April 4, 1973

Dr. Lawrence K. Altman
Medical News

New York Times

New York, New York 10036

Dear Dr. Altman,

I was pleased to “meet” you again in the pages of Hippocrates
Revisited. (This gives me a chance to express my admiration for your
work as a journalist.)

Two point in re your article.

(1) Are you acquainted with J.B.S. Haldane's self-experimentation?
Clark's biography goes into some of this (Chapter 7). I wish I could
fetch some references to his writings about it. His essays of the
mid 40's surely say something. Perhaps Helen Spurway (who now lives
in India) or his other colleagues could contribute.

(2) I think there are hazards in the viewpoint you quote from
Wells. Many a general has risked his owm life in pursuit of glory,
and has perhaps felt justified then in disposing of the lives of
others. There is a danger that in suggesting that willingness to
self-experiment be a necessary condition, it may become accepted as

sufficient. In fact, that willingness is totally irrelevant to most

situations in clinical experimentation, and may even distract
attention from the basic moral issues.

Of course, there are circumstances of such hazard that no one
else should be induced to volunteer. But what besides the expecaation
of "glory" then distinguishes the experimenter as a more appropriate
subject than other properly informed volunteers. And will that kind of
preoccupation with "glory" lead to the most careful work? Most
responsible men in publicly sanctioned roles are likely to be even
more meticulous about the lives of others than with their own.

IT am not decrying the heroism of many men in special situations --
that meticulous care I just mentioned might frustrate some experiments,
and it will then be more "convenient" to self-experiment. I do not see
how the Wellsian paradigm will really improve the ethical or technical
quality either of medical research or of strategic decision making.

Sincerely youus,

Joshua Lederberg
Professor 66 Genetics

JL/rr

 

 

PPI ' oy WL? Oo