Henry K. Beecher
Encyclopedia
Henry Knowles Beecher was an important figure in the history of anesthesiology and medicine, receiving awards and honors during his career. His 1966 article on unethical practices in medical experimentation within the New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...

was instrumental in the implementation of federal rules on human experimentation and informed consent. A 1999 biography—written by Vincent J. Kopp, M.D. of UNC Chapel Hill
University of North Carolina at Chapel Hill
The University of North Carolina at Chapel Hill is a public research university located in Chapel Hill, North Carolina, United States...

 and published in an American Society of Anesthesiologists
American Society of Anesthesiologists
The American Society of Anesthesiologists is an association of physicians, primarily anesthesiologists, that share a common goal of raising the standard of the medical specialty of anesthesiology and the improvement of patient care by fostering and encouraging education through research and...

 newsletter—describes Beecher as an influential figure within the development of medical ethics and research techniques, though he has not been without controversy.

Life

Born as Harry Unangst in Peck, Kansas
Peck, Kansas
Peck is an unincorporated community on the Sedgwick County and Sumner County border in Kansas, United States.-19th century:In 1887, the Chicago, Kansas and Nebraska Railway built a branch line north-south from Herington through Peck to Caldwell...

 in 1904, he changed his surname to Beecher in his 20s. This change was said to be for the name recognition of influential 19th century Beechers—preacher Henry Ward Beecher
Henry Ward Beecher
Henry Ward Beecher was a prominent Congregationalist clergyman, social reformer, abolitionist, and speaker in the mid to late 19th century...

 and author Harriet Beecher Stowe
Harriet Beecher Stowe
Harriet Beecher Stowe was an American abolitionist and author. Her novel Uncle Tom's Cabin was a depiction of life for African-Americans under slavery; it reached millions as a novel and play, and became influential in the United States and United Kingdom...

. He was, in fact, unrelated to the Beecher family
Beecher family
Originating in New England, one particular Beecher family in the 19th century was a political family notable for issues of religion, civil rights, and social reform. Notable members of the family include clergy , educators, authors and artists. Many of the family were Yale-educated and advocated...

.

Education

Beecher received a BA degree in 1926 and an MA degree in physical chemistry
Physical chemistry
Physical chemistry is the study of macroscopic, atomic, subatomic, and particulate phenomena in chemical systems in terms of physical laws and concepts...

 in 1927, both from the University of Kansas
University of Kansas
The University of Kansas is a public research university and the largest university in the state of Kansas. KU campuses are located in Lawrence, Wichita, Overland Park, and Kansas City, Kansas with the main campus being located in Lawrence on Mount Oread, the highest point in Lawrence. The...

. While it had been his goal to earn a Ph.D. in chemistry at the Sorbonne
Sorbonne
The Sorbonne is an edifice of the Latin Quarter, in Paris, France, which has been the historical house of the former University of Paris...

, Henry was "persuaded" to study medicine instead. Entering the Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....

 in 1928, Beecher received research fellowships in 1929, 1930 and 1931. Beecher graduated cum laude in 1932. Two of his articles published in the Journal of Applied Physiology in 1933 earned Warren Triennial Prizes. These two articles and a study in Beecher's last year of college caught the attention of Harvard Professor of Surgery, Edward Churchill, M.D., who became his professional mentor. Post-college, he trained for two years under Churchill at Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...

. Henry traveled to Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...

 in 1935 to work in the physiology laboratory of Nobel Laureate August Krogh
August Krogh
Schack August Steenberg Krogh FRS was a Danish professor of Romani background at the department of zoophysiology at the University of Copenhagen from 1916-1945...

.

Professional work

Returning to America in 1936, Beecher was hired as Anaesthetist-in-Chief at MGH and Instructor in Anaesthesia at Harvard Medical School by Dr. Churchill. Henry became an Associate Professor in 1939 and the Henry Isaiah Dorr Professor of Anaesthesia Research in 1941—the first endowed chair in anesthesiology in America.

During World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

, Beecher served in the U.S. Army with Dr. Churchill in North Africa
North African campaign
During the Second World War, the North African Campaign took place in North Africa from 10 June 1940 to 13 May 1943. It included campaigns fought in the Libyan and Egyptian deserts and in Morocco and Algeria and Tunisia .The campaign was fought between the Allies and Axis powers, many of whom had...

 and Italy
Italian Campaign (World War II)
The Italian Campaign of World War II was the name of Allied operations in and around Italy, from 1943 to the end of the war in Europe. Joint Allied Forces Headquarters AFHQ was operationally responsible for all Allied land forces in the Mediterranean theatre, and it planned and commanded the...

. His experiences during the war in clinical pharmacology would inspire him to investigate placebo-like phenomena.

Medical ethics

As professor of anesthesiology at Harvard Medical School, Beecher published a 1966 article that drew attention to 22 examples of unethical clinical research that had risked patients' lives. Though heralded for the position of this article, he was severely criticized by the medical establishment for what was felt as an unfair generalization from a few select cases. However, this article and the subsequent Congressional investigation laid the foundation for current guidelines on informed consent and human experimentation.

Controversy

In July 2007 the public German TV-channel SWR
Südwestrundfunk
The Südwestrundfunk is a public broadcasting company for the southwest of Germany, specifically the states of Baden-Württemberg and Rhineland-Palatinate. The company has main offices in three cities: Stuttgart, Baden-Baden and Mainz, with the director's office being in Stuttgart. It is an...

 claimed that Beecher was involved as scientific expert with CIA studies on human drug experiments in the 1950s and may have contributed with his work in the United States and in secret CIA-prisons in Western-Germany to the KUBARK Counterintelligence Interrogation document of 1963. .

According to these recent reports, and also according to US-historian Alfred W. McCoy
Alfred W. McCoy
Alfred William McCoy is a historian of Southeast Asia. He is the J.R.W. Smail Professor of History at the University of Wisconsin–Madison. McCoy graduated from the Kent School in 1964. He earned his B.A...

, Dr. Beecher was scientifically responsible for human experiments with drugs (e.g. mescaline
Mescaline
Mescaline or 3,4,5-trimethoxyphenethylamine is a naturally occurring psychedelic alkaloid of the phenethylamine class used mainly as an entheogen....

) conducted by the CIA in post-war Germany. They took place in a secret CIA-prison located in "Villa Schuster" (later renamed to "Haus Waldhof") in Kronberg near Frankfurt
Frankfurt
Frankfurt am Main , commonly known simply as Frankfurt, is the largest city in the German state of Hesse and the fifth-largest city in Germany, with a 2010 population of 688,249. The urban area had an estimated population of 2,300,000 in 2010...

, which was related to the nearby US-interrogation center Camp King
Camp King
Camp King is a site on the outskirts of Oberursel, Taunus , with a long history. It began as a school for agriculture under the auspices of the University of Frankfurt. During World War II, the lower fields became an interrogation center for the German Air Force. After World War II, the United...

 (West-Germany). According to a witness, during these experiments, several interrogated individuals died. This report states that since September 1951, Beecher was frequently in Camp King
Camp King
Camp King is a site on the outskirts of Oberursel, Taunus , with a long history. It began as a school for agriculture under the auspices of the University of Frankfurt. During World War II, the lower fields became an interrogation center for the German Air Force. After World War II, the United...

 and prepared human experiments, deliberated with the interrogation-staff of the CIA (called "rough boys") and recommended the test of various drugs. Several times he allegedly met with former Nazi-physician Walter Schreiber
Walter Schreiber
Dr Walter Paul Emil Schreiber was a German military officer and brigadier-general of the Medical Service of the Wehrmacht....

 (at Camp King respectively in Villa Schuster) to an "exchange of ideas". Later Beecher described Schreiber in a report as "intelligent and cooperative."

The documents presented in the TV-documentation state that the US-army had sent reports about Nazi-experiments in concentration camps like Dachau concentration camp to Dr. Beecher for evaluation. The library of Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....

 still possesses a report of the US-army about these Nazi-experiments that it inherited from Dr. Beecher, a report which he evaluated.

According to Koch, in January 1953, a depressive patient at the New York State Psychatric Institute and Hospital got—upon recommendation of Dr. Beecher—a mescaline-injection at 9:53, fell in a deep coma at 11:45 and died within half an hour.

Placebo effect

The general literature commonly misattributes the term "placebo effect
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...

" to Henry K. Beecher's 1955 paper The Powerful Placebo. While this paper did not introduce the idea of placebo reactions (the term had been first used by Graves in 1920), its importance was that it stressed—for the first time—the necessity of double-blind, placebo-controlled clinical trials. In his 1955 paper, Beecher only speaks of placebo effects on specific occasions when he is contrasting them with drug effects. His 1955 paper constantly and correctly speaks of "placebo reactors" and "placebo non-reactors"; furthermore, Beecher (1952), Beecher, Keats, Mosteller, and Lasagna (1953), Beecher (1959), consistently and correctly speak of "placebo reactors" and "placebo non-reactors"; they never speak of any "placebo effect"; and, finally, in his Research and the Individual: Human Studies (1970), Beecher simply speaks of "placebos".

Journal articles

  • Beecher, H.K., Ethics and Clinical Research. New England Journal of Medicine. June 1966 Reprinted with commentary by Harkness, Lederer and Wikler, in Bull WHO 2001
  • Beecher, H.K., Ethics and experimental therapy. Journal of the American Medical Association 186(9): 858-9,(30 Nov 1963) (Editorial)
  • Beecher, H.K.,Sheik Adhith Experimentation in man. Journal of the American Medical Association, 1959, 169 (5): 461–478.
  • Beecher, H.K., The Powerful Placebo, Journal of the American Medical Association, Vol.159, No.17, (24 December 1955).
  • Beecher, H.K., Keats, A.S., Mosteller, F. & Lasagna, L., The Effectiveness of Oral Analgesics (Morphine, Codeine, Acetylsalicylic Acid) and the Problem of Placebo "Reactors" and "Non-Reactors", Journal of Pharmacology and Experimental Therapeutics, Vol.109, No.4, (December 1953).
  • Beecher, H.K., Experimental Pharmacology and Measurement of the Subjective Response, Science, Vol.116, No.3007, (15 August 1952).

Papers

  • Beecher HK. Ethics and the explosion of human experimentation, 1965. In the Beecher papers, Francis A. Countway Library of Medicine, Harvard University.

Books

  • Beecher, H.K., Research and the Individual: Human Studies, Little, Brown, (Boston), 1970. ISBN 0-7000-0168-9
  • Beecher, H.K., Measurement of Subjective Responses: Quantitative Effects of Drugs, Oxford University Press, (New York), 1959.

Additional sources

  • Rothman R. Strangers at the bedside: a history of how law and

bioethics transformed medical decision making. New York, Basic
Books, 1991.
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