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Nasion Chamoru: The Verdict: No Harm, No Foul.(Report of the Advisory Committee on Human Radiation Experiments)
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THE VERDICT: NO HARM, NO FOUL.
(Report of the Advisory Committee on Human Radiation Experiments)

(Bulletin of the Atomic Scientists)

A national panel says that thousands of men, women, and children were dosed with small amounts of radiation, to little lasting effect. Nonsense, say the critics.

After 18 months spent examining the records of 4,000 human radiation experiments and hundreds of intentional radiation releases, a 14-member "national ethics commission" found that only a few hundred people should get medical notification, compensation, or even a personal apology from the federal government. The committee concluded that most of the tens of thousands of subjects cannot be identified or came to little physical harm, although the ethical costs of these experiments were high.

Between 1944 and 1974, the federal government authorized and funded experiments to test the effects of radiation on humans. According to the report of the Advisory Committee on Human Radiation Experiments, released in October, the majority of research involved radioisotopes used as tracers to "map" human metabolism, with no harmful effect: "Often nonbeneficial experiments on unconsenting patients constituted only minor wrongs. Often there was little or no risk to patient-subjects and no inconvenience."

But some of the details found in 840,000 pages of documents collected by the committee clash with this overall assessment, according to critics of the report. For example, institutionalized children and adult prisoners were used in experiments, some cancer patients died after being given total body irradiation with no medical benefit, and 410 uranium miners died of lung cancer from a radon hazard that could have been avoided.

The committee was established in January 1994 by Energy Secretary Hazel O'Leary, shortly after the Albuquerque Tribune revealed that 18 people had been injected with plutonium in a secret Manhattan Project experiment begun in April 1945. The Tribune series won a host of awards including a Pulitzer Prize and captured the public's attention.

President Bill Clinton, members of Congress, and even critics of the committee's report agreed that it provided unprecedented insight into a murky area of American history. But activists are up in arms over the committee's "no harm, no foul" recommendations. They question why so few people will receive any notification or apology, why others will not be given compensation, and why certain subjects of radiation experiments were left out of the committee's consideration.

Instead of closing this ugly chapter in America's atomic history, "The committee's report constitutes a continuing conspiracy to conceal the facts," said David Egilman, a clinical assistant professor of medicine at Brown University. According to E. Cooper Brown of the Task Force on Radiation and Human Rights, a coalition of 30 organizations representing citizens exposed to radiation, "We refuse to accept the committee's conclusion that, for those who were put at risk, a warning would be of no benefit. These are the very kinds of determinations and judgments that made the radiation experiments possible in the first place."

American ethic

The experiments occurred at "one of those times in history in which wrongs were committed by very decent people who were in a position to know that a specific aspect of their interaction with others should be improved," the committee concluded. It praised the goals of the investigators: "The seeming likelihood that atomic bombs would be used again in war . . . meant the country had to know as much as it could, as quickly as it could."

But the means the radiation investigators used were another story. As far back as the 1940s, officials with the Atomic Energy Commission (AEC), Defense Department, and other agencies involved, should have known better, the report said: "So many of the ideas and values with which we are familiar were apparent then."

Under the Nuremberg Code of Medical Ethics adopted in 1949, researchers were required to get consent and could not conduct experiments in which the harm outweighed the potential benefit to an individual. The committee found "no evidence that any government statement . . . contained a provision permitting a waiver of consent requirements for national security reasons."

But researchers were rarely held to, or even informed of, these policies. For example, a stack of copies of the Nuremberg Code was found in Defense Department files, all stamped "top secret." Some doctors did not seek consent from sick patients because they viewed their experiments as justified medical tinkering. Even when there was no prospect of medical benefit, it was common for researchers to conduct experiments without patient consent.

While the committee could not determine if there were "systematic injustices" against certain groups, it found that "ethically troubling [experiments] were conducted on institutionalized children, seriously ill and sometimes comatose patients, African-Americans, and prisoners."Testimony before the committee showed that the poor were seen as appropriate subjects because, as Paul Beeson, a professor at Emory University in the 1940s, said, "We were taking care of them, and felt we had a right to get some return from them, since it wouldn't be in professional fees and since our taxes were paying their hospital bills."

Perhaps most important, the committee found that hiding experiments from subjects was simply the norm. While national security was often used as a justification, secrecy had more to do with "concern for embarrassment to the government, potential legal liability, and concern that public misunderstanding would jeopardize government programs." In some cases, secrecy lasted to the present day. About 250 intentional radiation releases near a Pueblo reservation in New Mexico between 1944 and 1961 were not made public until 1994.

That secrecy had devastating results for science, according to Jackie Kittrell, one of the founders of the American Environmental Health Studies Project and a lawyer representing about 200 women who accuse Vanderbilt University of giving them radioactive iron in what was called a "cocktail." She argued that legal and insurance concerns subverted medical findings: "A veil of secrecy was lowered over the medicine and science of radiobiology. The potential knowledge of that period was warped, subverted, and lost."

What harm done?

The committee found that most of the experiments involved radioactive tracers that caused little harm. In a few non-therapeutic tracer experiments with children, however, "Radioisotope exposures were associated with increases in the potential lifetime risk for developing cancer that would be considered unacceptable today." In some cases, "Patients died soon after receiving external radiation or radioisotope doses in the therapeutic range that were associated with acute radiation effects."

In the 1940s and 1950s, injections of radioactive isotopes, including plutonium and uranium, were given to more than 40 people to learn about the occupational dangers facing nuclear workers. The risks from these experiments were supposed to be low, since most of the people given injections were considered very sick. In fact, some patients had the potential to--and did--live more than 10 years. A few University of Rochester subjects injected with uranium isotopes were suffering from no more than alcoholism or malnutrition.

And the occasional choice of relatively healthy people may not have been accidental: "Although this protocol specified cancer patients as potential subjects, evidently the deliberate choice was made later by the experimenters to select patients without malignant diseases in the hope of ensuring normal metabolism," the committee said. "The uranium injections at Rochester were designed to produce detectable minimal harm--that was the endpoint of the experiment."

The government also sponsored 30 years of total body irradiation experiments. In the early years, total body irradiation was thought to be a legitimate treatment for cancer. But "dual-use" experiments continued even after evidence was found that other treatments were more effective--and less risky. "There was no indication that the army reviewers considered whether any therapeutic benefits to the patients outweighed the risks that the TBI treatments might pose," the committee said of one series of treatments. Total body irradiation "may have contributed to the deaths of at least eight and as many as 20 patients," according to contemporaneous reports.

Prisoners and institutionalized children were targeted in some radiation experiments. The committee found that 11 of 21 research projects they reviewed "exposed children to much higher risk than is acceptable today," partly because of an inadequate understanding of radiation. One of these experiments involved small amounts of radioactive substances with no medical benefit given to institutionalized mentally retarded children at the Fernald State School in Massachusetts. Between the late 1940s and 1961, researchers manipulated these children into participating in experiments by offering special treats like extra milk, occasional outings, and membership in a "Science Club."

In addition to medical experiments, government contractors released radiation into the environment on hundreds of occasions between 1944 and 1968, mostly around the nuclear weapons complexes where residents already were subject to numerous unintentional releases. The committee found that the scientists responsible knew intentional releases carried risks.

In the infamous 1949 "Green Run" release, radioactive gas was deliberately and secretly discharged from the Hanford site in Washington state. It is unlikely that the Green Run killed anyone, but it did increase the incidence of thyroid disease, including cancer. The committee added that the fact there was little harm was a matter of luck, not planning: "In 1949, at the time the Green Run was conducted, the most important environmental pathways for human exposure to radioiodine were unknown."

The committee also looked at the effects on uranium miners of exposure to naturally occurring radon. The miners were not part of a traditional experiment, but the committee concluded that in the 1950s, the AEC did not inform the miners of the hazards of this exposure or require ventilation systems to protect them, while collecting data on their health. This "intergovernmental buck passing and decades of study . . . resulted in the premature deaths of hundreds of miners." The committee added, however, that there was not "enough information to assess the moral responsibility of individual AEC and PHS [Public Health Service] employees and officials for these failures." By 1990, 410 of the 4,100 miners studied had died of lung cancer. Normally, only 75 lung cancer deaths would be expected in a group of miners this size.

Mostly harmless

"Damage is measured in the pain felt by people who believe that they or their loved ones were treated with disrespect for their dignity," according to the committee.

But this kind of damage alone does not warrant medical follow-up or financial compensation under the committee's recommendations to Congress. None of these recommendations, however, bar individuals from seeking compensation from private institutions or state government--if they learn of their exposure.

The committee concluded that to be eligible for medical notification from the government, a person must have an increased lifetime risk of dying from radiation-induced cancer of more than one in 1,000 (compared to the normal lifetime risk of 220 per 1,000).

One group exceeded this level of risk. Between half a million and 2.3 million schoolchildren throughout the country, according to the Centers for Disease Control and Prevention, were part of nasal radium experiments or received these treatments between 1945 and 1965 for ear and adenoid infections. The committee estimated they would have a 4.35 per 1,000 lifetime risk of incurring deadly tumors to the central nervous system--a 62 percent increase over the normal risk. Using these numbers, Stewart Farber, a consulting scientist and organizer of the Radium Experiment Assessment Project, concluded that between 2,368 and 10,241 people would die of cancer from this exposure.

But these subjects should not be notified because, according to the committee, they would not benefit medically from early detection and treatment of their cancers: "At greatest risk are the brain, and head, and neck tissues, for which there is neither an acceptable nor recommended screening procedure." Thus, the committee concluded there was "no subject of biomedical experiments for whom there is a need to provide active notification and medical follow-up for the purpose of protecting their health."

Subjects of other experiments will at least hear from the government--if their names are found. For the subjects of intentional releases and the uranium workers, the committee recommended changes in existing environmental exposure compensation laws to include additional subjects and diseases.

A select few should get personal, individual apologies and financial compensation, regardless of whether they suffered physical harm. This group includes the families of 18 people who received plutonium injections in the experiments described by the Albuquerque Tribune; one woman--known only as CAL-Z-who received a zirconium injection in 1948; and several who received total body irradiation during World War II. These people were singled out because the committee found conclusive evidence that the government kept information secret from them for the express purpose of avoiding embarrassment and liability. Only the identities of those who received plutonium are known.

Other individuals would be eligible for apologies and financial compensation--medical expenses and related harms--if they met two requirements: if they suffered physical harm, and if the experiments were misrepresented as conventional treatments or had no direct medical benefit. Some of the people that may meet these requirements, but will have to prove it in court, are the subjects of total body irradiation, iodine 131 and uranium injections, and a group of prisoners who received testicular irradiation.

The committee was divided on what to do about other experiments with no medical benefit and no physical harm. Early drafts of the report included recommendations that individual apologies be offered as "a symbol of the country's expression of regret to all others who were similarly situated but who may not now be identifiable." But three committee members did not support this recommendation.

In the end, the committee agreed to recommend apologies in cases where people were unjustly selected as subjects or there was clear and conclusive evidence they did not give consent. Under these requirements, only the Fernald children, prisoners, and some people who received radioactive injections will receive individual apologies.

The committee added that there are probably many other groups that deserve apologies, but "experiment-specific factual support is not currently available." Instead, they will have to settle for President Clinton's October 3 speech, which included a general apology to all subjects and to the American public.

Not far enough

Even before the committee's recommendations were released, critics attacked its decision to base compensation on the consequences of experiments rather than ethical transgressions. Under the committee's notion of harm, "If the government shoots someone and misses, they are under no obligation to apologize for the shooting. The bullet must have hit and seriously injured or killed someone in order to elicit an apology," Egilman of Brown University said. Plaintiff lawyer Leonard Schroeter called the recommendations a sellout that will result in the "betrayal of hundred of thousands of victims of radiation experiments," and decrease "confidence in an already beleaguered government."

In addition to dismissing many human rights claims, the committee did not consider precedents for compensation for non-physical harm or a legal theory for compensation based on the "rental" of an experimental subject's body, Anthony Roisman of the Human Experiment Litigation Project said. The committee report "essentially holds no one responsible or accountable for their actions," said Brown of the Task Force on Radiation and Human Rights.

"The government still is making decisions from its pocketbook, and is scared to look too deeply," lawyer Kittrell said. But Washington attorney Kenneth Feinberg, a member of the committee, defended the decision to limit compensation in a Washington Post op-ed piece. "These recommendations deserve consideration both by the public and policy makers all too eager to find wrongdoing and write a blank check to the victims.... The mere possibility of compensation breeds a proliferation of grievances--real and imagined."

Roisman argued that by limiting the possibility of compensation, the committee is "dispensing justice by political committee." The federal government is protected from lawsuits by sovereign immunity. "Whether by congressional act or executive order, justice requires that this shield be set aside, for it is only through the court-sanctioned discovery process that individual experiment victims and their families will finally gain access to the full truth," Brown said.

Sen. John Glenn, an Ohio Democrat, was more concerned with the lack of medical monitoring offered to subjects. "It seems to me that the government has a moral and ethical responsibility to provide health tests and monitoring to those people involved in these experiments--even if the risk of cancer is infinitesimally small," he said.

Brown University's Egilman also disagreed with the committee's decision to assess harm by looking at deaths rather than illness, and to notify only those people with a more than one in 1,000 increased risk of dying: "Given the committee's guidelines, a government experiment on 50,000 people attending a football game which is expected to cause 50 deaths is an acceptable form of covert experimentation." He compared this to Environmental Protection Agency standards for regulating hazards with risks of one in 100,000. "The committee's report will set risk assessment and regulatory efforts back several decades," he said.

Egilman added that by not providing notification and medical follow-up, the government has shifted the burden of proof to subjects, while refusing them necessary epidemiological studies. "The Nuremberg Code states ,the duty and responsibility for ascertaining the quality of consent rests upon each individual who initiates, directs, or engages in the experiment,'" he pointed out.

Other critics questioned whether the scientific knowledge to make decisions about risk is even available. Lawyer Kittrell argued that the committee recognized that government fear of litigation "led to the scientific and medical process not having integrity. But then it buys into the results of this distorted process without doing the necessary follow-up."

The issue of medical notification was particularly contentious for the subjects of nasal irradiation. Lorraine Marin, a board member of the North American Brain Tumor Coalition and a radiation oncologist, said although there is no cheap or simple screening tests for brain, head, and neck cancers, "there is a medical benefit to people knowing if they were subject to nasal radiation. They could alert their doctors and get more complete checkups." She added: "Ideally the government should sponsor an epidemiological study."

Geoffrey Sea, director of the Atomic Reclamation and Conversion Project, added that the increased risk to these children is actually much higher than the committee's estimate of 62 percent. "This estimate is just for brain cancer. The committee ignored the risks of thyroid, nasopharyngeal, and other cancers," he said.

Left out

The committee said that its "ability to review all the experiments and [intentional] releases was limited not only by time and resources, but even more so by the information available. For the majority of experiments identified, only the barest descriptions remain." But plaintiff lawyer Schroeter provided a different explanation: "It turned out to be a potential Pandora's box, [and] political expediencies appear to be prevailing."

Sea said that particular experiments were marginalized by the committee "because it was impossible, given the overwhelming evidence, to say they caused no harm." These experiments include the University of Cincinnati total body irradiation experiments--implicated in eight deaths--in which the committee refused to review the available medical records. In addition, the committee commissioned its own study of the doses given to fetuses at Vanderbilt when faced with an 1967 AEC epidemiological report that showed three children died of radioiron-induced cancers. "They couldn't accept the conclusion of harm, so they tried to make something out of the incomplete dosimetry data," Sea said.

Farber of the Radium Experiment Assessment Project contended that the committee ignored the 7,000 military personnel who received nasal irradiation in the 1940s for pressure-related ear problems. The committee originally contended they were not part of an experiment, although a February 1994 internal navy memo said that the initial use of radium on submariners was considered humansubject research. In the end, the committee said some of them were part of an experiment but they "did not attain our arbitrary 1/1,000 criterion for risk."

Jack Geiger of the City University of New York Medical School criticized the committee for focusing on intentional releases of radiation into the environment while ignoring the more common routine releases. He argued that these, too, were "experiments on public health without public awareness." He added that nuclear weapons plant and cleanup workers are the subjects of experiments in their daily work: "To put workers in situations of risk without information on the effects constitutes an experiment."

Kittrell, who has done archival work in the human radiation experiment field, said the committee could have identified more individuals. "Many of the names are out there, in the possession of private institutions. The government has not made the right effort to get at these names."She noted that Vanderbilt University has the names of about 400 women involved in radiation studies, which it has refused to release. "The committee should have been given subpoena power so it could have ordered private organizations to release information."

But Dan Guttman, the committee's executive director, said while the committee found few names, it opened thousands of records to the public. "We are making a database available, and the search for names will be a bottom-up rather than a top-down operation, which is the only practical way," he said. In addition to this database, the committee recommended that CIA records on human experiments become top priority for declassification. While it found no evidence of CIA-sponsored radiation experiments, "numerous documents, some of which remain partially classified, make reference to possible CIA interest in this area," the committee said.

The right committee?

For some critics, the shortcomings in these recommendations reflect the biases of the committee. Their backgrounds "interfered with their ability to objectively analyze the historical evidence," Egilman of Brown University said. Sea of the Atomic Reclamation and Conversion Project pointed out that there were no subjects of experiments on the committee, although the inclusion of a representative from the most affected community is a requirement for many presidential committees. The committee also had only one biostatistician and no epidemiologist: "It was heavily weighted toward radiation biologists, oncologists, and lawyers. It was weak in terms of public health," said David Rush, head of the epidemiology program at Tufts University.

"I have a suspicion that at root, there was too much deference to the experiment industry by this committee," Roisman of the Human Experiment Litigation Project said. Four of the committee's 14 members were from institutions where human radiation experiments were, and may still be, carried out. For example, committee chair Ruth Faden is director of the Bioethics Institute at Johns Hopkins University. In the 1940s, Johns Hopkins trained "the Army and Navy doctors who performed the initial experiment and popularized the radium nasal irradiation procedure," Farber wrote in a letter to Faden.

In addition, committee member Henry Royal co-authored two studies on the health effects of Chernobyl with Eugene Saenger, the chief researcher behind the total body irradiation experiments at the University of Cincinnati. Royal acknowledged this connection, but explained in a letter to Faden that they did not work together on the project and had only limited social interaction. The committee did not ask Royal to recuse himself from reviewing the Cincinnati experiments.

Committee Executive Director Guttman called the charges against these members scandalous. "The fact of the matter is that all experts in this field have some affiliation with some institute being investigated. " Noting that the committee devoted a great deal of its time, and much criticism, to the research being done today with human subjects (see "Experimentation Continues," page 36), he said, "If there was a conflict for these people, they wouldn't have criticized current research at their own institutes."

Perhaps the most intense criticism was directed at committee member Feinberg, whose Washington law firm specializes in mediation and negotiation. Sea of the Atomic Reclamation and Conversion Project said that in the committee's public hearings, "Royal and Feinberg worked as a team. Royal the scientist would declare there was no harm, and Feinberg the lawyer would say well then, nothing need be done."

Feinberg was the settlement negotiator in the Agent Orange mass tort case. The case was settled in 1984 for $180 million or an average settlement for total disability or death of less than $5,000 per person, Washington-based public interest attorney Rob Hagen said. Schroeter, in a 1994 article for the Gonzaga Law Review, said Feinberg was "instrumental in disposing for a pittance, the claims of more than two million Vietnam veterans who had been exposed to Agent Orange." Tod Ensign, director of the veteran's group Citizen Soldier, told a House Veterans Affairs Subcommittee shortly after the committee was named, "There is a deep suspicion that [Feinberg] has been placed on the panel so that, once again, he can minimize the assistance provided to ailing veterans."

While a member of the committee, Feinberg sent a letter to San Francisco law firm Leiff, Cabraser & Heimann, which is representing the Vanderbilt subjects, offering his services as a mediator in their class action case against Vanderbilt University. Feinberg said offering his services in this human radiation case "does not present a conflict" because the negotiation would be non-binding and he would be willing to do this work for free. He has not received a response from the Vanderbilt lawyers.

The right thing

President Clinton accepted the committee's report in a White House ceremony on October 3. In his remarks he said--five times--that America must "do the right thing".for the subjects of radiation experiments. "Our greatness is measured not only in how we so frequently do right, but also how we act when we know we've done the wrong thing; how we confront our mistakes, make our apologies, and take action."

The committee no longer has the authority to decide what should be done for these people. Eighteen months and 925 pages later, its offices are closed and phones disconnected. And the subjects of human radiation experiments now look to Congress, which is expected to take up some of the committee's recommendations this year, to do the right thing.

RELATED ARTICLE: Experimentation continues

Human radiation experiments are not merely a relic of America's Cold War past. Approximately $3.5 billion a year is still spent on human-subject research--radiation and other--conducted or supported by the departments of Defense, Energy, Health and Human Services, and Veterans Affairs, as well as NASA and the CIA.

The Department of Health and Human Services is the biggest sponsor of human-subject research, including diagnostic procedures using radiation. The CIA's continued involvement in human-subject experiments was revealed for the first time in the committee's report. The CIA told the committee that a senior staff physician devotes four hours a month to human-subject protection activities and the CIA approved 12 human-subject experiments, none involving ionizing radiation, between 1988 and 1993.

The committee did not find gross violations of human rights in any of the current experiments, but it concluded that there are "serious deficiencies in some parts of the current system. These deficiencies are of a magnitude warranting immediate attention."

After reviewing 125 recent research projects, the committee reported that 34 percent have no ethical problems and 14 percent have serious deficiencies. About 29 percent of the studies that put people at "more than minimal" risk were considered at the low end of ethical acceptability. Fewer ethical problems were found among the radiation studies, possibly because their review process includes additional layers of scrutiny.

The committee's main concerns were the old issues of informed consent and questionable recruitment procedures. Even after all these years, some consent forms do not include explicit descriptions of risks and alternatives. Committee member Jay Katz said that his evaluation showed informed consent was not adequate in 50 percent of more-than-minimal-risk studies and an additional 24 percent have some ethical problems.

The committee recommended adding additional layers of protection, particularly for classified research. Today, for research that involves minimal risks, local review boards can "waive any or all elements of informed consent if, among other things, it is not practicable for the research to be carried out without such a waiver." The committee said that informed consent should be required for all human subjects of classified research, and an independent panel of non-governmental experts with security clearance should review all classified research proposals.

Another area of continued concern were environmental releases: "Events that raise the same concerns as the intentional releases . . . could still take place in secret under current environmental laws and regulations, "the committee found. Although today's environmental regulations apply to secret programs, the government still invokes national interest exceptions to avoid these constraints. "An exception under the Atomic Energy Act could still be invoked today.... Once the exception is invoked, there is no formal limit on the risks to which members of the public may be exposed."

But the committee did not recommend banning all secret controlled releases. Instead, it said an independent review panel that reports to Congress should be established with the necessary security clearances to review all classified research. Some question this recommendation. David Rush, head of the epidemiology program at Tufts University, called this recommendation "unconscionable." "I can't imagine any circumstances where these releases are justified," he said. But Steven Aftergood of the Federation of American Scientists, while not endorsing the decision, pointed out that the committee may have decided to regulate rather than prohibit such releases for fear that a prohibition would drive them underground. Sen. John Glenn said he believes that a "legislative solution may be necessary with regard to the so-called ,planned-releases.'"

On October 3, President Bill Clinton announced the formation of a National Bioethics Advisory Commission to look into these proposals and to supervise a review of human subject protections in all federal agencies. Members of the commission have not yet been named.

RELATED ARTICLE: More information

While no federal agency is responsible for investigating individual cases of human radiation experimentation, most documents collected by the committee will be available to the public at the National Archives in Washington, D.C. Some documents are available on the World Wide Web at the Presidential Advisory Committee on Human Radiation Experiments site (http://www. achre.gov) and the Energy Department's Office of Human Radiation Experiment's site (http://www.ohre.doe. gov). Copies of the report can be ordered from the Government Printing Office for $44 by calling 202-512-1800 or writing to P.O. Box 371954, Pittsburgh, Pennsylvania 15250-7954. The report is expected to be published by Oxford University Press this year.

RELATED ARTICLE: Key recommendations

* No subjects need be notified or provided with medical follow-up in order to protect their health.

* Compensation and apologies should be given to about 30 people used in experiments the government kept secret to avoid embarrassment or liability.

* Compensation and apologies should be given to subjects who can prove in court they were hurt by experiments that did not offer the prospect of medical benefit.

* Apologies should be given to subjects of experiments where there is clear evidence that they did not give consent or were part of a group that was unjustly targeted.

* Existing compensation laws should be extended to cover subjects of intentional releases and more of the uranium miners.

* Current human subject protections should be extended to subjects of all secret and non-federally funded research.

* All secret intentional releases should be reviewed by an independent panel.

RELATED ARTICLE: The experiments

The committee focused on the following ethical issues and case studies involving ionizing radiation:

The use of sick patients in experiments with no medical benefit:

* Plutonium, uranium, and polonium injections between 1945 and 1957 at the Universities of Rochester, California, and Chicago; Massachusetts General Hospital; and Oak Ridge National Laboratory.

Problems when treatment and research were intertwined:

* Total body irradiation experiments and experimental therapies on sick patients between World War II and the 1970s at the M.D. Anderson Hospital and Baylor University in Houston, the U.S. Naval Hospital in Bethesda, and the University of Cincinnati.

The use of children in non-therapeutic research:

* Twenty-one separate radioisotope experiments to better understand child physiology.

* The Fernald School radioactive iron and calcium research in the 1940s and 1950s using institutionalized children.

* The Vanderbilt University study of radioactive iron in the 1940s using pregnant women.

Experiments on other vulnerable populations:

* The testicular irradiation and sterilization of 131 Oregon and Washington prisoners in the 1960s and 1970s.

* The iodine 131 experiments in the 1950s on 120 subjects in Alaska, some of whom were not familiar with modern American medicine.

Experiments in occupational settings:

* Human subject experiments on military personnel as part of atomic bomb tests including flash blindness research and tests on protective clothing.

* Uranium miners in the western United States exposed to naturally-occurring radon.

Intentional releases of radiation into the environment:

* Radiological warfare research at the Dugway Proving Ground in Utah.

* Detonation of 244 atomic bomb trigger devices containing lanthanum 140 at Bayo Canyon in New Mexico.

* The Green Run release of radioactive gases at Hanford, Washington, in 1949 to test detection equipment.

Observational research:

* Residents of the Marshall Islands, whose Pacific homeland was irradiated by an atomic bomb test in 1954

RELATED ARTICLE: The committee

Ruth R. Faden (chair), director of the Bioethics Institute at Johns Hopkins University in Baltimore, Maryland, and senior research scholar at Georgetown University in Washington, D.C.

Kenneth R. Feinberg, lawyer with Kenneth R. Feinberg & Associates in Washington, D.C.

Eli Glatstein, chair of the Department of Radiation Oncology at the University of Texas in Dallas.

Jay Katz, professor of law and psychoanalysis at Yale Law School in New Haven, Connecticut.

Patricia A. King, law professor at Georgetown University Law Center in Washington, D.C.

Susan E. Lederer, associate professor of humanities at Pennsylvania State University in Hershey, Pennsylvania.

Ruth Macklin, professor of bioethics at the Albert Einstein College of Medicine in the Bronx, New York.

Lois L. Norris, a vice president of the Omaha National Bank in Omaha, Nebraska.

Nancy L. Oleinick, professor of radiation biochemistry at Case Western Reserve University in Cleveland, Ohio.

Henry R. Royal, professor of radiology and associate director of the Division of Nuclear Medicine at the Washington University Medical Center in St. Louis, Missouri.

Philip K. Russell, professor of international health at Johns Hopkins University in Baltimore, Maryland.

Mary Ann Stevenson, assistant professor of radiation oncology at the Harvard Medical School and the deputy chief of the Department of Radiation Oncology, New England Deaconess Hospital, Boston, Massachusetts.

Duncan C. Thomas, director of biostatistics for the University of Southern California Department of Preventive Medicine in Los Angeles, California.

Reed V. Tuckson, president of Charles Drew University in Los Angeles, California.

Danielle Gordon is an assistant editor of the Bulletin. 177736992 10405J-F0096SUTB0041

This will be the year of the comprehensive nuclear test ban--or not. Chances have never seemed better to finally shut the door on nuclear testing, but the window of opportunity is small. If treaty negotiations are not finished by the middle of the year, concern about U.S. and Russian presidential elections could stop them cold. Luckily, recent U.S. initiatives have improved the prospect of early agreement.

Test ban talks began at the Conference on Disarmament (CD) in Geneva in January 1994. Progress has been slow, due mainly to the nuclear powers, inability to agree on exactly what should be banned. The United States, Russia, Britain, and France had initially sought to exempt certain lowyield nuclear tests from the treaty on the grounds that they are difficult if not impossible to detect and that they are necessary to maintain a functional nuclear arsenal. Without some level of testing, they argued, a nation's confidence in its nuclear weapons would erode.

The original U.S. proposal was to permit experiments--"hydronuclear" tests--with a tiny nuclear yield, equivalent to four pounds of TNT or less. But this proposal was not popular with Russia, Britain, or France, all of whom wanted to allow tests with higher yields. On the other hand, the U.S. position was not supported by China because it favored a ban on any test with a nuclear yield, regardless of size--although, at the same time, China favored a provision that would permit "peaceful nuclear explosions" of any yield.

In an effort to break the gridlock, the Clinton administration had to decide whether to go up or down--to adopt a position that would permit tests with yields equivalent to tens or hundreds of tons of TNT, or to recommend zero.

Finally, on August 11, 1995, after a prolonged debate within the administration, President Bill Clinton declared his support for a "true zeroyield comprehensive test ban," or CTB. This announcement ended speculation that the United States might seek a treaty that allowed low-yield nuclear tests of up to 500 tons, as the U.S. Defense Department had advocated earlier in the year (see May/June 1995 Bulletin). In addition to affirming his support for a true CTB, Clinton withdrew the U.S. position in favor of allowing "hydronuclear tests." "I am convinced," said the president, "this decision will speed the negotiations so that we can achieve our goal of signing a comprehensive test ban next year."

The threshold issue had nagged at the Clinton administration for months. As Robert Bell, a National Security Council senior defense aide, explained at a White House press briefing, "We were wrestling with [an] extremely narrow contingency that between now and 10 years from now, a problem with a critical weapons type would be discovered that would be so far-reaching that if you fixed it and wanted to maintain confidence in the performance and safety and reliabili ty of the weapon, you would need to test it at least to the boost phase, which would have required [a] 500ton threshold."

The Energy Department, the Arms Control and Disarmament Agency (ACDA), the White House science adviser, and many independent experts favored zero yield. As ACDA Director John Holum told the Washington Post in June, the question was "what degree of safety and reliability are you satisfied with, given that the world has changed and the nonproliferation value of the [Nuclear NonProliferation Treaty] is substantial." ACDA argued that the goal--achieving a CTB in l996--would be doomed if the United States proposed a 500ton threshold, because none of the non-nuclear states at the talks in Geneva would go along.

On the other hand, it appeared last spring that neither Russia nor France would accept the zero-yield standard.

During the debate, Energy Secretary Hazel O'Leary focused on resolving the central technical issue: How useful would sub-kiloton tests be in maintaining the nuclear arsenal? Victor Reis, O'Leary's assistant for defense programs, commissioned the JASONs, a government panel of senior scientific advisers on defense issues, to study the matter at their 1995 summer session. The JASONs report would not be finished until late July, and the Energy Department sought to delay a decision until then.

Meanwhile, Defense Secretary William Perry caused an uproar when he told the Associated Press on June 20 that among the options the administration was considering was one that would permit tests with a nuclear yield equivalent to "several hundred tons" of TNT. Coming on the heels of France's announcement that it was resuming nuclear tests in the South Pacific, Perry's remarks created the impression that the United States and France were-acting together to torpedo the test ban. Aiming for a lower profile, the White House canceled a high-level meeting on the issue that had been set for June 23, and National Security Adviser Anthony Lake said a decision would await the results of the JASONs study.

According to senior administration officials, the international outrage that followed the French announce ment played a key role in building the case against a higher threshold. "The response to Chirac was a reality check that cannot be ignored," said one. Unless an overwhelming technical justification for, low-yield tests could be made, those arguing that the political costs of low-yield tests outweighed their utility had the upper hand.

So it was up to the JASONs. Their mandate was to look at the value of sub-kiloton nuclear tests in maintaining the safety and reliability of the nuclear arsenal. Chaired by Sidney Drell of the Stanford Linear Accelerator Center in California, this hyper-credible group included four former senior weapons designers: John Kammerdiener and John Richter from Los Alamos National Laboratory in New Mexico, Seymour Sack from Lawrence Livermore National Laboratory in California, and Robert Peurifoy from Sandia National Laboratory in New Mexico. "They provided the highlevel seal of approval," said an insider.

The JASONs concluded that lowyield testing on a continuous basis would be "tantamount to remaking a CTBT into a threshold test ban treaty. While such ongoing testing can add to long-term stockpile confidence, it does not have the same priority as the essential stockpile stewardship program . . . nor does it merit the same priority as the measures to enhance performance margins. . . . In the last analysis the technical contribution of such a testing program must be weighed against its costs and its political impact on the nonproliferation goals of the United States." On this basis, Clinton opted for zero yield.

Getting unanimous support within the administration wasn't easy, though. The Pentagon and the Joint Chiefs conditioned their approval on a number of "safeguards"--full funding for the stockpile stewardship program "over the next decade and beyond"; maintaining the weapons laboratories and the capability to resume nuclear tests; and improved treaty monitoring and intelligence-gathering capabilities. In addition, Clinton declared that, in the event that a high level of confidence in a nuclear weapon type could no longer be certified, he was prepared to invoke the "supreme national interest" clause to pull out of the treaty and conduct whatever nuclear testing might be required. "Exercising this right, however, is a decision I believe I or any future president will not have to make," his of ficial statement read.

The U.S. endorsement of zero yield gave a great boost to the CTB talks in Geneva. On August 10, the day before Clinton's announcement, France abandoned its position favoring tests up to 200 tons and declared it would support a prohibition on all nuclear explosions. France did not initially rule out hydronuclear tests, but it has since associated itself with the U.S. position. French President Jacques Chirac told Larry King in October that "France will ask no tests at all, even small ones. The zero option." In September, Britain officially adopted the U.S. position as well.

Russia got on the zero-yield bandwagon in late October after Boris Yeltsin met with Clinton in Hyde Park, New York, during the U.N.'s fiftieth anniversary celebration. The two presidents agreed to "work together to succeed in getting a zeroyield" CTB this year, according to Clinton.

Russia had been hoping to allow tests up to 10 tons and to exempt tests in contained vessels. But Moscow was not in a strong position to go it alone, and its concerns may have been met with promises of Western assistance. According to a senior Russian diplomat, Moscow believes that to maintain its arsenal it must have an expensive stockpile stewardship program like the one the United States is planning, or conduct lowyield tests. "But we cannot afford the facilities the United States is building," he said.

China is now odd man out. Although it supports zero yield in principle, Beijing still seeks allowance of "peaceful nuclear explosions." But this position may be a delaying tactic, not a genuine desire to conduct these explosions. It is not clear what, if anything, will get China to cooperate. As a result, Beijing may be a significant hurdle. The only viable strategy may be isolation--completing the treaty and putting China in the uncomfortable position of blocking consensus. Once the Conference on Disarmament approves the CTB, the other weapons states

might sign the treaty without China.

Why is China stalling? For the same reason that France was stalling before: It has a program of nuclear tests that it wants to complete before the treaty is signed. The danger is that the Chinese tests may continue beyond the time frame of the negotiations. Even if China plans to end its tests by a date-certain, unexpected results could cause delays. China recently said that it would stop nuclear testing once a CTB comes intoforce, rather than when it is signed. Depending on the agreement at the Conference on Disarmament, there could be as long as a two-year gap between signing and enforcement.

France does not have this problem. In June 1995, President Jacques Chirac announced that by the end of the following May, Paris would conduct as many as eight nuclear tests in the South Pacific. But after the international outcry against the French testing program, French leaders bent over backwards to point out that the tests will probably end well before the deadline. France has also tried to mute criticism by reducing the total number of tests to six and by agreeing to sign the South Pacific Nuclear WeaponFree-Zone Treaty (the Treaty of Raratonga) by mid-year.

If all of the weapon states agree to zero yield, they must agree on how to describe that commitment. Originally it was thought that the nuclear powers would agree on "activities not prohibited" by the treaty, such as hydronuclear tests, and that a mutual understanding would

be submitted for the record. Defining what is and what is not a "nuclear explosion"--a politically difficult task--would have been avoided.

At first glance, the zero-yield position would seem to solve the problem. If there is a nuclear yield, it is prohibited. But this interpretation would ban experiments that could involve minute fission energy releases. The Energy Department has announced that it will conduct six such

"subcritical experiments" over the next two years at the Nevada Test Site. (See "Bad Timing" on the preceding page.)

To get around the definition problem, the treaty could say that it bans all nuclear energy releases resulting from compression of a critical mass of fissile material. If this is too complicated, the best solution might be statements by the nuclear weapon states that they understand the treaty to ban all nuclear explosions, including hydronuclear experiments.

If these issues (and others, as Rebecca Johnson notes below) are resolved, the treaty could be signed this year. Getting it to that point will be a daunting task, to be sure, but not in comparison to what has already been accomplished. Moreover, the political momentum exists now as never before, helped in no small part by the response to the French nuclear tests.

The United States is pushing to have the text completed by April so that the treaty can be delivered to the United Nations next fall. Other n,ations view June as a more plausible deadline, given the procedural issues involved. But letting the talks extend past the Russian presidential election in June would be asking for trouble.

As for the U.S. ratification debate, that will be left to the next Senate and the next president. Chances are that ratification will be difficult, with the outcome dependent on factors such as Chinese nuclear testing, the status of stockpile stewardship, the political situation in Russia, and the outcome of the November elections.

RELATED ARTICLE: Bad timing

In late October, soon after the administration won kudos for endorsing a comprehensive test ban (CTB) that excluded low-yield and hydronuclear tests, the Energy Department announced plans to conduct "subcritical experiments" at the Nevada Test Site in 1996 and beyond. Although the Energy Department will try to make these underground tests transparent to outside observers, doing anything with high explosives and plutonium "underground at Nevada" is bound to create concern with nations that are suspicious of U.S. weapons activities.

And if the location of the experiments is troubling, the timing couldn't be less fortunate. Energy plans to conduct the tests in June and September of this year, and on four undetermined dates in 1997. June is the target month for finalizing a CTB treaty text, and, if all goes well, September is the tentative date for the ceremony at which the treaty would be signed. (Energy has indicated that the dates of the experiments may change, as there is no immediate need to conduct them.)

The tests would involve high explosives and fissile material. They are considered "subcritical" because, unlike nuclear tests, they do not achieve a self-sustaining chain reaction.

Experiments of this type were endorsed by the JASONs in their August report on nuclear testing, but they did not specify a location. However, when President Clinton dropped plans for the hydronuclear tests--which would have produced minuscule fission yields--these subcritical experiments were approved in their place. In fact, the facility that would have been used for hydronuclear tests--the Low Yield Nuclear Experiment Research (LYNER) facility--will now be used for subcritical experiments. Energy also announced a new, five-year, $1.5 billion deal with Bechtel Nevada Corporation to manage the test site.

According to Energy, the tests will "improve knowledge of the dynamic properties of aged nuclear materials," to better maintain the arsenal as it ages. Energy states that it was unable to attain this information from past nuclear tests, which focused on overall warhead performance. None of the planned experiments would employ a modified nuclear warhead, but Energy does not rule out the possibility of doing "bomb configuration" tests in the future. The department states that "energy from the explosion will only be that from the chemical explosive," with no nuclear energy release other than that naturally occurring from plutonium decay. This means that the tests comply with the president's zero-yield test ban policy.

The location of the tests could be changed. They could be performed in above-ground pressure vessels rather than underground--as long as it does not compromise public safety. The two tests planned for this year would use 100 pounds or less of high explosives, which, according to the department, exceeds the above-ground containment capabilities of the laboratories. But a former Los Alamos weapons scientist has said that the labs routinely contained blasts in the range of 50 pounds in the past, and 100 pounds or greater is not beyond their technological reach.

Tom Zamora Collina is the executive director of the Institute for Science and International Security in Washington, D.C.

Gordon, Danielle, The verdict: no harm, no foul.(report of the Advisory Committee on Human Radiation Experiments). Vol. 52, Bulletin of the Atomic Scientists, 01-11-1996, pp 32(9).