vaccine as an example. What seems to be unassailable is that military authorities are loath to violate informed-consent standards without justification (in accordance with the Uniform Code of Military Justice) or without authorization by appropriate civilian authorities.7 Thus, DOD sought and received from FDA a waiver of informed consent for the voluntary use of some compounds during the first Gulf War. Although the waiver was controversial, especially after the war, that it was sought is noteworthy. The stated motive for the waiver request was the concern that military personnel could be exposed to agents (such as nerve gas and botulinum toxin) for which there was no approved therapy but substantial evidence in other contexts that the compounds in question could be protective. Under the Uniform Code of Military Justice, members of the armed forces are required to obey all lawful orders, including those involving medical care that may maintain or re-establish their ability to do their job. However, they are under no obligation to participate in a medical experiment.

Today, the formal procedures in place for the use of military personnel in medical experiments are at least as stringent—and probably far more stringent—than those common in industry and academe. That implies not that no abuses can occur, nor that convenient alternative frameworks (such as field testing) cannot be used to circumvent the research rules, but only that the official policies and procedures in the military are rigorous.

The IC is subject to the same common provisions of informed consent and prior review although it is claimed that no human experiments are performed by intelligence agencies. An interesting and unresolved policy dilemma is whether classified research can ever be ethically sound inasmuch as it lacks transparency, such as in the form of public accountability. For example, if a member of an ethics review board disagrees with a majority decision involving a classified human experiment, that member would be unable to engage in a public protest of that decision.

A contemporary problem is the status of detainees at military installations who are suspects in the war on terrorism.8 Presumably, the ethical standards that apply to all human research subjects should apply to them as well. But if they are not protected by the provisions of the Geneva protocols for prisoners of war, the question would be whether as potential research subjects they are nonetheless

7

The Uniform Code of Military Justice is available from http://www4.law.cornell.edu/uscode/10/stApIIch47.html. Last accessed March 27, 2008.

8

Acts of terrorism do not in themselves imply that the perpetrators have a fundamentally different neurological constitution from other human beings. Our own social and political history is rife with examples of behavior that terrorized those who felt themselves to be potential targets—guerilla actions during the Revolution and the Civil War, racist lynchings, labor insurrections, domestic rebel movements, and presidential assassinations. Often, the perpetrators have been called radicals or anarchists rather than terrorists, but the principle is the same. Like today’s foreign terrorists, some may be attracted for many reasons to an extremist ideology, including an exceptionally rigid idealism, youthful immaturity, physical or psychological coercion, psychopathological conditions, or some combination of them. Such conditions are not peculiar to an ethnic, national, racial, or religious group.



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