A leading Israeli doctor and medical ethicist has called for the prosecution of
doctors responsible for thousands of unauthorised and often illegal experiments
on small children and geriatric and psychiatric patients in Israeli hospitals.
An investigation by the government watchdog, the state comptroller, has revealed
that researchers in 10 public hospitals administered drugs, carried out unauthorised
genetic testing or undertook painful surgery on patients unable to give informed
consent or without obtaining health ministry approval.
At one hospital, staff pierced children's eardrums to apply an experimental
medication yet to be approved in any country. At another, patients with senile
dementia had their thumbprints applied to consent forms for experimental drugs.
Israel's health minister, Dan Naveh, said he was "shocked" at what
he described as a failure of his department and some of Israel's hospitals.
Dr Jacques Michel, the former director of Hadassah hos pital who triggered
the comptroller's inquiry with a public warning about the abuses in 2001, yesterday
called for the prosecution of the doctors.
"These doctors should be punished very severely because they really are
criminals," said Dr Michel, who is head of the committee that approves
medical experimentation at Hadassah, which is not among the accused hospitals.
"They should be stripped of their licences to practise and they should
be prosecuted. If you don't show by example that the medical profession does
not accept this kind of conduct the phenomenon will go on and on.
"It's not an isolated phenomenon. It spread through different institutions."
The state comptroller, Eliezer Goldberg, found that patients were often not
properly informed about the experiments they were agreeing to and, in some cases,
not told at all.
Every Israeli hospital has a medical ethics committee to oversee adherence
to the 1964 Helsinki code on experimentation. But the comptroller said the committees
routinely failed to apply their own regulations and that the health ministry
was negligent in enforcing standards.
Mr Goldberg described a series of incidents at Harzfeld geriatric hospital
as "extremely grave", including the cases of a 101-year-old woman
and another aged 91 who supposedly consented to experimental drugs without their
families being informed.
Researchers applied the thumbprints of seven other patients at Harzfeld to
consent forms that they were too senile to read or sign.
"At this age, 25-30% of these people are not fit to give informed consent
because they suffer from dementia or senility," said Dr Michel.
In other cases, doctors were unable to produce the consent forms they said
that patients had signed although the law requires researchers to keep the documents
for 15 years.
Kaplan hospital conducted painful clinical trials on patients to draw urine
samples by needle, a procedure normally reserved for extreme circumstances.
The comptroller found that 40% of the patients who signed consent forms - five
of them with a fingerprint - were mentally unfit to do so.
Mr Goldberg said two women died from infections, but their deaths were not
reported to the ministry nor was a legally required investigation committee
The comptroller said that in some cases the deaths of patients who were part
of clinical trials were not immediately reported, which undermined attempts
to establish whether the experiments were to blame.
Dr Michel believes some doctors bowed to incentives from pharmaceutical firms
to test experimental drugs.
"I don't have to explain the enormous power of the pharmaceutical industry
to direct research according to its priorities," he said.
Mr Goldberg described how one researcher was also the medical director of a
company that initiated the clinical trial he was responsible for.
The health ministry said it has already taken steps to tighten supervision
following the comptroller's report.
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