Cloth $40.00 ISBN: 9780226465319 Published May 2009
E-book $7.00 to $32.00 About E-books ISBN: 9780226465333 Published August 2009

Contested Medicine

Cancer Research and the Military

Gerald Kutcher

Gerald Kutcher

264 pages | 6 x 9 | © 2009
Cloth $40.00 ISBN: 9780226465319 Published May 2009
E-book $7.00 to $32.00 About E-books ISBN: 9780226465333 Published August 2009

In the 1960s University of Cincinnati radiologist Eugene Saenger infamously conducted human experiments on patients with advanced cancer to examine how total body radiation could treat the disease. But, under contract with the Department of Defense, Saenger also used those same patients as proxies for soldiers to answer questions about combat effectiveness on a nuclear battlefield.
 

Using the Saenger case as a means to reconsider cold war medical trials, Contested Medicine examines the inherent tensions at the heart of clinical studies of the time. Emphasizing the deeply intertwined and mutually supportive relationship between cancer therapy with radiation and military medicine, Gerald Kutcher explores post–World War II cancer trials, the efforts of the government to manage clinical ethics, and the important role of military investigations in the development of an effective treatment for childhood leukemia. Whereas most histories of human experimentation judge research such as Saenger’s against idealized practices, Contested Medicine eschews such an approach and considers why Saenger’s peers and later critics had so much difficulty reaching an unambiguous ethical assessment. Kutcher’s engaging investigation offers an approach to clinical ethics and research imperatives that lays bare many of the conflicts and tensions of the postwar period.

Christopher Lawrence, Wellcome Trust Centre for the History of Medicine, University College London

“What is truly original about Contested Medicine is that, by using the science studies approach applied to a specific historical case, Kutcher shows not only how ethics were constitutive of the shape of experimental work on cancer at its inception but how both of these things were mutually changed over time.”

Samuel Hellman, University of Chicago

Contested Medicine is an extremely interesting, thorough, and thoughtful consideration of the experimental treatments using whole-body radiation applied to cancer patients at the University of Cincinnati by Dr. Eugene Saenger and his colleagues. What makes this work especially valuable is the rich context provided for the studies as well as the case study method used in the analysis. It is quite nuanced and provides the social and historical context for the studies and the evolving bioethics of the time.”

John V. Pickstone, University of Manchester

“Gerald Kutcher uniquely combines high-level expertise in medical physics, the sociology of scientific knowledge, and medical history. In this elegant book he sensitively dissects a historical case study that biomedical ethics has made notorious. But Kutcher does not judge retrospectively; he seeks to recreate the tensions of the time. Clinicians, historians, and social scientists can all learn much from his example.”

Susan Lindee, University of Pennsylvania

“Beautifully written and filled with insights, Kutcher’s Contested Medicine movingly illuminates the ethical complexity of some of the most notorious biomedical research of the twentieth century. This is not a reclamation or an innocence project for the notorious Saenger and his colleagues, who irradiated and even apparently hastened the death of patients suffering from advanced cancer. Rather, it demonstrates in persuasive detail the vexing consistencies of Saenger’s research practices with those of his peers, and in the process it explains how and why Saenger could carry out this troubling research program over many years without being shunned and isolated by the scientific community. Kutcher’s sometimes passionate book is an extremely important contribution to our ongoing assessment of modern medicine and its ethical quandaries. It should be widely read.”

Trevor Pinch, Cornell University
"With its assured writing style and treatment of the relevant clinical and ethical issues, Contested Medicine: Cancer Research and the Military is one of the most interesting books on medical ethics to appear in years. Gerald Kutcher avoids seeking easy moral generalizations and avoids the trap of providing an insiders’ account as he teases out the nuances of cold war research on cancer. The needless suffering and lonely deaths in the cause of medical research which this book documents need a chronicler of Kutcher’s skill and sympathy for us to feel the real moral weight of what was at stake."
Howard Spiro | Yale Journal for Humanities in Medicine
"A passionate book. . . . A thoughtful essay on controlled clinical trials and on clinical experimentation, whether therapeutic or observational. For this alone, the book should be available in every medical library, although some of the details may be more than most of us want—or one hopes—need."

Contents
Acknowledgments  
Introduction
 
Part I. Research Imperatives and Clinical Ethics
1  Cancer Clinical Trials  
2  The Production of Trustworthy Knowledge  
3  Military Medicine and Cancer Therapy  
 
Part II. A Case of Contested Knowledge
4  Cancer Patients as Proxy Soldiers  
5  A Cancer Patient’s Story  
6  Peer Review  
7  Public Disclosure  
 
Part III. Attempts at Closure
8  Ethical Judgment  
 
Epilogue
Bibliography
Index
For more information, or to order this book, please visit http://www.press.uchicago.edu
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