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 Jewish Chronic Disease Hospital Cancer Study The Jewish Chronic Disease Hospital Cancer Study was a study performed in 1963 by Chester M. Southam at the Jewish Chronic Disease Hospital in Brooklyn, New York, in which 22 elderly Jewish patients were injected with live cancer cells in order to study the immune response of healthy individuals dosed with cancer cells. The study eventually became a scandal and is a considered a definitive example of unethical medical research, particularly for its lack of informed consent1.

The Study Chester M. Southam, was a distinguished research-physician from the Sloan-Kettering Institute of Cancer Research. Southam had previously injected healthy prison inmates from the Ohio State Penitentiary with living cancer cells in an attempt to gauge the immune response of healthy human beings to cancerous tissues. In 1963, Southam had decided to determine whether a previously established immune deficiency seen in cancer patients was caused directly by the cancer or was a side effect of their overall debilitated condition. Southam selected the Jewish Chronic Disease Hospital (JCDH) for his study and chose to inoculate 22 elderly, infirm and debilitated patients at the hospital with live cancer cells and then to gauge their immune response afterwards. Based on previous studies of some 600 research subjects, Southam firmly believed that all of cancer cells injected into the patients would eventually be destroyed by their immune systems, the only question being time. Using the rational that the study posed no risk to the patients, Southam concluded that informing the elderly patients they would be injected with cancer cells would only distress them and withheld that information. Southam instead informed the elderly patients only that their immune system was to be tested, but not that they would be tested with cancer, nor that the testing was part of a research study. When asked to assist in Southam’s research, several staff physicians at the hospital refused on grounds that valid informed consent could not be acquired from the elderly patients, many of whom had poor English and suffered from dementia or dementia-like conditions that made understanding what they were consenting to nearly impossible. Southam continued with the research regardless of the refusal of the staff physicians and had 22 individuals injected with cancer cells. The physicians soon after resigned from the hospital in protest. A Grievance Committee made up of senior management from JCDH was formed to evaluate the situation and eventually accepted the resignations of the physicians and fully endorsed Southam’s work2.

Scandal Breaks Prompted by complaints from the resigned physicians and a lone member of JCDH’s Board of Directors, William Hyman, the New York Board of Regents established a second Grievance Committee in 1965 to assess wrongdoing on part of Southam. They assessed Southam’s actions in the study, largely as to whether or not they met requirements for informed consent required by the Nuremburg Code2. Repercussions Southam was found guilty by the committee of fraud, deceit and unprofessional conduct in the practice of medicine. The committee sentenced Southam to have his medical license placed on probation for 1 year. The doctors who had refused to cooperate with Southam were expelled from the American College of physicians for their “irresponsible” resignations, though this decision was ultimately overturned. William Hyman, the JCDH board member who had pressed to have Southam’s actions assessed by a Grievance Committee, was denied re-election to the JCDH board of Directors the following year, despite having helped found the hospital in 1954. Despite being found guilty of unprofessional medical conduct, Southam was elected president of the American Association of Cancer Research in 1968. The Jewish Chronic Disease Hospital changed its name to Kingsbrook Jewish Medical Centre in 19683 and exists to this day. No long term side effects were seen to persist in the elderly patients involved in Southam’s cancer study. The case of Southam’s cancer injection study at JCDH was immortalized in Henry Beecher’s 1966 landmark paper in the New England Journal of Medicine which outlined a series of unethical medical research studies4. Since that time, Southam’s study has come to be recognized as one of the many scandals that eventually led to large scale changes in how medical research ethics codes are operated and enforced.

See Also 	Human experimentation in the United States 	Tuskegee Syphilis Study 	Willowbrook State School

References 1. Hornblum A.M. (1998) “They’re Dropping Like Flies Out Here!” Acres of skin. London, Great Britain. Routledge.

2. Emanuel, Ezekiel J., Arras, J.D. (2008) The Jewish Chronic Disease Hospital Case. The Oxford Textbook of Clinical Research Ethics. New York, New York. Oxford University Press.

3. http://www.sgu.edu/school-of-medicine/affiliated-hospitals.html

4. Beecher, H. K. (1966) Ethics and Clinical Research. New England Journal of Medicine 274:24 pp. 1354-1360