The Exploitation of Inmates: Stateville Penitentiary Malaria Experiment By Katelyn Kalata Western Illinois University Testing on humans for the advancement of science took off during the 1940s, particularly in the United States and Europe. While German concentration camps were becoming known worldwide by the mid-1940s, they were not the only location where human testing occurred during that time period. Following World War II, the defense team in the Nuremberg Trials pointed its attention to the United States. Stateville Correctional Center, located in Crest Hill, Illinois, was one of the many institutions that used an imprisoned population to research diseases and to experiment with different forms of medical treatments and vaccines. Stateville was mentioned during the Nuremberg Trials to justify Nazi experimentation, and the ethical issues related to the “Malaria Project” are still analyzed by researchers today.1 Given the title of a “project” because of its prolonged nature and unforeseen end-date, Nathaniel Comfort is one of the several scholars who examine how this experiment was different than a typical research study.2 Another critical person mentioned throughout this essay is infamous inmate Nathan Leopold. Leopold served as a participant and as a lab assistant. He wrote an autobiography describing the experience, thus, providing scholars with an inside look of what the project looked like. Considering his perspective through reading his autobiography and while analyzing the ethics behind the experiment, it becomes clear that the impact the environment has on a person’s psyche can be profound. A significant source for the research of this essay relies on Leopold’s perspective; however, a variety of primary and secondary sources used throughout this essay 1 “On October 18, 1945, twenty-two of Nazi Germany's political, military, and economic leaders were brought to trial in Nuremberg for crimes against peace, war crimes, and crimes against humanity. For the first time in history, an international tribunal composed of the Allied countries and representatives of Nazi-occupied countries would punish the leaders of a regime and an army who were responsible for crimes committed.” “The Nuremberg Trials,” United States Holocaust Museum, https://www.ushmm.org/collections/bibliography/nuremberg-trials 2 Nathaniel Comfort, “The Prisoner as a Model Organism: Malaria Research at Stateville Penitentiary,” Studies in History and Philosophy of Science 40, no. 3 (September 2009), 9. 10.1016/j.shpsc.2009.06.007 1 further support the notion that these inmates were heavily swayed to participate due to their unique circumstances. While the experiment proved to be successful in finding a cure for the Chesson strain of malaria, the project cannot be deemed ethical with the data gathered because of the context in which consent was obtained. Although the Malaria Project was not as horrendous as the Nazi medical experiments since the inmates at Stateville were not forced into participating, the level of consent in a prison setting is compromised due to prison conditions, mental state of the inmates, and the overall unethical aspects surrounding medical experimentation on humans. WHY DID THESE EXPERIMENTS OCCUR? Records dating back to 2000 B.C. confirm that Malaria has affected a multitude of civilizations around the world with its ravaging effects on the human body. The disease is transmitted by a female mosquito that carries and injects "sporozoites" into humans and is detrimental to those who do not receive care once symptomatic.3 The invasion of this foreign species begins by invading the liver, multiplying, and “resulting in the production of many uninucleate merozoites… [that] flood… into the blood and invade [healthy] red [blood] cells.”4 The parasite quickly multiplies within the body, and an individual will begin to show symptoms a week following the initial infection. The symptoms typically include “fever with chills, headache, muscle pain, nausea, vomiting, appetite loss, and arthralgia (joint pain).”5 Severe cases of infection include having “impaired consciousness, respiratory distress, multiple convulsions, 3 Francis E.G. Cox, “History of the Discovery of the Malaria Parasites and their Vectors,” Parasites & Vectors 3, (February 2010), 2. 10.1186/1756-3305-3-5 4 Cox, “History of the Discovery,” 2. 5 “Symptoms and Severity,” Manta Ray Media, accessed March 22, 2020. https://www.vivaxmalaria.org/p-vivax/symptoms-severity 2 prostration, shock, pulmonary oedema [sic] (radiological), abnormal bleeding, and jaundice."6 The carrier of this parasite was not discovered until the 1880s which left millions of people clueless without any preventative measures and few effective treatments. Quinine became a commonly used treatment for malaria; however, its availability was limited during World War I and World War II because the United States no longer had access to the East Indies where it naturally grew.7 Scientists at this time were on the search for a synthetic form of quinine because it could be created within a lab. Malaria drastically increased the death toll during WWII; there were reportedly “eight-million man-days [lost] to the disease” in the Pacific theater of war from the deadly malaria virus.8 The University of Chicago was one of the many institutions that began searching for an antimalarial drug that could be readily available, effective, and safe. The “Malaria Project,” led by likeable and competent Doctor Alf Alving, would begin at Illinois’ Stateville Penitentiary in 1944.9 However, this was not the only institution that would employ a captive population as test subjects within the Malaria Project. Researchers used mentally ill patients at the Manteno State Hospital, Illinois, and included patients who had schizophrenia and other mental disorders as their test subjects. These individuals could not and should not have been able to consent to these experiments because they lacked the mental capacity to make decisions of that magnitude. Yet, they were the first individuals used within the Malaria Project. Karen M. Masterson, the author of The Malaria Project, suggests that the “research triangle,” featuring top-rated labs and researchers, inmates at 6 “Symptoms and Severity,” https://www.vivaxmalaria.org/p-vivax/symptoms-severity 7 Comfort, “The Prisoner as a Model Organism,” 2. 8 Barbara E. McDermott, “Coercion in Research: Are Prisoners the Only Vulnerable Population?” Journal of the American Academy of Psychiatry and the Law 41 no.1, (2013), 8. 9 Alf S. Alving, Craige Branch Jr., Theodore Pullman, Merrill Whorton, Ralph Jones Jr, and Lillian Eichelberger, “Procedures Used at Stateville Penitentiary for the Testing of Potential Antimalarial Agents,” The Journal of Clinical Investigation (May 1948), 2. 3 Stateville Penitentiary, and patients at Manteno State Hospital, would “produce the most important malaria-related drug studies of the war.”10 She acknowledges their inability to consent while recognizing the successes within the project. Stateville Penitentiary provided researchers with the optimal situation in a scientific experiment; scientists had a definite control group. According to the Malarial Research Unit from the University of Chicago’s original research plan, the test consisted of "white, male inmate volunteers in good physical health… [who were between the ages] of twenty-one to forty… whose stay in the institution was ascertained to be eighteen months or longer…"11 Following infection, Alving would be able to properly monitor and observe the results through the panopticon structure of the prison.12 After an individual was infected and received treatment, he received surveillance for at least a year.13 This situation proved to be ideal because researchers had the ability to monitor changes within their patient’s conditions. Other sources from the time period determined that using inmates did not affect the wartime economy because inmates were incarcerated and could not contribute. Comfort describes the prison population as being “indebted” to society.14 While the ethics of the Malaria Project are questionable, the experiment makes sense when considering the context of American society in the 1940s because World War II was such an important event in American culture and society. The determination to find effective preventative measures and effective treatments led to ignoring ethical “red flags.” 10 Karen M. Masterson, The Malaria Project (New York: Penguin Group, 2014), 269. 11 Alving, “Procedures Used at Stateville Penitentiary,” 2. 12 A Panopticon is “a building, as a prison or library, so arranged that all parts of the interior are visible from a single point.” “Panopticon,” Farlex, https://www.thefreedictionary.com/panopticon 13 Masterson, The Malaria Project, 329. 14 Comfort, "The Prisoner as a Model Organism,” 7. 4 THE EXPERIMENT The experiment began by selecting six inmates who were influential among the population of the prison. This was done to maximize the number of participants and to receive helpful insight and advice from those who understood the social dynamics within Stateville.15 Alving asked these inmates their thoughts regarding the experiment to help estimate the number of participants. Leopold assured Alving that he would receive enough volunteers to conduct his research. Leopold became an outstanding figure within the group as he worked alongside researchers by infecting inmates, and he would later become a test subject to try to receive a shortened prison sentence. No sources suggest that