pain around the area of
injection," said an account of the experiments in the Federal
Corrections journal.

Present for the experiment were prison psychiatrist George Scott and
Dr. G.S. Varnam, medical director of Bristol Laboratories of Canada.
But Dr. James Taggart, from Bristol's clinical research branch in
Syracuse, headed the study.

In an interview, Mr. Scott, 83, had trouble recalling pharmaceutical
tests, but said plainly, "Never was there anything unethical."

Evidence of U.S. influence can be seen as early as 1963 in a letter
from the Upjohn Co. of Canada to Dr. Louis Gendreau, director of
medical services for the federal penitentiary service. It noted
Upjohn's desire to undertake a project at Kingston Penitentiary as
soon as the company's research laboratories in Kalamazoo, Michigan,
indicated their plans.

A handwritten postscript to the letter suggests Dr. Gendreau read an
article in that week's Saturday Evening Post -- with comedian Jack
Benny on the cover -- about U.S. prison trials.

U.S. prisoners took part in a wide range of experiments, involving
everything from testing toothpaste and mouthwash to injection of
cancer cells and exposure to intense radiation.

The U.S. projects -- involving more than 3,000 inmates annually by the
early 1960s -- included infecting Atlanta prisoners with malaria,
prompting intense fevers and chronic aches.

Inmates of the Federal Reformatory in Chillicothe, Ohio, were given
strains of live polio virus with the aim of developing an oral vaccine.

Pharmaceutical companies saw prison trials as a cheap and easy means
of vetting new drugs. One Michigan state prison had its own test
facility built and run by pharmaceutical firms.

Criticism of the practices, notably Jessica Mitford's 1973 book Kind
and Usual Punishment, focused public attention on the ethical
dimensions of inmate testing. Some argued inmates were incapable of
offering voluntary consent because prisons are inherently coercive
environments. Others said medical research should not be conducted on
the backs of disadvantaged people such as prisoners. Hearings led by
U.S. Senator Ted Kennedy delved into the subject of human
experimentation, including prison testing.

In the early 1960s, however, Canadian justice officials pointed to the
U.S. prison trials as a good reason to allow the same sort of studies.
A July 1963 memo by Dr. Gendreau stressed the "highly important
medical research and valuable results" stemming from the malaria and
polio vaccine work.

But the Canadian prison research differed from the U.S. programs in at
least one respect. Canadian officials decided early on that paying
prisoners for their participation -- common in the U.S. -- should be
discouraged.

But ethical considerations weren't the main reason -- at least not
initially. The prison service objected to inmates being paid for
participating in a 1956 study of alcoholism because they would then
routinely expect to receive money from future researchers.

A technician who assisted in a 1967 drug trial recalls being advised
not to reward the prisoners. "We never gave them one bloody penny," he
said. "I know that for a fact." Instead, officials encouraged
donations to each prison's inmate welfare fund.

Participants in the 1967 Rolitetracycline study received cigarettes,
soft drinks and sandwiches. In addition, Bristol's U.S. lab sent a
cheque to purchase a television for a Kingston hospital that treated
inmates.

Interest from pharmaceutical companies in prison research increased
after the federal Health Department's Food and Drug division insisted
in 1963 that new drugs, even those used in other countries, be subject
to clinical trials on human beings to demonstrate their safety. The
intent was to avoid another Thalidomide tragedy, which caused
deformities in the children of mothers who took the sedative in pregnancy.

"Penitentiaries, which contain a regimented and controlled (at times)
population, have been considered as a potential source of assistance
in this work," Dr. Gendreau wrote to the prisons commissioner. "More
and more requests will be made, supported by the fact that many such
experiments are permitted and being carried on in United States
federal and state prisons."

In September 1963, the prison service issued an ethics policy to be
"rigidly applied and observed" for medical and psychological research.

The detailed policy, modeled largely on the Nuremberg Code -- written
after the Second World War atrocities of the Nazis were revealed --
stressed the importance of voluntary consent, the justification for
the experiment, the safety of the subject and approval of the project
by the commissioner and his medical staff.

It appears most countries, other than the United States, interpreted
the Nuremberg Code provision concerning the ability to "exercise free
power of choice" as precluding the use of prisoners in
experimentation.

"It should be noted that the use of prisoners as research subjects
seems to have been a uniquely American practice in the years following
World War Two," said the 1995 report of U.S. Advisory Committee on
Human Radiation Experiments.

It's now clear that Canada could have been added to the
list.

In her book, Ms. Mitford said observation of the Nuremberg Code "would
end altogether the practice of using prisoners as subjects."

The ethics policy of the Canadian prison service said all necessary
precautions must be taken to protect subjects from even remote
possibility of any harmful consequences.

"The utmost consideration must be given to the avoidance of any
suffering either mental or physical," read a provision of the code.

But, on the surface, some of the experiments seem to have clearly
violated the edict by their very design.

One test, carried out by researchers from Queen's University involved
administration of what male penitentiary inmates described as
"painful, and even terrifying" electric shock to determine whether the
stimulus would encourage smokers to quit.

The findings, published in a 1968 edition of Canadian Psychologist,
noted evidence of reduced smoking levels more than two years later
among those who received the worst shocks.

In the days before the U.S. tests generated intense criticism,
Canadian officials perceived the effects on inmate volunteers as positive.

"It provides for them an opportunity to identify themselves with
society, whose laws they have violated," Dr. Gendreau wrote in a 1963
memo. "It gives participating inmates a feeling of self-respect. It
builds up the self-esteem of those who have a low opinion of
themselves; they know they can become useful to millions of people."

An account of a 1965 Manitoba prison study to discover a serum to
prevent miscarriages suggests the appeal to prisoners' sense of worth
was persuasive.

"The inmates selected, while skeptical at first, willingly signed the
paper permitting the use of their bodies when it was mentioned that it
might help preserve the life of an unborn baby," said a Federal
Corrections article.

However, even in the 1960s, not everyone in the prison community
agreed with testing on inmates.

Dr. Guy Richmond, a former senior medical officer with the British
Columbia Corrections branch, wrote in his 1975 career retrospective,
Prison Doctor, that research on prisoners for commercial or military
purposes should be forbidden.

"I also disapprove of experiments which might prove harmful to the
inmates, even if they volunteer or are promised rewards such as money
or remission of sentence," wrote Dr. Richmond, stationed at B.C.'s
Oakalla prison until 1969, when he retired.

"We had requests from drug companies to try products of theirs not yet
on the market which required more testing for side effects. Since we
felt such experiments were undesirable the requests were denied."

Dr. Richmond, though, performed some research involving prisoners,
studying the sex chromatin of male and female homosexual offenders in
1956. He looked for abnormalities that might explain their sexual
preference, but found none.

Records on the nature and number of tests conducted in the Canadian
prison system are scarce. There is little readily available
information on the outcome of many studies, nor data on whether any
prisoners suffered ill-effects.

Still, the commissioner of penitentiaries' annual report for 1967-68
suggests the practice of testing new drugs had become commonplace as
the end of the decade neared.

"A number of pharmaceutical firms have carried out research using
inmates to determine what the effects of some of their marketable
drugs could be -- this after they had agreed to comply with the rules
and regulations governing such research and had received the approval
of the commissioner."

In 1972, plans for a Quebec study of three penicillin preparations
rankled prison officials when the firm organizing the tests struck
Leclerc Institution's in-house doctor from the ethics committee
reviewing the experiment. The prison doctor had been replaced by a
University of Montreal professor. However, federal officials let the
study proceed.

Under the heading "adverse effects," the experiment protocol said,
"Untoward effects, either observed or volunteered, that would be
considered drug-related should be reported."

Pharmaceuticals weren't the only commercial products tried out on
prisoners. Brands of shampoo and cigarettes were tested at Leclerc
Institution.

Nor were companies alone in their use of inmates. In October, 1967,
the federal Health Department's Food and Drug Directorate studied the
absorption and excretion of acetylsalicylic acid, or ASA, when
administered orally and rectally. Several blood and urine specimens
were collected from the 10 Kingston-area prisoners who
volunteered.

In another study, researchers from Queen's University teamed up with
the Food and Drug Directorate to assess ways the human body alters and
excretes chemicals such as agricultural pesticides and sweetening agents.

A nervous Health Department official suggested publicizing the project
"to prevent inaccurate, misleading and derogatory claims about it
which we fear may appear in the lay press."

A draft news release prepared by the department stressed the
"extremely small amounts" of the chemicals to be given to volunteers,
the need to understand the body's reaction to the substances and the
"elaborate care" taken to protect subjects.

University researchers in Halifax, Toronto and elsewhere also saw
prisons as ready-made laboratories. Penitentiary officials frequently
received requests from academics to perform tests -- some related to
correctional research, others with no apparent connection.

In a study done before the penitentiary ethics code was drafted,
several Prison for Women inmates dipped their arms in water full of
ice cubes until they could no longer bear the pain to see whether drug
addicts had lower tolerance thresholds than non-addicts.

The experience may have been unpleasant, but was ultimately harmless,
said James Inglis, the Queen's University psychology professor who
supervised the student conducting the research.

Mr. Inglis, now retired, believes such an experiment would still be
allowed today.

"I think it would probably get past an ethics committee without any
bother, because there's no question of hurting anybody or deceiving
them. They were told what was happening."

The attractive nature of the prison setting for academic researchers
created tensions.

Prison psychologist Mark Eveson, who administered the LSD trials,
wrote the commissioner of penitentiaries in November, 1962, expressing
frustration.

MR. Eveson believed university participation in research projects
could be of assistance to the prison service, but only if federal
officials retained "a strong measure of control" on the work done to
ensure maximum practical value for correctional staff.

"I do not feel we should encourage the kind of projects which appear
in many theses in which the penitentiary populations are used as
subjects merely because there are no other populations so permanent
and captive in nature."

Checked-by: Patrick Henry