Johns Hopkins Magazine - April 1994 Issue

Public Policy & International Affairs

Research Findings and News: The ethics of human testing, etc.

Hopkins ethicist heads U.S. panel on radiation experiments

The U.S. Department of Energy recently tapped Ruth R. Faden, professor of health policy and management at the School of Hygiene and Public Health, to chair a committee that will examine the ethics of controversial government radiation experiments conducted from the 1940s to the 1970s.

"I've agreed to do it as a matter of public service," Faden says. "I'm challenged by the task, and humbled."

Faden, whose specialty is medical ethics, will head an interdisciplinary committee of specialists in biomedical ethics, law, history, radiation medicine, radiation biology, internal medicine, and epidemiology. The committee will examine the cases of people subjected to government-sponsored radiation experiments to determine if researchers conducted the experiments in an ethical manner. Secretary of energy Hazel O'Leary called on Faden because the professor is an expert on the crucial issue of informed consent.

O'Leary recently began disclosing information about government-sponsored research including 204 previously unreported underground nuclear tests, as well as the deliberate exposure of more than 800 Americans to nuclear material. Press reports have described additional testing that has raised disturbing ethical questions and led to hundreds of calls to a government hotline by people who claim either to have been test subjects or to be their surviving relatives.

Faden says that as the committee examines each case, there will be three crucial issues:

The committee may also be involved in deciding issues of compensation. Faden says its first and most difficult task will be to establish criteria for judging the ethics of the testing. Legal experts have pointed out that the standards of informed consent during the 1940s and 1950s were nebulous compared to modern standards.

"One part of our task is backward looking, at studies that have been done," she says. "The second part is forward looking, to minimize the likelihood that anything like this could hap- pen again." The stated life-span of the committee is one year, though Faden acknowledges that the process could take longer than 12 months. It's hard for me to judge how fast we can move," she says. "The biggest unknown is how much is out there."

Faden describes the government's efforts to reveal the full extent of radiation testing as sincere, not a public relations move to counter media reports. She points out that none of the people responsible for the testing play any part in the present administration.

"I can tell you that everyone I've dealt with is, I believe, completely sincere in a desire to put the historical record right and do right by the victims," she says. "The people in authority now really are appalled." --DK

The underground economy of life on the streets

One of the most obvious differences between Baltimore's homeless people and their counterparts in other large cities is that they are just plain hard to pick out, says Felicity Northcott, an anthropology doctoral student who spent more than two years working in the city's shelters and soup kitchens.

"There are very few people on the streets of Baltimore who fit our idea of what a homeless person looks like," says Northcott. "In places like New York and Washington, it's very obvious that there are a lot of homeless people because they fit our visual stereotype. In Baltimore, homeless people tend to be much better dressed."

The reason: large quantities of top-quality clothing, including used Brooks Brothers suits and Nike sneakers, are donated to shelters for the homeless.

Dapper street people are only one facet of a complex culture that has its own system of economics and desperate priorities, says Northcott. "People think of the homeless as being completely outside the economy, but they are not," she said. The dollars they obtain from welfare, Social Security disability, Supplemental Security Income, and unemployment insurance are an important factor in urban economics. And, she says, "food stamps keep half of the mom and pop stores going in Baltimore."

The underground economy of the streets works something like this: a homeless person sells his or her food stamps to a store owner at 60 cents on the dollar (an illegal arrangement, by the way). The store owner redeems the food stamps at full value, making a handsome profit. Meanwhile, the homeless person has a ready supply of cash.

Not only do neighborhood stores buy food stamps outright; less reputable entrepreneurs set up shop solely for the purpose of trading in food stamps.

"The price that they paid was a little bit lower than what some of the stores were paying," Northcott said. "But obviously stores can't buy everybody's [food stamps] because that looks very suspicious."

Food stamps are only one element of a monetary exchange that features constant bartering and cash flow. Other currencies include a plethora of consumer goods that are donated to shelters, such as shipments of sturdy leather work boots--an easy item to sell on the streets. The homeless hawk various kinds of donated clothing and all manner of foods, such as cheese, bread, and butter, which they receive through government surplus distributions, says Northcott.

"You can sell anything; you can buy almost anything. It's amazing how much stuff cycles through the shelter system in Baltimore," she says.

Northcott says her doctoral research underscores the resiliency of people confronted with the harshest of living conditions. "Just being able to get through the day-to-day stuff on the street indicates that you are a lot tougher than people would give you credit for," she says, referring to the depressing struggle of a lifestyle that revolves around such questions as, Where are you going to sleep? Where are you going to eat? Where are you going to go to the bathroom? Where are you going to shower? Where are you going to get clothes? Is it going to be cold? Are you going to freeze to death? --EV

Friends don't let friends bike drunk

The well-known admonition "Don't drink and drive" should be amended to include bicyclists, according to a recent study done by researchers at Hopkins's Injury Prevention Center.

Looking at bicyclists age 15 or older who died in accidents between 1987 and 1991 in the U.S., the team found that roughly two-thirds of them had been tested for alcohol use. Of those tested, 32 percent had been drinking, and 23 percent had blood alcohol concentrations (BACs) of .10 percent or higher--the legal limit for automobile drivers in most states.

"We identified an ignored field," says research associate Guohua Li, who led the study. "Drinking and driving has been a hot topic, but people know nothing about the effects of drinking behavior on biking."

Male cyclists, the Hopkins researchers found, are nearly four times as likely as females to have BACs over .10; males are also tested for alcohol more frequently. For both sexes, cyclists age 25-34 were most likely to test positive for alcohol use in a fatal crash: 48 percent of men and 26 percent of women in this age group who were tested had been drinking. Weekend and nighttime crashes were more likely to involve alcohol, Li says.

He was struck by one set of statistics in particular. In the 15-19 age group, which consists of underage drinkers only, 14 percent of the males and 16 percent of the females who were tested had been drinking.

Study co-author Susan Baker, who is co-director of the Center, believes that a lack of preventive education contributes to the problem. While emphasis is placed on teaching young drivers not to drink and drive, the effects of alcohol on cycling go ignored, she says. "Safety tips and warnings about cycling never include alcohol use."

The researchers suggest that bicyclists who die within four hours of injury should be tested for alcohol, as should seriously injured cyclists. And they conclude that alcohol regulations for motor vehicle operators should be extended to include bicyclists. --EB

How conservatives have been co-opted

Samuel Francis '69 is a conservative intellectual with a message for American conservatives: Your leaders have failed you; it's time to take your movement back.

Francis has been a syndicated columnist with The Washington Times since 1986; before that he was a legislative assistant to Senator John East for five years. In a new collection of his essays, Beautiful Losers (University of Missouri Press, 1993), Francis contends that conservative political leaders have failed to confront a political and cultural establishment estranged from the concerns of Middle America. Instead, he says, they've been co-opted by it.

He believes that the intellectual leaders of the Right are liberals at heart, or at least that they've embraced an agenda indistinguishable from that of the Left. He says that so-called neoconservative leaders like Ben Wattenberg, Norman Podhoretz, and Irving Kristol had comprised the right wing of the Democrats; when that party began to fly the banner of George McGovern, Wattenberg et al found refuge with the Right but did not abandon their essentially liberal agenda.

The result of an unchallenged liberal establishment, Francis writes, "is an economy that does not work, a democracy that does not vote, families without fathers, classes without property, a government that passes more and more laws, a people that is more and more lawless, and a culture that neither thinks nor feels except when and what it is told or tricked to think and feel." Middle Americans, he writes, "don't know what to do. They sort of sit around and stew in perpetual alienation. They don't trust either party, they don't trust mainstream religion, they don't trust the government or the news media."

What Francis prescribes is a conservative grass-roots effort to regain control of political and cultural institutions at the local level: "Conservatives now must try to rebuild their own culture. They must develop a conservative counter-culture." He blames liberal control of mass media and popular culture for closing off alternate viewpoints, and wants the Right to forget what he sees as its obsession with the presidency and instead gain control of local governments and school boards. "Conservative Americans will become players at the local level," he says, "and that eventually will influence the culture." He foresees Patrick Buchanan as a likely standard bearer; Ross Perot, he says, isn't radical enough. --DK

Written by student intern Erin Bohensky '94, Dale Keiger, and Emil Venere.

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