Research: Volunteers Behind Bars

John Richard Russell, 58, was serving a life sentence for murder in Mississippi State Penitentiary at Parchman when he developed cancer in his left lung. His right lung was also diseased, though not cancerous, and an acute kidney inflammation made it clear that he had not long to live. Not surprisingly, Russell accepted the suggestion of Dr. James Hardy that he volunteer to be the first human being to receive a transplanted lung. At the University Medical Center at Jackson, Dr. Hardy gave Russell the left lung of a patient who had just died of a heart attack.

Dr. Hardy did not expect the transplanted lung to survive indefinitely. He hoped that before the graft was rejected it would be a crutch to help Russell’s right lung recover. In fact, the surgeons were delighted to find that the transplanted lung worked with more than 98% of normal efficiency. Fortnight ago, Russell’s kidney disease killed him. But in the last 18 days of his life, he had helped to make medical history.

Variant Virus. The case of John Richard Russell was an extreme example of a widespread phenomenon: much medical progress in the U.S. owes its success to research conducted on prisoner volunteers. The Federal Government sponsors medical research in 15 of its 37 penal institutions, mostly in the bigger ones, which have their own hospitals and plenty of doctors. Usually the projects are conducted by the U.S. Public Health Service.

By far the biggest of the federal projects is at the U.S. Penitentiary in Atlanta. There, to run its malaria research, PHS has installed a staff inside the walls, with its own offices and laboratories, and a separate ward for the prisoners who volunteer to be bitten by malaria-bearing mosquitoes. World War II’s crash campaign to find quinine substitutes depended on federal prisoners.

Now, PHS researchers are confident that they have in their vials a still more significant discovery: the first long-acting preventive against malaria.

Of more immediate concern to the average man is the work at the National Institutes of Health Clinical Center in Bethesda, Md., where cons in a guarded ward are exposing themselves to the risk of Asian influenza. Here the purpose is to test the effectiveness of new vaccines that have had to be developed because the Asian flu virus of 1957-61 has been displaced by a variant strain.

Vaccination against the Asian ’57 strain gives only modest, if any, protection against Asian ’62. But volunteers who got a new vaccine developed by Dr.

Vernon Knight and his colleagues, and then took a chance on flu, did not get the disease. If these findings are confirmed in the next few weeks, PHS will recommend inclusion of the new vaccine component in flu shots to be given this fall. Eventually, it is hoped, the Bethesda group’s work with other prisoners will lead to a vaccine against the common cold.

For their pains, federal prisoners get compensation ranging from a pack of cigarettes up to $25 in cash. If a volunteer’s lot is particularly onerous or carries some risk of major discomfort, the Bureau of Prisons may give him “meritorious good time credits,” which shave a few days off his sentence.

Apart from the federal system, at least a dozen states allow prisoners to be recruited for research. The Ohio Penitentiary in Columbus has pioneered in cancer research by providing volunteers who were given injections of cancer cells. The fact that none of them developed cancer has shown that healthy people have some immunity against another person’s disease. At the Cook County Jail in Chicago, prisoners have received injections from leukemia victims. They did not get leukemia, and their serum later protected mice against the disease—another clue to the mysteries of immunity. Profit Motive. Prisoner volunteer programs sometimes get involved in ethical questions when the profit motive becomes dominant. Perhaps the nation’s biggest, the program in Oklahoma State Penitentiary at McAlester was being drastically overhauled last week for this reason. It had become a gold mine for private contractors. As the prison’s medical director for 25 years, Dr. Austin R. Stough (rhymes with scow) had made deals with pharmaceutical companies to test new drugs. From this, Stough and his partner, Dr. Cranfill K.

Wisdom, and their two companies grossed an estimated $300,000 a year.

The prisoner volunteers got small fees. Far bigger, and worth at least $700,000 a year, was a Stough-Wisdom program to supply blood plasma to commercial concerns. Its success depended on the recent finding that a man can donate blood as often as once a week, provided that only the plasma is kept and the red blood cells are promptly reinfused into his arm. Stough-Wisdom got about $15 a quart and paid the prisoners $5 a donation. The money and resulting self-respect were good for prisoners’ morale. But state officials decided that the program should not be run for private profit, and are turning it over to a research council headed by medical professors.