Question

Read The Case of Willowbrook State Hospital Case at the beginning of Chapter 12:

Willowbrook State Hospital, an institution for the cognitively impaired or mentally challenged (formerly called mentally retarded) children on Staten Island, experienced a large num-ber of infectious diseases among its patients. Conditions at the hospital were not good, and most children suffered from hepa-titis, measles, and parasitic and respiratory infections. Hepatitis, in particular, was a problem as many of the children were not toilet-trained and the disease was spread through an oral-intestinal route. Researchers determined that nearly all susceptible children became infected with hepatitis during their first year at the hospital.

Between the years 1956 and 1970, 10,000 children were admitted to Willowbrook Hospital. Of those children, almost 800 were entered into a research project to gain information about hepatitis with the hopes of eventually developing an immunization against the disease. All the parents of the children in the research project granted written consent. The children were injected with the same strain of hepatitis that was already prevalent in the hospital. The physician-researchers in charge of the project received

intense criticism for subjecting the children to the research. The researchers defended their actions by stating that:

a. The children that were used as subjects were unharmed or, at least, not made any more ill than they already were.

b. The children may have even benefitted, because they were placed on an isolated unit and thus were not exposed to the other infectious diseases.

c. The children in the study may have had a subclini-cal infection, which would render them immune to the hepatitis virus.

d. The children may have been better off as a result of the research, because the study added to the growth of information about the disease.

e. All the parents had given their informed consent.

The medical community was outraged about the experiment and raised the following objections:

a. Cognitively impaired or mentally challenged persons, especially children, should not be used for research experimentation.

b. The children are unable to defend or speak for themselves.

c. There is a greater possibility of abuse with children than with adults.

d. The parents may have been coerced to grant consent, as the hospital was full and there was only space to admit children into the hepatitis unit.

e. The experiment did not appear to be therapeutic.

f. The benefits to the hospital and the community at large were minimal.

g. The experiments were designed to confirm existing studies about the effects of gamma globulin immunization for hepatitis.

h. Researchers withheld from the nonresearch children (control group) an inoculation that may have been effective against hepatitis.

Because the 800 children were isolated from other children, they did not acquire infectious diseases prevalent at the time. Ultimately, the claim that the children in the research study benefited from the project was upheld in court.

1. In your opinion, was the injection of hepatitis virus given to these 800 children in the research project ethical because their parents gave consent and the children were apparently unharmed?

2. Who, if anyone, should have spoken out for the rights of these cognitively impaired or mentally challenged children?

3. According to the case, the court found Willowbrook State Hospital's study actually benefitted the children. Do you agree or disagree with this outcome?

Answer 1

1.A research during its process has both benefits and harms but it is very essential that always the benefits should outweigh other biases .It should cause no harm to the subjects involved ,appropriate informed consent from the person in accordance to their age ,if children,mentally disabled from parents and guardians respectively. In this case it is considered to be ethical because the childrens were not harmed and the research was conducted after the parents consent.

2.An ethical team could have spoken on behalf of the cognitively impaired children and the mentally challenged children.

3.It is a must to agree because this research has caused no harm to the children rather benefited them.It also acted as a preventative measures in the future to prevent this infection not only in children but also adults.