Henry Knowles Beecher (February 4, 1904 – July 25, 1976) was a pioneering American
anesthesiologist
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine ...
placebo effect
A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures.
In general ...
at
Harvard Medical School
Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consi ...
New England Journal of Medicine
''The New England Journal of Medicine'' (''NEJM'') is a weekly medical journal published by the Massachusetts Medical Society. It is among the most prestigious peer-reviewed medical journals as well as the oldest continuously published one.
His ...
'' — "Ethics and Clinical Research" — was instrumental in the implementation of federal rules on human experimentation and informed consent. A 1999 biography—written by Vincent J. Kopp, M.D. of
UNC Chapel Hill UNC is a three-letter abbreviation that may refer to:
Education
* University of Northern California (disambiguation), which may refer to:
** University of Northern California (Santa Rosa), in Petaluma, California, United States
** University of Nor ...
and published in an
American Society of Anesthesiologists
The American Society of Anesthesiologists (ASA) is an educational, research and scientific association of physicians organized to raise the standards of the medical practice of anesthesiology and to improve patient care.
As of 2021, the organizat ...
newsletter—describes Beecher as an influential figure in the development of medical ethics and research techniques, though he has not been without controversy.Kopp, Vincent J., M.D. Henry K. Beecher, M.D.: Contrarian (1904–1976) .'' September 1999 Newsletter, American Society of Anesthesiologists. The Beecher Prize, named in honor of Henry K. Beecher, is awarded annually by Harvard Medical School to a medical student who has produced exceptional work in the field of medical ethics. Also, the Henry K. Beecher Award by
The Hastings Center
The Hastings Center is an independent, nonpartisan bioethics research institute and think tank based in Garrison, New York. It was instrumental in establishing the field of bioethics and is among the most prestigious bioethics and health policy ...
was established in 1976 in honour of Henry K. Beecher, who was also its first recipient.
Biography
Youth
Born as Harry Unangst in Peck, Kansas in 1904, he changed his surname to Beecher in his 20s. This change was said to be for the name recognition of influential 19th-century Beechers—preacher
Henry Ward Beecher
Henry Ward Beecher (June 24, 1813 – March 8, 1887) was an American Congregationalist clergyman, social reformer, and speaker, known for his support of the abolition of slavery, his emphasis on God's love, and his 1875 adultery trial. His r ...
Beecher received a BA degree in 1926 and an MA degree in
physical chemistry
Physical chemistry is the study of macroscopic and microscopic phenomena in chemical systems in terms of the principles, practices, and concepts of physics such as motion, energy, force, time, thermodynamics, quantum chemistry, statistica ...
in 1927, both from the
University of Kansas
The University of Kansas (KU) is a public research university with its main campus in Lawrence, Kansas, United States, and several satellite campuses, research and educational centers, medical centers, and classes across the state of Kansas. T ...
. While it had been his goal to earn a Ph.D. in chemistry at the
Sorbonne
Sorbonne may refer to:
* Sorbonne (building), historic building in Paris, which housed the University of Paris and is now shared among multiple universities.
*the University of Paris (c. 1150 – 1970)
*one of its components or linked institution, ...
, Henry was "persuaded" to study medicine instead. Entering the
Harvard Medical School
Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consi ...
in 1928, Beecher received research fellowships in 1929, 1930 and 1931. Beecher graduated cum laude in 1932. Two of his articles published in the Journal of Applied Physiology in 1933 earned Warren Triennial Prizes. These two articles and a study in Beecher's last year of college caught the attention of Harvard Professor of Surgery, Edward Churchill, M.D., who became his professional mentor. Post-college, he trained for two years under Churchill at Massachusetts General Hospital. Henry traveled to
Denmark
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in 1935 to work in the physiology laboratory of Nobel Laureate
August Krogh
Schack August Steenberg Krogh (15 November 1874 – 13 September 1949) was a Danish professor at the department of zoophysiology at the University of Copenhagen from 1916 to 1945. He contributed a number of fundamental discoveries within severa ...
.
Career
Returning to America in 1936, Beecher was hired as Anaesthetist-in-Chief at MGH and Instructor in Anaesthesia at Harvard Medical School by Dr. Churchill. Henry became an Associate Professor in 1939 and the Henry Isaiah Dorr Professor of Anaesthesia Research in 1941—the first endowed chair in anesthesiology in America.
During
World War II
World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposing ...
, Beecher served in the
U.S. Army
The United States Army (USA) is the land service branch of the United States Armed Forces. It is one of the eight U.S. uniformed services, and is designated as the Army of the United States in the U.S. Constitution.Article II, section 2, cl ...
with Dr. Churchill in
North Africa
North Africa, or Northern Africa is a region encompassing the northern portion of the African continent. There is no singularly accepted scope for the region, and it is sometimes defined as stretching from the Atlantic shores of Mauritania in ...
and
Italy
Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
. His experiences during the war in clinical pharmacology would inspire him to investigate placebo-like phenomena.
Work in medical ethics
As professor of anesthesiology at Harvard Medical School, Beecher published a 1966 article that drew attention to 22 examples of unethical clinical research that had risked patients' lives.Beecher, H.K., Ethics and Clinical Research. New England Journal of Medicine. 16th June 1966 Though heralded for the position of this article, he was severely criticized by the medical establishment for what was felt as an unfair generalization from a few select cases. However, this article and the subsequent congressional investigation laid the foundation for current guidelines on informed consent and human experimentation.
Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death
Dr Beecher was the instigator and chairperson of an Ad Hoc Committee of the Harvard Medical School convened to examine the issue of irreversible coma. The resulting report is a foundation moment in defining the notion of brain death. The report continues to have significance for contemporary bioethical debates regarding brain death.
U.S. Army interrogation drugs
In July 2007 the public German TV-channel SWR claimed that Beecher was involved as scientific expert with CIA studies on human drug experiments in the 1950s and may have contributed with his work in the United States and in secret CIA-prisons in Western-Germany to the
KUBARK Counterintelligence Interrogation
The U.S. Army and CIA interrogation manuals are seven controversial military training manuals which were declassified by the The Pentagon, Pentagon in 1996. In 1997, two additional CIA manuals were declassified in response to a Freedom of Informa ...
document of 1963.Koch, Egmont R.: Documentar ''"Folterexperten—Die geheimen Methoden der CIA"'', one part at GoogleVideo (English: ''Torture Experts—The Secret Methods of the CIA''), TV-Documentary in public German Television SWR about secret CIA-prisons in post-war Germany, released on the 9th of July 2007, Showing original documents from the National Archives which have been released recently. See also: https://www.swr.de/betrifft/das-folter-haus-im-taunus-folterexperten-die-geheimen-methoden-der-cia/-/id=98466/did=4154008/nid=98466/bapbk3/index.html
According to these recent reports, and also according to US-historian
Alfred W. McCoy
Alfred "Al" William McCoy (born June 8, 1945) is an American historian and educator. He is the Fred Harvey Harrington Professor of History at the University of Wisconsin–Madison.mescaline) conducted by the CIA in post-war Germany. They took place in a secret CIA-prison located in ''"Villa Schuster"'' (later renamed to ''"Haus Waldhof"'') in
Kronberg
Kronberg im Taunus is a town in the Hochtaunuskreis district, Hesse, Germany and part of the Frankfurt Rhein-Main urban area. Before 1866, it was in the Duchy of Nassau; in that year the whole Duchy was absorbed into Prussia. Kronberg lies at t ...
near
Frankfurt
Frankfurt, officially Frankfurt am Main (; Hessian: , " Frank ford on the Main"), is the most populous city in the German state of Hesse. Its 791,000 inhabitants as of 2022 make it the fifth-most populous city in Germany. Located on it ...
, which was related to the nearby US-interrogation center Camp King (West-Germany). According to a witness, during these experiments, several interrogated individuals died. This report states that since September 1951, Beecher was frequently in Camp King and prepared human experiments, deliberated with the interrogation-staff of the CIA (called "rough boys") and recommended the test of various drugs. Several times he allegedly met with former Nazi-physician Walter Schreiber (at Camp King respectively in Villa Schuster) for an "exchange of ideas". Later Beecher described Schreiber in a report as ''"intelligent and cooperative."''
The documents presented in the TV-documentation state that the US Army had sent reports about Nazi-experiments in concentration camps like Dachau to Beecher for evaluation. The library of
Harvard Medical School
Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consi ...
still possesses a report of the US-army about these Nazi-experiments that it inherited from Beecher, a report which he evaluated.
According to the German documentarian Egmont R. Koch, in January 1953, a depressive patient at the New York State Psychiatric Institute and Hospital got — upon recommendation of Beecher — a mescaline-injection at 9:53, fell in a deep coma at 11:45 and died within half an hour.
According to the neuroanesthesiologist George A. Mashour:
It may appear paradoxical that Beecher, who advocated the ethical treatment of human subjects, had also engaged in potentially unethical work on hallucinogens for the government. A more compelling hypothesis, however, is that Beecher advocated ethical treatment of human subjects largely because of such work.
The placebo effect
Henry K. Beecher's 1955 paper ''The Powerful Placebo'' was not the first to introduce the idea of the
placebo effect
A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures.
In general ...
(the term had been first used by T. C. Graves in 1920),, but its importance was that it stressed—for the first time—the necessity of double-blind, placebo-controlled clinical trials. In his 1955 paper, Beecher only speaks of placebo effects on specific occasions when he is contrasting them with drug effects. His 1955 paper constantly and correctly speaks of "''placebo reactors''" and "''placebo non-reactors''"; furthermore, Beecher (1952), Beecher, Keats, Mosteller, and Lasagna (1953), Beecher (1959), consistently and correctly speak of "''placebo reactors''" and "''placebo non-reactors''"; they never speak of any "placebo effect"; and, finally, in his ''Research and the Individual: Human Studies'' (1970), Beecher simply speaks of "''placebos''".
Notable students
*
Bjørn Aage Ibsen
Bjørn Aage Ibsen (August 30, 1915 – August 7, 2007) was a Danish anesthetist and founder of intensive-care medicine. He graduated in 1940 from medical school at the University of Copenhagen and trained in anesthesiology from 1949 to 1950 ...
, Danish anesthesiologist and founder of intensive-care medicine.
Works
Journal articles
Beecher, H.K., Ethics and Clinical Research. ''New England Journal of Medicine''. June 1966 Reprinted with commentary by Harkness, Lederer and Wikler. in ''Bull World Health Organ'' 2001
*Beecher, H.K., Ethics and experimental therapy. ''Journal of the American Medical Association'' 186(9): 858-9,(30 Nov 1963) (Editorial)
*Beecher, H.K., Sheik Adhith. Experimentation in man. ''Journal of the American Medical Association'', 1959, 169 (5): 461–478.
*von Felsinger J.A., Lasagna L., Beecher H.K. The response of normal men to lysergic acid derivatives (di- and mono-ethyl amides). ''Journal of Clinical and Experimental Psychopathology'', 1956; 17:414-428.
*Lasagna L., von Felsinger J.M., Beecher H.K. Drug-induced mood changes in man. 1. Observations on healthy subjects, chronically ill patients, and “postaddicts.” ''Journal of the American Medical Association'', 1955: 157:1006-1020. Beecher, H.K., The Powerful Placebo, ''Journal of the American Medical Association'', Vol.159, No.17, (24 December 1955)
*Beecher, H.K., Keats, A.S., Mosteller, F. & Lasagna, L. The Effectiveness of Oral Analgesics (Morphine, Codeine, Acetylsalicylic Acid) and the Problem of Placebo "Reactors" and "Non-Reactors", ''Journal of Pharmacology and Experimental Therapeutics'', Vol.109, No.4, (December 1953).
* Beecher, H.K., Experimental Pharmacology and Measurement of the Subjective Response, ''Science'', Vol.116, No.3007, (15 August 1952).
Papers
*Beecher HK. Ethics and the explosion of human experimentation, 1965. In the Beecher papers, Francis A. Countway Library of Medicine, Harvard University.
Books
*Beecher, H.K., ''Research and the Individual: Human Studies'', Little, Brown, (Boston), 1970.
*Beecher, H.K., ''Measurement of Subjective Responses: Quantitative Effects of Drugs'', Oxford University Press, (New York), 1959.