Tuesday, October 26, 2010

earliest informed consent documents: Walter Reed's yellow fever experiments in Cuba

I love medical history. Here is one of the first informed consent documents.


Walter Reed was a U.S. Army physician who helped prove in 1900 that yellow fever was transmitted by mosquitoes and not by contact with people who already had the disease. It's incredible to think, but the idea that diseases were spread by microorganisms only gained traction near the end of the 19th century.

Reed and his team conducted experiments at Camp Lazear in Cuba, and required human subjects to test different infection vectors. The team created a contract for the subjects to sign.

From the Philip S. Hench Walter Reed Yellow Fever Collection:
The documents take the form of a contract between individual volunteers and the Commission, represented by Reed. At least 25 years old, each volunteer explicitly consented to participate, and balanced the certainty of contracting yellow fever in the general population against the risks of developing an experimental case, followed by expert and timely medical care. The volunteers agreed to remain at Camp Lazear for the duration of the experiments, and as a reward for participation would receive $100 "in American gold," with an additional hundred-dollar supplement for contracting yellow fever. These payments could be assigned to a survivor, and the volunteers agreed to forfeit any remuneration in cases of desertion.

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