List of medical ethics cases

Last updated

Some cases have been remarkable for starting broad discussion and for setting precedent in medical ethics.

Contents

Research

Research
casecountrylocationyearsummary
Psychosurgery 1880sPsychosurgery (also called neurosurgery for mental disorder) has a long history. During the 1960s and 1970s, it became the subject of increasing public concern and debate, culminating in the US with congressional hearings. Particularly controversial was the work of Harvard neurosurgeon Vernon Mark and psychiatrist Frank Ervin, who wrote a book, Violence and the Brain, in 1970. [1] The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1977 endorsed the continued limited use of psychosurgical procedures. [1] [2] Since then, a few facilities in some countries have continued to use psychosurgery on small numbers of patients. In the US and other Western countries, the number of operations has further declined over the past 30 years, a period during which there have been no major advances in ablative psychosurgery. [3]
Surgical removal of body parts to try to improve mental health United States New Jersey 1920sControversial psychiatrist Henry Cotton at Trenton State Hospital in New Jersey became convinced that insanity was fundamentally a toxic disorder and he surgically removed body parts to try to improve mental health. [4]
The Monster Study United StatesIowa1939The Monster Study is the name given to a stuttering experiment performed on orphan children in Davenport, Iowa in 1939. It was conducted by Wendell Johnson at the University of Iowa. The research began with the selection of 22 subjects from a veterans' orphanage in Iowa. None were told the intent of the research, and they believed that they were to receive speech therapy. The study was trying to induce stuttering in healthy children. The experiment became national news in the San Jose Mercury News in 2001, and a book was written. On 17 August 2007, six of the orphan children were awarded $925,000 by the State of Iowa for lifelong psychological and emotional scars caused by six months of torment during the Iowa University experiment. Although none of the children became stutterers, some became self-conscious and reluctant to speak. [5] A spokesman for the University of Iowa called the experiment "regrettable".
Medical Experimentation on Black Americans [6] United StatesVariousOccurred over many decadesThere has been a long history of medical experimentation on African Americans. From the era of slavery, when atrocities were committed on black women by J. Marion Sims, to the present day, Black Americans have been unwitting subjects of medical experimentation. [7] [8] Author Harriet Washington argues that "diverse forms of racial discrimination have shaped both the relationship between white physicians and black patients and the attitude of the latter towards modern medicine in general." [9]

In the 1960s, Ionia State Hospital, located in Ionia, Michigan, was one of America's largest and most notorious state psychiatric hospitals in the era before deinstitutionalization. Doctors at this hospital diagnosed African Americans with schizophrenia because of their civil rights ideas. See The Protest Psychosis .

Plutonium injectionsUnited States1945–1947Eighteen people were injected with plutonium by Manhattan Project doctors; the most notorious of them, Albert Stevens, received more radiation than any other living person. None of the patients were told about the experiment, nor did the doctors ask for their consent. See Eileen Welsome's book The Plutonium Files . [10]
Doctors' Trial United States1946German medical doctors went on criminal trial for Nazi human experimentation. See The Years of Extermination .
Guatemala syphilis experiments U.S./
Guatemala		1946–48The syphilis experiments in Guatemala were United States human experiments conducted in Guatemala from 1946 to 1948. The experiments were led by physician John Charles Cutler. They were done during the administration of American President Harry S. Truman and Guatemalan President Juan José Arévalo. [11]

Doctors infected soldiers, prostitutes, prisoners, and mental patients with syphilis and other sexually transmitted diseases without the informed consent of the subjects, and treated most subjects with antibiotics. This resulted in at least 83 deaths. [12] In October 2010, the US formally apologized to Guatemala for conducting these experiments.

Skid Row Cancer Study United StatesNew York State1950sMore than 1200 homeless men from Lower Manhattan were convinced with promises of food and shelter to have their prostates biopsied by a Dr. Perry Hudson. They were not informed of possible side effects, i.e., rectal tearing and impotence. The homeless were targeted for these biopsies because the biopsies were painful and untested, and less vulnerable populations would not volunteer.
Radioactive iodine experimentsUnited States1950sThe U.S. Atomic Energy Commission has a history of involvement in experiments involving radioactive iodine. In a 1949 operation called the "Green Run", the AEC released iodine-131 and xenon-133 to the atmosphere, which contaminated a 500,000-acre (2,000 km2) area containing three small towns near the Hanford site in Washington. [13] In 1953, the AEC ran several studies on the health effects of radioactive iodine in newborns and pregnant women at the University of Iowa. Also in 1953, the AEC sponsored a study to discover if radioactive iodine affected premature babies differently from full-term babies. [14] In another AEC study, researchers at the University of Nebraska College of Medicine fed iodine-131 to 28 healthy infants through a gastric tube to test the concentration of iodine in the infants' thyroid glands. [14]
Henrietta Lacks United States Baltimore 1951A product derived from a cancer patient's specimen, HeLa is the cornerstone of an industry. Cancerous tissue was taken from her without her consent.
Albert Kligman's dermatology experiments United StatesPhiladelphia1951–1974Clinical non-therapeutic medical experiments on prison inmates was conducted at Holmesburg Prison in Philadelphia from 1951 to 1974 under the direction of dermatologist Albert Kligman. [15]
Allan Memorial Institute Canada Montreal, Quebec 1957–1964The Allan Memorial Institute is known for its role in the Project MKULTRA run by the CIA. The Agency's initiative to develop drug-induced "mind control" techniques was implemented in the institute by its then-Director Donald Ewen Cameron.
UK mental institutionsUK1960sIn the 1960s, there was abuse and inhumane treatment of psychiatric patients who were hidden away in institutions in the UK. Barbara Robb documented her difficult personal experience of being treated at Ely Hospital. She wrote the book Sans Everything and she used this to launch a campaign to improve or close long stay facilities. Shortly after, a long stay hospital for mentally disabled people in Cardiff was exposed by a nurse writing to the News of the World. This exposure prompted an official inquiry, which was highly critical of conditions, staff morale, and management. At the same time Michael Ignatieff and Peter Townsend both published books which exposed the poor quality of institutional care. [16]
Milgram experiment United States1961The Milgram experiment on obedience to authority figures was a series of notable social psychology experiments conducted by Yale University psychologist Stanley Milgram, which measured the willingness of study participants to obey an authority figure who instructed them to perform acts that conflicted with their personal conscience. [17] The detailed findings are discussed in his 1974 book, Obedience to Authority: An Experimental View. [18] The experiments were controversial, and considered by some scientists to be unethical and physically or psychologically abusive. Psychologist Diana Baumrind considered the experiment "harmful because it may cause permanent psychological damage and cause people to be less trusting in the future." [19]
Harry Bailey's deep sleep therapy Australia Sydney 1962-1979Controversial Australian psychiatrist Harry Bailey treated mental patients via deep sleep therapy and other methods at a Sydney mental hospital. He has been linked with the deaths of 85 patients. [20] He died by suicide before he could be punished.
Political abuse of psychiatry Soviet Union, Romania,
Hungary,
Czechoslovakia, Yugoslavia and China		1960s to 1980sPsychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience. [21] : 6  In the period from the 1960s to 1986, abuse of psychiatry for political purposes was reported to be systematic in the Soviet Union and other Eastern European countries. [22] : 66  Political abuse of psychiatry also takes place in the People's Republic of China. [23] Psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the USSR were used for political purposes. [24] : 77 
Stanford prison experiment United States1971The Stanford prison experiment was a study of the psychological effects of becoming a prisoner or prison guard. The experiment was conducted in August 1971 by a team of researchers led by psychology professor Philip Zimbardo. [25] Participants took on the roles of prisoners and guards in a mock prison situated in the basement of the Stanford psychology building. Some of the prisoners were subjected to psychological torture. Many of the prisoners passively accepted psychological abuse, and Zimbardo himself permitted the abuse to continue. Two of the prisoners quit the experiment early and the entire experiment was abruptly stopped after only six days. Certain portions of the experiment were filmed and excerpts of footage are publicly available.
Human radiation experiments United States1970sHuman radiation experiments were directed by the United States Atomic Energy Commission and the Manhattan Project. In Nashville, pregnant women were given radioactive mixtures. In Cincinnati, some 200 patients were irradiated over a period of 15 years. In Chicago, 102 people received injections of strontium and cesium solutions. In Massachusetts, 74 schoolboys were fed oatmeal that contained radioactive substances. In all of these cases, the subjects did not know what was going on and did not give informed consent. [10] The government covered up most of these radiation mishaps until 1993, when President Bill Clinton ordered a change of policy. The resulting investigation was undertaken by the Advisory Committee on Human Radiation Experiments. See The Plutonium Files .
Tuskegee syphilis experiment United States Tuskegee, Alabama 1972A 40-year experiment conducted by the U.S. Public Health Service withheld standard medical advice and treatment from a poor minority population with an easily treatable disease. The experiment targeted black male farmers who were told they needed to be treated for 'bad blood', [26] but who were, in fact, syphilitic. In addition to many fatalities, some children were born with congenital syphilis due to the study.
Moore v. Regents of the University of California United States California 1976Researchers commercialized a patient's discarded body parts. The man did not authorize the use of his bodily tissues or fluids, and researchers did not obtain informed consent. He did not want his donation to generate commercial profit for private entities.
Eugene Landy United States California 1980sEugene Ellsworth Landy was an American psychologist and psychotherapist best known for his unconventional 24-hour therapy as well as ethical violations concerning his treatment of Beach Boys co-founder Brian Wilson in the 1980s. In 2015, Landy's relationship with Wilson was dramatized in the biographical film Love & Mercy .
Willowbrook State School United States Staten Island 1987A school had been infecting disabled children in experiments for years.
Study 329 Canada, United States12 psychiatric centers1994–2001 SmithKlineBeecham, known since 2000 as GlaxoSmithKline, conducted a clinical trial from 1994 to 1997 in 12 psychiatric centers in North America to study the efficacy of paroxetine (Paxil, Seroxat), an anti-depressant, on teenagers. The trial data suggested that the drug was not efficacious and that the paroxetine group were more likely to think about suicide. The paper that wrote up the study was published in 2001, ostensibly authored by a group of academics, but actually ghostwritten by the drug company. The article downplayed the negative findings and concluded that paroxetine helped with teenage depression. The company used this paper to promote paroxetine for teenagers. The ensuing controversy led to several lawsuits, including from the parents of teenagers who killed themselves while taking the drug, and intensified the debate about medical ghostwriting and conflict of interest in clinical trials. In 2012 the US Justice Department fined GlaxoSmithKline $3 billion for several violations, including withholding data on paroxetine, unlawfully promoting it for adolescents, and preparing a misleading article about study 329. New Scientist wrote in 2015: "You may never have heard of it, but Study 329 changed medicine." [27]
Death associated with psychotropic drugsUnited States Cheyenne, Wyoming 1998In 1998, 60-year-old Donald Schell went to see his doctor complaining of difficulty sleeping. He was diagnosed with an anxiety state and placed on Paxil (paroxetine - see "Study 329" above), an SSRI anti-depressant. Within 48 hours of being put on Paxil Schell killed his wife, daughter, infant granddaughter, and himself. Tim Tobin, Schell's son-in-law, took legal action against SmithKline (now GlaxoSmithKline). The Tobin case was heard in Wyoming from May 21 to June 6, 2001. The jury returned a guilty verdict against SmithKline and awarded Tobin $6.4 million. [28] [29] [30] [31] This was the first guilty verdict returned against a pharmaceutical company regarding adverse behavioral effects of a psychotropic drug. [28]
Robert Courtney United States Kansas City, Missouri 2002Courtney is a former pharmacist who owned and operated Research Medical Tower Pharmacy in Missouri. [32] In 2002, he was convicted of pharmaceutical fraud and sentenced to federal prison. [32]
Greenberg v. Miami Children's Hospital Research Institute United States Florida 2003Patients donated tissue samples, which researchers subsequently used in a plan to generate profit.
GlaxoSmithKline human experimentsVarious2004–2012

In 2004 GlaxoSmithKline (GSK) sponsored at least four medical trials using Hispanic and black children at New York's Incarnation Children's Center. Normally trials on children require parental consent but, as the infants were in care, New York's authorities held that role. Experiments were designed to test the "safety and tolerance" of AIDS medications, some of which have potentially dangerous side effects. [33]

In 2006, GSK and the US Army were criticized for Hepatitis E vaccine experiments conducted in 2003 on 2,000 soldiers of the Nepali Army. It was said that using soldiers as volunteers is unethical because they "could easily be coerced into taking part." [34]

In January 2012, GSK and two scientists who led the trials were fined approximately $240,000 in Argentina for "experimenting with human beings" and "falsifying parental authorization" during vaccine trials on 15,000 children under the age of one. Babies were recruited from poor families that visited public hospitals for medical treatment. Fourteen babies allegedly died as a result of the trials. [35]

Death from prescription drugsUnited States Hull, Massachusetts 2006 Rebecca Riley, the daughter of Michael and Carolyn Riley of Massachusetts, was found dead in her home at age four, her lungs filled with fluid, after prolonged exposure to various medications. The medical examiner's office determined the girl died from "intoxication due to the combined effects" of prescription drugs. Police reports state she was taking 750 milligrams a day of Depakote, 200 milligrams a day of Seroquel, and .35 milligrams a day of Clonidine. Rebecca had been taking the drugs since the age of two for bipolar disorder and ADHD, diagnosed by child psychiatrist Kayoko Kifuji of the Tufts-New England Medical Center. [36]
University of Minnesota Research Participant Dan MarkingsonUnited StatesMinnesota2004 University of Minnesota research participant Dan Markingson committed suicide in May 2004 while enrolled in an industry-sponsored pharmaceutical trial comparing three FDA-approved atypical antipsychotics: Seroquel (quetiapine), Zyprexa (olanzapine), and Risperdal (risperidone). Writing on the circumstances surrounding Markingson's death in the study, which was designed and funded by Seroquel manufacturer AstraZeneca, University of Minnesota Professor of Bioethics Carl Elliott noted that Markingson was enrolled in the study against the wishes of his mother, Mary Weiss, and that he was forced to choose between enrolling in the study or being involuntarily committed to a state mental institution. [37] Further investigation revealed financial ties to AstraZeneca by Markingson's psychiatrist, Dr. Stephen C. Olson, oversights and biases in AstraZeneca's trial design, and the inadequacy of university Institutional Review Board (IRB) protections for research subjects. [38] Although a 2005 FDA investigation appeared to clear the university, greater awareness of the case stemming from Elliott's 2010 article in the magazine Mother Jones resulted in a group of university faculty members sending a public letter to the Board of Regents urging an external investigation into Markingson's death. [39]

Termination of mechanical ventilation and life support

Termination of life support
casecountrylocationyearsummary
Betancourt v. Trinitas Hospital United States New Jersey 2008A hospital wished to withhold treatment from someone whom it judges to have no chance of living.
Mordechai Dov Brody United States Brooklyn 2008The parents of a brain-dead boy wanted to keep him on life support.
Cuthbertson v Rasouli Canada Toronto 2013The wife of a brain-damaged man wanted to keep him on life support.
Lantz v. Coleman United States Connecticut 2007Prison officials question whether to force-feed inmates who are on hunger strike.
Charlie Gard case United Kingdom Great Ormond Street Hospital, London, England 2017After losing a UK Supreme Court case, the parents of Gard, 10 months, petitioned the EU Court in France, and lost the final appeal. They wanted the hospital to allow them to travel to the U.S. for an experimental therapy that may have provided some temporary benefit but likely would not have improved his neurological condition, due to a mitochondrial DNA depletion disease (the treatment is nucleoside bypass therapy). At the least, they wanted for the hospital to continue to provide advanced life support palliative care for their son—respiration, nutrition, hydration—or to send him home on life support to eventually die, but those requests were also denied and support was turned off on July 27, 2017. Gard died the next day.
Tirhas Habtegiris United States Texas 2005The hospital removes life support from an unconscious immigrant from Eritrea against her family's wishes. The family are in a foreign country and unable to travel.
Rom Houben Belgium 2010A man seems to be in a persistent vegetative state, and after 23 years a communication test is conducted.
Sun Hudson case United StatesTexas2004An infant is removed from life support against his mother's wishes.
Baby K United States Virginia 1992The mother of an anencephalic baby wishes to keep the child on life support perpetually.
Jesse Koochin United States Salt Lake City 2004Parents wish to keep a child on life support.
Spiro Nikolouzos case United States Texas 2005A family wishes to keep life support for a man in a persistent vegetative state.
David Vetter United States Texas 1984A boy dies at age 12 after living a lifetime with highly unusual medical care in a sterile environment.
Jahi McMath case United States California 2013A teenaged girl is declared brain-dead and her family wishes to maintain her body on mechanical ventilation perpetually.

Withholding life-prolonging medical treatment

Withholding life-prolonging treatment
casecountrylocationyearsummary
Baby Doe Law United States New York 1983The parents of a child born with severe birth defects request the right to refuse treatment and keep the child off life support.
Baby M Australia Melbourne 1989Parents and doctors agreed to withhold life-prolonging measures of severely disabled newborn baby, including surgeries and medication, while Right to Life activists claimed the baby was murdered. [40]
Informed consent to medical treatment
casecountrylocationyearsummary
Christiane Völling Germany2011Informed consent and involuntary sex reassignment in the case of an adult intersex woman.
Gillick competence England1985The right of minors to request contraception from their doctor without parental consent.

Person wishes for assisted suicide

Assisted suicide
casecountrylocationyearsummary
Betty and George Coumbias Canada Vancouver, British Columbia 2007A couple request the legal right to commit suicide together, although only the husband was ill.
Dax Cowart United States1973A man who suffered severe burns requests the right to die.
Giovanni Nuvoli Italy Alghero, Sardinia 2007A man in pain requests a legal right to die.
Sue Rodriguez Canada Victoria, British Columbia 1991A woman requests a right to assisted suicide.
Ramón Sampedro Spain Galicia 1998For 29 years a man requests his right to assisted suicide.
Aruna Shanbaug case India Karnataka 2011A writ petition under Article 32 of the Constitution has been filed on behalf of the petitioner Aruna Ramachandra Shanbaug by one Ms. PinkiVirani of Mumbai, claiming to be a next friend.
Piergiorgio Welby Italy Rome 2006A patient requests a legal right to die.

Person wishes for euthanasia for another

Euthanasia of another
casecountrylocationyearsummary
Andrew Bedner United States White River Junction, Vermont 2008A parent is charged with critically harming his child who is on life support. If the child dies, the parent may be charged with murder. At question was whether parents should be legally allowed to make medical decisions for children they have allegedly abused.
Tony Bland England Sheffield 1993Bland was the first patient in English legal history to be allowed to die by the courts through the withdrawal of life-prolonging treatment.
Carol Carr United States Georgia 2002A mother euthanizes her adult sons to relieve their suffering from Huntington's disease.
Cruzan v. Director, Missouri Department of Health United States Missouri 1990The parents of a woman in a persistent vegetative state request the right to remove her life support equipment.
Eluana Englaro Italy Lecco 1992Parents receive permission to remove the life support from a woman in a persistent vegetative state for 17 years.
June Hartley United States California 2009A sister is charged with euthanizing her brother after he has medical problems.
Jack Kevorkian United StatesMichigan1994A medical doctor advocates for assisted suicide and the right to die.
Robert Latimer Canada Saskatchewan 1993A man euthanizes his child who has lived for years in pain.
Karen Ann Quinlan case United StatesNew Jersey1976A 21-year-old girl is in a persistent vegetative state. Her parents wish to remove her from artificial respiration.
Terri Schiavo case United States Florida 2005A woman is in a persistent vegetative state. Her husband wishes to remove her life support. Her parents wish her to remain on life support.
Marlise Munoz United States Texas 2013A woman was declared brain-dead by her physician. Her husband and family wished to remove life support. The hospital persisted in keeping her on life support because it claims it cannot legally withdraw life support from a pregnant patient.

Related Research Articles

<span class="mw-page-title-main">Milgram experiment</span> Series of social psychology experiments

Beginning on August 7, 1961, a series of social psychology experiments were conducted by Yale University psychologist Stanley Milgram, who intended to measure the willingness of study participants to obey an authority figure who instructed them to perform acts conflicting with their personal conscience. Participants were led to believe that they were assisting an unrelated experiment, in which they had to administer electric shocks to a "learner". These fake electric shocks gradually increased to levels that would have been fatal had they been real.

Psychosis is a condition of the mind or psyche that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are disorganized thinking and incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

<span class="mw-page-title-main">Tricyclic antidepressant</span> Class of medications

Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade. They are named after their chemical structure, which contains three rings of atoms. Tetracyclic antidepressants (TeCAs), which contain four rings of atoms, are a closely related group of antidepressant compounds.

Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment can be often more damaging than helpful to patients. The term anti-psychiatry was coined in 1912, and the movement emerged in the 1960s, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historical critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive therapy and insulin shock therapy. The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of whom agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.

Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorders. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt. The first significant foray into psychosurgery in the 20th century was conducted by the Portuguese neurologist Egas Moniz who, during the mid-1930s, developed the operation known as leucotomy. The practice was enthusiastically taken up in the United States by the neuropsychiatrist Walter Freeman and the neurosurgeon James W. Watts who devised what became the standard prefrontal procedure and named their operative technique lobotomy, although the operation was called leucotomy in the United Kingdom. In spite of the award of the Nobel prize to Moniz in 1949, the use of psychosurgery declined during the 1950s. By the 1970s the standard Freeman-Watts type of operation was very rare, but other forms of psychosurgery, although used on a much smaller scale, survived. Some countries have abandoned psychosurgery altogether; in others, for example the US and the UK, it is only used in a few centres on small numbers of people with depression or obsessive-compulsive disorder (OCD). In some countries it is also used in the treatment of schizophrenia and other disorders.

<span class="mw-page-title-main">Lobotomy</span> Neurosurgical operation

A lobotomy or leucotomy is a discredited form of neurosurgical treatment for psychiatric disorder or neurological disorder that involves severing connections in the brain's prefrontal cortex. The surgery causes most of the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain, to be severed.

<span class="mw-page-title-main">Alprazolam</span> Benzodiazepine medication

Alprazolam, sold under the brand name Xanax and others, is a fast-acting, potent tranquilizer of moderate duration within the triazolobenzodiazepine group of chemicals called benzodiazepines. Alprazolam is most commonly prescribed in the management of anxiety disorders, especially panic disorder and generalized anxiety disorder (GAD). Other uses include the treatment of chemotherapy-induced nausea, together with other treatments. GAD improvement occurs generally within a week. Alprazolam is generally taken orally.

Orthomolecular medicine is a form of alternative medicine that claims to maintain human health through nutritional supplementation. It is rejected by evidence-based medicine. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. Treatment for disease, according to this view, involves attempts to correct "imbalances or deficiencies based on individual biochemistry" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids. The notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective for chronic disease prevention; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.

<span class="mw-page-title-main">Bupropion</span> Medication mainly used for depression and smoking cessation

Bupropion, formerly called amfebutamone, and sold under the brand name Wellbutrin among others, is an atypical antidepressant primarily used to treat major depressive disorder and to support smoking cessation. It is also popular as an add-on medication in the cases of "incomplete response" to the first-line selective serotonin reuptake inhibitor (SSRI) antidepressant. Bupropion has several features that distinguish it from other antidepressants: it does not usually cause sexual dysfunction, it is not associated with weight gain and sleepiness, and it is more effective than SSRIs at improving symptoms of hypersomnia and fatigue. Bupropion, particularly the immediate release formulation, carries a higher risk of seizure than many other antidepressants, hence caution is recommended in patients with a history of seizure disorder. The medication is taken by mouth.

<span class="mw-page-title-main">Human subject research</span> Systematic, scientific investigation that involves human beings as research subjects

Human subject research is systematic, scientific investigation that can be either interventional or observational and involves human beings as research subjects, commonly known as test subjects. Human subject research can be either medical (clinical) research or non-medical research. Systematic investigation incorporates both the collection and analysis of data in order to answer a specific question. Medical human subject research often involves analysis of biological specimens, epidemiological and behavioral studies and medical chart review studies. On the other hand, human subject research in the social sciences often involves surveys which consist of questions to a particular group of people. Survey methodology includes questionnaires, interviews, and focus groups.

<span class="mw-page-title-main">Depression (mood)</span> State of low mood and aversion to activity

Depression is a mental state of low mood and aversion to activity. It affects about 3.5% of the global population, or about 280 million people of all ages. Depression affects a person's thoughts, behavior, feelings, and sense of well-being. Experiences that would normally bring a person pleasure or joy give reduced pleasure or joy, and the afflicted person often experiences a loss of motivation or interest in those activities.

<span class="mw-page-title-main">Psychiatry</span> Branch of medicine devoted to mental disorders

Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions. These include various matters related to mood, behaviour, cognition, perceptions, and emotions.

<i>Madhouse: A Tragic Tale of Megalomania and Modern Medicine</i> 2005 book by Andrew Scull

Madhouse: A Tragic Tale of Megalomania and Modern Medicine is a 2005 book by the psychiatric sociologist Andrew Scull which discusses the work of the controversial psychiatrist Henry Cotton at Trenton State Hospital in New Jersey in the 1920s.

The word schizophrenia was coined by the Swiss psychiatrist Eugen Bleuler in 1908, and was intended to describe the separation of function between personality, thinking, memory, and perception. Bleuler introduced the term on 24 April 1908 in a lecture given at a psychiatric conference in Berlin and in a publication that same year. Bleuler later expanded his new disease concept into a monograph in 1911, which was finally translated into English in 1950.

<span class="mw-page-title-main">Unethical human experimentation in the United States</span> Experiments that were performed on humans in the US that are deemed unethical

Numerous experiments which were performed on human test subjects in the United States in the past are now considered to have been unethical, because they were performed without the knowledge or informed consent of the test subjects. Such tests have been performed throughout American history, but have become significantly less frequent with the advent and adoption of various safeguarding efforts. Despite these safeguards, unethical experimentation involving human subjects is still occasionally uncovered.

Human subject research legislation in the United States can be traced to the early 20th century. Human subject research in the United States was mostly unregulated until the 20th century, as it was throughout the world, until the establishment of various governmental and professional regulations and codes of ethics. Notable – and in some cases, notorious – human subject experiments performed in the US include the Tuskegee syphilis experiment, human radiation experiments, the Milgram obedience experiment and Stanford prison experiments and Project MKULTRA. With growing public awareness of such experimentation, and the evolution of professional ethical standards, such research became regulated by various legislation, most notably, those that introduced and then empowered the institutional review boards.

Psychosurgery, also called neurosurgery for mental disorder or functional neurosurgery, is surgery in which brain tissue is destroyed with the aim of alleviating the symptoms of mental disorder. It was first used in modern times by Gottlieb Burckhardt in 1891, but only in a few isolated instances, not becoming more widely used until the 1930s following the work of Portuguese neurologist António Egas Moniz. The 1940s was the decade when psychosurgery was most popular, largely due to the efforts of American neurologist Walter Freeman; its use has been declining since then. Freeman's particular form of psychosurgery, the lobotomy, was last used in the 1970s, but other forms of psychosurgery, such as the cingulotomy and capsulotomy have survived.

Psychiatry is, and has historically been, viewed as controversial by those under its care, as well as sociologists and psychiatrists themselves. There are a variety of reasons cited for this controversy, including the subjectivity of diagnosis, the use of diagnosis and treatment for social and political control including detaining citizens and treating them without consent, the side effects of treatments such as electroconvulsive therapy, antipsychotics and historical procedures like the lobotomy and other forms of psychosurgery or insulin shock therapy, and the history of racism within the profession in the United States.

Dan Markingson was a man from St. Paul, Minnesota who died by suicide in an ethically controversial psychiatric research study at the University of Minnesota. For nearly eleven years, University of Minnesota officials defended the conduct of its researchers, despite significant public criticism, numerous news reports, and pressure for an external investigation. In March 2015, an investigation by a state watchdog agency found a number of major ethical violations in the case, including serious conflicts of interest and financial incentives, poor oversight of the study, pressure on Markingson to join the study while he was in a highly vulnerable state, and a series of misleading public statements by university officials. Shortly afterward, the university suspended recruitment into psychiatric research studies. On April 9, 2015, Charles Schulz, MD, announced his resignation as Chair of the Department of Psychiatry.

References

  1. 1 2 Mashour, G.A.; Walker, E.E.; Martuza, R.L. (2005). "Psychosurgery: past, present and future". Brain Research Reviews. 48 (3): 409–18. doi:10.1016/j.brainresrev.2004.09.002. PMID   15914249. S2CID   10303872.
  2. ↑ Casey, B.P. (Mar 2015). "The surgical elimination of violence? Conflicting attitudes towards technology and science during the psychosurgery controversy of the 1970s". Science in Context. 28 (1): 99–129. doi:10.1017/S0269889714000349. PMID   25832572. S2CID   25379245.
  3. ↑ Sachdev, P.; Chen, X. (2009). "Neurosurgical treatment of mood disorders: traditional psychosurgery and the advent of deep brain stimulation". Current Opinion in Psychiatry. 22 (1): 25–31. doi:10.1097/YCO.0b013e32831c8475. PMID   19122531. S2CID   30892980.
  4. ↑ Wessely, Simon (October 2009). "Surgery for the treatment of psychiatric illness: the need to test untested theories". Journal of the Royal Society of Medicine . 102 (10): 445–451. doi:10.1258/jrsm.2009.09k038. PMC   2755332 . PMID   19797603.
  5. ↑ Huge payout in US stuttering case – BBC News
  6. ↑ Turda, M. (2007). "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present". Social History of Medicine. 20 (3): 620–621. doi:10.1093/shm/hkm086.
  7. ↑ Washington, Harriet A. (2008). Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Knopf Doubleday Publishing Group. pp. 61, 235, 256, 349. ISBN   978-0767929394.
  8. ↑ Nelson, Alondra (7 January 2007). "Unequal Treatment. Medical Apartheid". The Washington Post . Archived from the original on 7 November 2012. Retrieved 3 March 2021.
  9. ↑ Turda, M. (2007). "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present". Social History of Medicine . 20 (3): 620–621. doi:10.1093/shm/hkm086. PMC   2575876 .
  10. 1 2 R.C. Longworth. Injected! Book review:The Plutonium Files: America's Secret Medical Experiments in the Cold War Archived 2013-01-05 at archive.today , The Bulletin of the Atomic Scientists , Nov/Dec 1999, 55(6): 58–61.
  11. ↑ "Fact Sheet on the 1946–1948 U.S. Public Health Service Sexually Transmitted Diseases (STD) Inoculation Study". United States Department of Health and Human Services. nd. Archived from the original on 2013-04-25. Retrieved 2013-04-15.
  12. ↑ "Guatemalans 'died' in 1940s US syphilis study". BBC News. 29 August 2011. Retrieved 29 August 2011.
  13. ↑ Goliszek, Andrew (2003). In The Name of Science . New York: St. Martin's Press. pp.  130–131. ISBN   978-0-312-30356-3.
  14. 1 2 Goliszek, Andrew (2003). In The Name of Science . New York: St. Martin's Press. pp.  132–134. ISBN   978-0-312-30356-3.
  15. ↑ Richardson, Theresa (2001). "Acres of skin: human experiments at Holmesburg Prison. A true story of abuse and exploitation in the name of medical science". Canadian Journal of History. 36 (1): 184–186. doi:10.3138/cjh.36.1.184.
  16. ↑ "Report on Ely Hospital. Report of the Committee of Inquiry into Allegations of Ill – Treatment of Patients and other irregularities at the Ely Hospital, Cardiff". Socialist Health Association. 11 March 1969.
  17. ↑ Milgram, Stanley (1963). "Behavioral Study of Obedience". Journal of Abnormal and Social Psychology. 67 (4): 371–78. CiteSeerX   10.1.1.599.92 . doi:10.1037/h0040525. PMID   14049516. S2CID   18309531. as PDF. Archived 2011-06-11 at the Wayback Machine
  18. ↑ Milgram, Stanley (1974). Obedience to Authority; An Experimental View . Harpercollins. ISBN   978-0-06-131983-9.
  19. ↑ Baumrind, Diana (1964). "Some Thoughts on Ethics of Research: After Reading Milgram's "Behavioral Study of Obedience". American Psychologist. 19 (6): 421–423. doi:10.1037/h0040128. S2CID   144415590.
  20. ↑ Kaplan, Robert (2009). Medical Murder: Disturbing Cases of Doctors Who Kill. Allen & Unwin. ISBN   978-1741765779.
  21. ↑ Semple, David; Smyth, Roger; Burns, Jonathan (2005). Oxford handbook of psychiatry. Oxford: Oxford University Press. p. 6. ISBN   978-0-19-852783-1.
  22. ↑ Medicine betrayed: the participation of doctors in human rights abuses. Zed Books. 1992. p. 66. ISBN   978-1-85649-104-4.
  23. ↑ van Voren, Robert (January 2010). "Political Abuse of Psychiatry—An Historical Overview". Schizophrenia Bulletin . 36 (1): 33–35. doi:10.1093/schbul/sbp119. PMC   2800147 . PMID   19892821.
  24. ↑ Katona, Cornelius; Robertson, Mary (2005). Psychiatry at a glance. Wiley-Blackwell. p. 77. ISBN   978-1-4051-2404-1.
  25. ↑ The Stanford Prison Experiment – A Simulation Study of the Psychology of Imprisonment Conducted at Stanford University
  26. ↑ "Tuskegee Study – Timeline". NCHHSTP. CDC. June 25, 2008. Retrieved December 4, 2008
  27. ↑ "New look at antidepressant suicide risks from infamous trial", New Scientist, 16 September 2015.
  28. 1 2 Anne Thompson (July 9, 2001). "Paxil Maker Held Liable in Murder/Suicide". Lawyers Weekly USA.
  29. ↑ Tobin v. SmithKline Verdict, June 6, 2001
  30. ↑ Tobin v. SmithKline Judgment, June 6, 2001
  31. ↑ Philip J. Hilts (June 8, 2001). "Jury Awards $6.4 Million in Killings Tied to Drug". The New York Times.
  32. 1 2 Draper, Robert (8 June 2003). "The Toxic Pharmacist". The New York Times Magazine . Retrieved 2 March 2021.
  33. ↑ Barnett, Antony (4 April 2004). "UK firm tried HIV drug on orphans". The Observer. Archived from the original on 11 April 2004. Retrieved 2 March 2021.
  34. ↑ Andrews, J.R. (2006). "Research in the Ranks: Vulnerable Subjects, Coercible Collaboration, and the Hepatitis E Vaccine Trial in Nepal". Perspectives in Biology and Medicine. 49 (1): 35–51. doi:10.1353/pbm.2006.0001. PMID   16489275. S2CID   25881830.
  35. ↑ GSK fined over vaccine trials; 14 babies reported dead Buenos Aires Herald 1 Aug 2012.
  36. ↑ Kirk, S. A., Gomory, T., & Cohen, D. (2013). Mad Science: Psychiatric Coercion, Diagnosis, and Drugs. Transaction Publishers. pp. 218–219.{{cite book}}: CS1 maint: multiple names: authors list (link)
  37. ↑ Elliott, Carl (September–October 2010). "The deadly corruption of clinical trials. One patient's tragic, and telling, story". Mother Jones. Retrieved 4 August 2017.
  38. ↑ "A referenced summary of the Dan Markingson case". 2012-11-23.
  39. ↑ "Markingson letter". U of M Board of Regents. November 29, 2010. Retrieved 4 August 2017.
  40. ↑ Hagan, Kate (14 August 2010). "Doctors tread ethical minefield, 21 years on". The Age. Retrieved 4 August 2017.
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