Dr. John C. Cutler was a monster. A monster who died after a long and successful life in government and academia, with scholarships and lectures created in his memory. As readers may know, in the mid-1940s he experimented upon poor Guatemalans, including mental patients and orphans as young as nine, trying to find a cure for syphilis. The most horrifying example, already much posted on the web (I quoted it on “First Thoughts” a few days ago), is “that of a mental patient named Berta.”
She was, says the New York Times , reporting a recent hearing of the Presidential Commission for the Study of Bioethical Issues,
first deliberately infected with syphilis and, months later, given penicillin. After that, Dr. John C. Cutler of the Public Health Service, who led the experiments, described her as so unwell that she “appeared she was going to die.” Nonetheless, he inserted pus from a male gonorrhea victim into her eyes, urethra and rectum. Four days later, infected in both eyes and bleeding from the urethra, she died.
We do not know exactly how horrific were the experiments, but only because Cutler kept such poor records, and because he knew he was not supposed to be doing what he was doing and kept the experiments hidden. He was working for the government, and important people knew what he was doing in Guatemala”including the surgeon general, Dr. Thomas Parran, who noted, “You know, we couldn’t do such an experiment in this country.”
Cutler went on to work on the notorious Tuskegee experiments before becoming assistant surgeon general and then a professor at the University of Pittsburgh. And died at an advanced age, full of honors. Put not your trust in academic princes, as the psalmist could have said.
What makes what Cutler did so wrong? The members of the commission pointed almost uniformly to his failure to get the informed consent of his subjects, but what makes experimenting on people without getting their informed consent wrong? What is the ground of the developed ethical system for experimenting on human beings”a system developed through the Nuremberg trials”that the commission invoked in condemning Cutler’s work?
That is the difficult, and for the modern mainstream ethicist with certain commitments, the dangerous question. The answer would seem to be an understanding of intrinsic human dignity and the absolute integrity of the human person: that men and women are creatures who must make such decisions for themselves. And that dignity is most secure when fixed in something transcendent, something eternal and ultimate. If it isn’t, men like Cutler will do what he did, for the greater good, as he (presumably) saw it then.
Cutler’s offense wasn’t just deceiving people but treating them as people who could justifiably be deceived. His sin wasn’t just using them as means but seeing them as means. They are ends, and there are some things we cannot do to creatures who are ends in themselves. Ever. For any reason, however good, however urgent.
And this, to be fair, some members of the commission recognized. Its chairman, the University of Pennsylvania’s Amy Gutmann, said that Cutler “did not treat them [his victims] as human beings. He thought of them as material” for study. One member, the University of Virginia’s John Arras, said the researchers’ “attitude toward the Guatemalan people was pretty much what you’d expect if they were doing research on rabbits.”
Completely true. But relevant to others Gutmann, at least, would not include. The unborn human being, for example, and particularly that child in his embryonic stage. The mainstream bioethicist does not see that child as a human being, but as material for study”the diseases he wants to cure that way being as brutal as syphilis”creatures to whom his attitude is, if anything, less sympathetic than it is to the rabbits.
Arras declared that the worst parts of Cutler’s research “amounted to torture, and should be denounced no matter what historical era we’re talking about.” I have no idea what religious commitments he has, if any, but speaking publicly in a secular mode, in a press release issued by his university, he can only say in response to such evil, “The most powerful argument is to repeat a story.”
Stories can move hearts and therefore (sometimes) minds, but they do not replace a fixed moral standard, the kind of standard only religious people nowadays seem able or at least willing to provide in the public square. Stories are just stories, without a way to read them. They do not supply their own meaning. Only a fixed moral standard lets the reader see the correct meaning.
Arras is assuming, I think, that the story of Cutler’s abuse of Berta will teach people something about the morality of experimentation, because they will react to it the same way he does. And he is almost certainly right. Now, today, for normally moralled people looking back at an experiment conducted sixty years ago by people now dead. It’s an easy call, condemning Cutler.
But Cutler, and the consequentialists and utilitarians today, some of whom predictably pop up in our own comment section, would read the story differently, or perhaps tell a different one. He would have had to tell himself some justifying story, and I am fairly sure it would have gone something like this: syphilis is a brutal disease that had to be cured, because it caused so much suffering.
Perhaps corners were cut and mistakes were made, but they were cut and made in an urgent cause, by men who desperately wanted to save lives. Life isn’t black and white, and sometimes a few have to be sacrificed for the many. Someone has to be willing to make the hard decisions. People decades later shouldn’t judge him from the safety of a world he helped save from the effects of syphilis.
As stories go, it’s just as good a story as the one Arras presents. It makes sense of all the facts, it orders them to a moral and a dramatic end, it offers both a clear morality and an understanding of complexity. Without some fixed criteria for judging between the stories, it is as good a story, and therefore as effective a justification for acting as he did, as Arras’s story is”absent a fixed belief in the dignity of the human person”a reason for condemning it.
And yet Cutler’s story justified a man inserting pus from a male gonorrhea victim into the eyes, urethra, and rectum of a dying woman. Because in that story, in what we can guess was Cutler’s story, the victims were not men and women endowed by their creator with certain inalienable rights, among them the right not to be treated like rabbits, but mere “material” for his research.
We can guess why. They were judged proper subjects for experimentation because they were Guatemalan, or poor, or dark-skinned, or simply because they were vulnerable. They were the kind of people wealthy, powerful, white Americans could exploit”which exploitation seems to have included, in Berta’s case at least, something very close to murder.
You and I might think that we would never tell ourselves the story Cutler must have told himself. The Christian knows that in fact he might, were his circumstances different, because he has told himself similar stories on (we hope) much smaller matters. Cutler was a monster, but in all of us, except perhaps for the saint, lies the capacity for monstrousness, and the ability to tell ourselves stories of which we are the hero.
And we know that this is true even without such introspection, because this kind of story is one many people, people even more eminent than Cutler, tell about the kind of research that destroys embryonic human beings. It’s a little surprising how few apply to those experimenting on the unborn the standards they apply to a scientist who worked in a Central American country sixty years ago.
They will protest that the cases are different, that the embryo is not fully human, not yet a person, that it can therefore be destroyed for the greater good. Which is essentially what Cutler must have thought of Berta and her peers.
David Mills is Executive Editor of First Things . His previous “On the Square” articles can be found here .
RESOURCES
The New York Times ’ story on the Commission’s work, Panel Hears Grim Details of Venereal Disease Tests
The Pittsburgh Post-Gazette ‘s report on Dr. Cutler, Late Pitt dean Cutler denounced for infecting Guatemalans with syphilis in research experiment
Wikipedia entries on John C. Cutler and the Tuskegee Syphilis Experiment .
