In the winter of 1980, during the final months of her nearly 32-year reign, Juliana of the Netherlands received multiple distraught letters from subjects deeply disturbed by a news item making waves in national media.[1] In December, the Dutch Telegraaf had reported that a Leiden internist had taken blood samples from foetuses aborted in the fifth month of pregnancy for experimental purposes, an item quickly picked up on by other big media.[2] Due to recent developments in chemical abortion-techniques, foetuses were often left intact after leaving the uterus and sometimes still showed signs of life such as muscular movement or a heartbeat.[3] Although that did not mean these foetuses could survive outside of the womb, leading newspapers soon reported that experiments were conducted on “live-aborted children” in the Netherlands.[4]
In the evening of Tuesday January the 8th, chairman of the Dutch Doctors Association and World Federation of Doctors Who Respect Human Life physician Karel Gunning was interviewed on the national Evangelical Broadcasting and compared the status of the foetus in such experiments to those of slaves and Nazi concentration camp prisoners: “The point is—to justify these tests, you have to assume that they are not human […] That they have no soul and that they feel no pain […]”.[5] He therefore called upon all listeners to start spreading the word and to write letters to Prime Minister Van Agt, convincing him that this just could not happen in the Netherlands; that the Dutch people would not stand for it. After the broadcast, multiple families sat down to write letters to the Prime Minister and Queen Juliana, pleading them to please bring such a horrible and ungodly scientific practice to a halt.[6]
Gunning was right that a fundamental issue at stake in the permissibility of foetal experimentation was the moral status of the foetus: was ‘it’ human or not. This was, as one newspaper poetically headlined one of its articles on the incident, a question of ‘To be or not to be’.[7] But a matter of equal contention was also who precisely got to make this decision. Was this the scientific community or the investigative researcher? The women undergoing the abortion procedure? Or was this something the Dutch government really should decide upon?
In the case involving the Leiden internist, it had been the staff of the abortion clinic which had given permission for the contested blood tests. The women undergoing the procedure had been left out of the decision. As the internist explained in one newspaper: “That is not customary in clinics like Bloemenhove. They speak as little as possible about the foetus. There is, so to speak, no fruit and it also has never been there”.[8]
But, in fact, it was not the lacking permission of the women involved which had initially gotten the internist in hot water. Rather, it had been the lacking permission of another locus of decision making: the committee medical ethics of Leiden university. Upon submitting his research report for publication to the British Journal of Haematology, the internist had received a reply with the request to procure some sort of evidence that his study had been conducted in accordance with the reigning Dutch rules for the ethical assessment of clinical research.
To clear this hurdle, he had knocked on the door of the in-house committee medical ethics which had only recently been established at the Leiden medical faculty and university hospital. “A bit naïve, that he did not already do so before he began [his research]”, chairman Erik Noach commented in De Telegraaf. Nonetheless, his team would take on an after-the-fact ethical review of the blood tests taken on the potentially still living foetuses at the Bloemenhove clinic.[9]
In my upcoming PhD-thesis, I trace the history of Dutch research ethics committees like the Leiden CME. In the twenty-first century practice of science, these review boards have become firmly fixed governance bodies overseeing human research studies across the world. It is hardly an exaggeration to state that anyone today conducting ‘human research’ in the biomedical and even behavioural sciences is likely to have encountered one of these research ethics committees—as they are generically referred to—at least once in their career to await official permission for the execution of their research study protocols involving human subjects. They are what social scientists call obligatory passage points: a locus of control which scientists hoping to conduct research with human beings first have to pass through before they can participate in its practice.[10]
But their hegemony is only a recent phenomenon and their rise by no means self-evident. In the Netherlands, in 1980, the claim from CME-chairman Erik Noach that it was ‘naïve’ for the Leiden internist not to have consulted his committee medical ethics before deciding to draw blood from potentially still living foetuses was more confident than that it was realistic. Research ethics committees were still quite novel at the time—only the Leiden medical faculty had one that was actively up and running in the Netherlands.
But what was more, many a Dutch physician at the time considered the idea that their research activities would be overseen by a select group of appointed reviewers preposterous. Consider, for example, the opening lines of this letter, sent to the Dutch medical journal Medisch Contact by a disgruntled Leiden surgeon in the aftermath of the Leiden ‘scandal’ of foetal experimentation:
After years of silence about Him, there he is, God, the Father, with his watchful eye also in the Academic Hospital of Leiden. Finally in the hospital ‘for advanced medicine’ of the Praesidium Libertatis, while the confessional universities are arduously trying to get rid of Him. His name: CME.[11]
The acronym stood, of course, for Committee Medical Ethics. Leiden University, the oldest university of the Netherlands, had carried the slogan ‘bulwark of liberty’ (libertatis praesidium) since the late nineteenth century to advertise its status as an independent university where scientific research was protected from censorship and other undue political influences. But, by 1980, Leiden had also become the first Dutch university to restrict researchers in their freedom to conduct those experiments involving human beings they individually saw fit. A new authority had arisen within the walls of the Praesidium Libertatis, one which researchers now apparently had to ask for permission before they could conduct experiments with human beings. Failing to do so could be labelled naïve in the pages of the most widely read newspaper of the Netherlands—an institutional development that clearly did not sit well with all members of the Praesidium.
How could it be, the Leiden surgeon charged rhetorically, that in an era in which even the Royal Dutch Medical Association admitted it was no longer capable to “adopt in writing generally accepted rules of conduct”, a group of local individuals could be anointed to tell right from wrong within the walls of an academic hospital? Why was it, that in an age when traditional moral authority seemed to be withering away, a new ‘God’ could be inaugurated to watch over a scientific practice like human experimentation? And, on what grounds were people allowed to participate in committee deliberations? “Are we jubilant when in first instance a philosopher is added to the little club of moderators?”, the surgeon snarled, and “Are we then in second instance put at ease when the philosopher turns out to be an ethicist?” Really, what expertise could such scholars possess to grant them a seat at a committee table on medical ethics?
In my PhD-thesis, I answer the Leiden surgeon, by tracing how research ethics committees emerged as a set of watchful eyes in the Dutch oversight of human experimentation in the second half of the twentieth century and by determining what sort of control mechanism they became in the public governance of a historically controversial scientific practice. Once I finish my thesis—hopefully in the winter of 2017—I’ll give Shells & Pebbles an update on the answers I have found!
Footnotes
[1] Nationaal Archief, Den Haag (Hereafter: NL-HaNA), DG Volksgezondheid, 2.15.65, inv.nr. 2456.
[2] Frits Gonggrijp, ‘Commissies gepasseerd: Bloemenhove liet experimenten toe na late abortus’, in De Telegraaf, Friday 21 December 1979, p. 7.
[3] NL-HaNA, DG Volksgezondheid, 2.15.65, inv.nr. 2456, brief van de Hoofddirecteur Gezondheidszorg aan de Hoofdafdeling Staats- en Strafrecht, Ministerie van Justitie, 25 februari 1980.
[4] See, for example: ‘Bloemenhove experimenteerde al op levend-geaborteerde kinderen’, in Nederlands Dagblad, Saturday 22 December 1979, p. 2.
[5] NL-HaNA, DG Volksgezondheid, 2.15.65, inv.nr. 2456, 8-1-1980, EO, Tijdsein, N1, 20.50 uur. Dr. Gunning (Voorzitter Nederlands Artsenverbond) over medische proevenop levend geaborteerde kinderen, pp. 1-2.
[6] NL-HaNA, DG Volksgezondheid, 2.15.65, inv.nr. 2456.
[7] H. Hoffman, ‘Géén experimenten Bloemenhove-kliniek, Bloedmonsters genomen van foetaal weefsel, Te zijn of niet te zijn’, in Het Vrije Volk, Friday 28 December 1979, p. 7.
[8] Hoffman, ‘Géén experimenten Bloemenhove-kliniek.
[9] Gonggrijp, ‘Commissies gepasseerd’.
[10] M. Callon, ‘Elements of a sociology of translation: Domestication of the Scallops and the Fishermen of St. Brieuc Bay’, in J. Law (ed.), Power, Action and Belief: A New Sociology of Knowledge (London: Routledge, 1986), pp. 196-223.
[11] M.A. van Dongen, ‘Experimenten op Mensen’, in Medisch Contact Vol. 35 (1980), p. 170.