Holding Scientists and Medical Researchers Accountable for Unethical Human Testing, Part 1: J. Marion Sims, The Father of Gynecology

J. Marion Sims was knowns as the Father of Gynecology.
J. Marion Sims, the father of surgical genecology, discovered a way to repair severe damage caused by childbirth by operating on enslaved women without the use of anesthesia, even after it was widely available. (Public domain image/Wikimedia Commons

On Sunday I wrote about “7 Horrific Experiments U.S. Scientists Conducted on We The People and Their Final Solution.” I thought, OK, done. It’s a bleak topic and clearly using humans as guinea pigs in seven experiments is seven too many, but I’ve brought attention to the subject and can move on, right? Then a reader mentioned that I had only scratched the surface. Scratched the surface? The Tuskegee Syphilis Study ran for 40 years, the MKUltra Project for 20, and feeding mentally challenged kids oatmeal with radiation-laced milk went on for 12 years. These weren’t small or short-lived studies. The reader sent me the link to Wikipedia’s page on “Unethical human experimentation in the United States.” If you thought the list of seven was sickening, you’ll find the page unreadable. It just goes on and on and on with experiments in which humans may have consented but were hardly informed. The majority neither received information nor granted consent. These test subjects were used against their will. Animals have stronger protections against testing on them in this country than humans do.

Holding the perpetrators responsible requires that we proceed from a base of knowledge and morality. Science for the sake of science or “for the greater good” without preserving our inalienable rights granted to us by God, is evil. Scientists holding little regard for the physical and mental sovereignty and dignity of human beings should be prosecuted for crimes against humanity. There are some instances, however, where the researcher in question is more complex than a black or white characterization would indicate. This does not justify hurting people and/or shortening their lives. All humans are morally compromised to some extent or another, and some are so far gone that the likelihood of salvation is scant. Not every human experiment was conducted under evil intent. Time and place needs to be considered when assessing these abominations. All human experimentation without informed consent must stop. That is non-negotiable. We also need to arrive at a mature and empathetic way of assessing our country’s poor track record on human experimentation without throwing out advances. The results of some of these experiments amounted to nothing; some produced discoveries that improved not only the lives of the test subjects but the lives of future generations.

Take the case of J. Marion Sims (1813-1883), surgeon and the father of genecology. It’s easy to paint as evil the committed Confederate who lived and practiced medicine in the slave-holding South and held to all its sentiments, including possibly acting as a spy on trips to Europe to drum up financial and political support for the Confederacy. It’s doubly easy to paint him as evil for operating on enslaved African-American women without anesthesia. However, as the child of an anesthetist, I can tell you that the perfection of anesthesia was a long time in coming. Sims began his work prior to anesthesia being readily available, and even though its use spread quickly, it was new—very new. In a way, as someone who never buys the first-off-the-line of anything, I see this as wisdom. People don’t understand anesthesia. They go to sleep as-is and they wake up as-is, plus surgery. They’re unaware that they were intubated during the operation because if they weren’t, their throat would collapse on itself, making breathing impossible. Anesthesia is not “going to sleep.” Every muscle in your body completely and utterly relaxes in a near-death way. In fact, even today, the exact right anesthetic cocktail is a micro-balancing act with constant monitoring by instruments, anesthesiologists, and anesthetists. Sims conducted his experimental surgeries from 1845 to 1849; anesthesia came on the scene in 1846.

What we are fed about Sims is that he operated on three black women in particular, Anarcha, Betsy, and Lucy. They all suffered from vesicovaginal fistuals, if not both vesicovaginal and rectovaginal fistulas. As uncomfortable a topic as this is, stick with me. In the case of Anarcha in particular, we know she had rickets and was malnourished. During childbirth, the baby’s head can trap areas of the bladder and rectum against the pelvic bones. This cuts off circulation to those areas and the tissue dies, sloughing off and creating holes. The result is incontinence and leaky bowels. Not only is this a hygienic issue for the woman’s skin and plumbing, but it’s a huge social concern due to the patient’s embarrassment and odor. Anarcha underwent 30 surgeries without anesthesia. During this time, Sims invented the vaginal speculum, the catheter, and the use of silver sutures. He also found a way to repair the holes. In fact, all three women were cured and were sent back to their owners.

This is not to make light of the pain these women endured, or the fact that they were slaves in the first place. When doctor’s assistants refused to work with Sims because of the pain he caused the women, Sims got other slaves to hold each other down for the procedure. He even accidentally left a sponge behind that nearly caused one patient to die of sepsis—and if you think he’s the only surgeon to do that, you’d be greatly mistaken. Sims came from an era when doctors did not believe that African Americans felt as much pain as Caucasian men and women. Even the desperation of the women to find a solution to their problem did not justify the torture they underwent. And yet, to this day women everywhere benefit from Sim’s work.

He soon moved from Alabama to New York and opened a women’s hospital. When he wanted to treat cancer patients, the hospital’s board of directors refused to admit them because board members believed the disease to be unseemly and contagious. Sims left so he could treat all patients, including those with cancer. That tells us something. Sims may have been racist, sexist, a man of his era, he may not even have enjoyed his work, but he cured a condition that made the lives of these women harder than they already were. And again, these surgeries were conducted before and in the dawning years of anesthesia. The man deserves some credit for his work, but he is judged by modern sensibilities without consideration for his time and place. Needless to say, his statutes have been removed.

It’s also important to note that Sims also tried to cure lockjaw in infants born into slavery, which at the time was a fatal condition. He used a shoemaker’s awl to pry the bones of the baby’s skull back into position after they were misshapen during strenuous passage through the birth canal. These experiments were fatal 100 percent of the time. He blamed the mothers and their midwives, and the conditions of poverty in which they lived, rather than his experiments. Sims would also perform clitoridectomies at the request of a husband or father, who could legally subject their spouse or daughter to such mutilation to address mental or behavioral issues. Sims also successfully addressed club feet, cleft palates, and harelips. Sims was neither a saint, nor a demon, and he serves as an example of a medical surgical researcher who from what we can surmise from his numerous writing and autobiography, genuinely tried to help his patients.

If only all scientists and medical researchers could be said to have contributed lasting improvement to the lives of countless people. More often than not, the evildoers took advantage of opportunities that presented themselves solely for what they could discover with little regard for the patients’ wishes, long-term health, or life. Next time, we’ll take a look at the men who probed “the sacred organ,” the brain, with electricity. Clearly, they are the forefathers of the men today who think they can control the world by controlling your brain, my brain, and everyone else’s brain. 

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