Would You Get Sick for Science?

Would you volunteer to be infected with a dangerous virus if it could help others?

It’s not just a theoretical question. Scientists often deliberately expose healthy volunteers to infections to test vaccines and understand disease. But as public trust in medical research has been undermined, finding volunteers willing to accept risks is becoming increasingly difficult.

During World War II, the U.S. military faced exactly that problem. Hepatitis was disabling a large number of American soldiers, so much so that they couldn’t fight.

Scientists understood remarkably little about the disease.

At the time, scientists didn't know there were different types of hepatitis viruses. They needed to understand how hepatitis spread, how long it took to cause illness, and why some people became much sicker than others. There was no useful animal model.

This left them with only one choice. They needed healthy human volunteers.

About 1,000 conscientious objectors, men who refused to fight on moral grounds but still wanted to serve their country, agreed to participate in hepatitis experiments. Instead of going to war, they offered their bodies to science.

Researchers told the volunteers all they knew, including suspected incubation periods and death rates. But they couldn't tell them what nobody yet knew.

Historian and bioethicist Sydney Halpern is the author of two books: Infected for Science and Dangerous Medicine: The Story behind Human Experiments with Hepatitis.

Professor Halpern told me that researchers couldn’t know what was to come.

“They didn't know that two decades or three decades later a carrier could very well develop cirrhosis or liver cancer. So, these experiments were much more dangerous than researchers at the time knew.”

That raises a troubling question: Can volunteers truly give informed consent when scientists themselves don't know all the risks?

There was another complication. Conscientious objectors faced enormous social pressure to prove their patriotism. So ethicists wondered whether they were genuinely free to say no.

Yet, decades later, Halpern interviewed two participants now in their 90s, and they wanted something understood:

“For these men, humanitarian service was really important. They were still proud of their service. They still wanted me to know that they had done this voluntarily and that it mattered to them that they had made this contribution”

And their contribution did matter. Their participation helped scientists distinguish the different forms of hepatitis A and B and understand how the diseases spread.

The lesson from those hepatitis volunteers isn't that risky research should stop. It’s that medical progress sometimes depends upon people willing to accept risk for the benefit of strangers.

We still need people willing to take risks for medical research. Studies with human volunteers have helped us understand influenza, malaria, and COVID, and they will be critical again when the next unfamiliar pathogen emerges.

— Dr. Michael Wilkes with a Second Opinion

Dr. Michael Wilkes' Second Opinion newsletter keeps you informed about what’s happening in medicine around the world — for free.
If you value this newsletter, consider donating to help keep it going.