Henry K. Beecher Explained

Henry K. Beecher
Birth Date:February 4, 1904
Birth Place:Peck, Kansas, U.S.
Death Place:Boston, Massachusetts, U.S.
Field:Medical ethics
Anesthesiology
Alma Mater:Santiago High

Henry Knowles Beecher (February 4, 1904[1] – July 25, 1976[2]) was a pioneering American anesthesiologist, medical ethicist, and investigator of the placebo effect at Harvard Medical School.

An article by Beecher's in 1966 on unethical medical experimentation in the New England Journal of Medicine — "Ethics and Clinical Research" — was instrumental in the implementation of federal rules on human experimentation and informed consent.[3] A 1999 biography—written by Vincent J. Kopp, M.D. of UNC Chapel Hill and published in an American Society of Anesthesiologists newsletter—describes Beecher as an influential figure in the development of medical ethics and research techniques, though he has not been without controversy.[4] 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 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 and author Harriet Beecher Stowe.[4] He was, in fact, unrelated to the Beecher family.[5]

Education

Beecher received a BA degree in 1926 and an MA degree in physical chemistry in 1927, both from the University of Kansas. While it had been his goal to earn a Ph.D. in chemistry at the Sorbonne, Henry was "persuaded" to study medicine instead.[4] Entering the Harvard Medical School 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 in 1935 to work in the physiology laboratory of Nobel Laureate August Krogh.[4]

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.[4]

During World War II, Beecher served in the U.S. Army with Dr. Churchill in North Africa and Italy. His experiences during the war in clinical pharmacology would inspire him to investigate placebo-like phenomena.[4]

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.[6] 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.[4] 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.[7] The resulting report is a foundation moment in defining the notion of brain death.[8] The report continues to have significance for contemporary bioethical debates regarding brain death.[9]

U.S. Army interrogation drugs

In July 2007 the German public television channel SWR claimed that Beecher was involved with CIA studies on human drug experiments in the 1950s as a scientific expert, and may have contributed to the KUBARK Counterintelligence Interrogation document of 1963 based on his work in the United States and in secret CIA prisons in West-Germany.[10]

According to these reports, and partly generated by interest in US historian Alfred W. McCoy's research,[11] Beecher was scientifically responsible for human experiments with drugs (e.g. mescaline) conducted by the CIA in post-war West-Germany. These experiments took place in a secret CIA prison located in "Villa Schuster" (later renamed to "Haus Waldhof") in Kronberg near Frankfurt, a dependency of the nearby US interrogation center in Camp King (West-Germany). According to a witness, several interrogated individuals died during these experiments. According to sources Beecher visited Camp King frequently from September 1951 onwards and prepared human experiments, deliberated with the interrogation staff of the CIA (called "the rough boys") and recommended various drugs for testing. Allegedly, he also met former National-Socialist physician Walter Schreiber several times, both at Camp King as well as in Villa Schuster, for an "exchange of ideas". Later, Beecher described Schreiber in a report as "intelligent and cooperative."

The aforementioned documentary states, based on documents sourced from the United States National Archives, that the US Army had sent reports about Nazi experiments in concentration camps like Dachau to Beecher for evaluation. One of the reports Beecher evaluated is still extant in the library of Harvard Medical School. [12]

According to the German documentarian Egmont R. Koch, in January 1953, Beecher recommended that a depressive patient at the New York State Psychiatric Institute and Hospital be given a mescaline injection. The injection took place at 9:53, with the patient falling into a deep coma at 11:45 and dying within half an hour after that.[10]

According to the neuroanesthesiologist George A. Mashour:

The placebo effect

Henry K. Beecher's 1955 paper The Powerful Placebo was not the first to introduce the idea of the placebo effect (the term had been first used by T. C. Graves in 1920),[13],[14] but its importance was that it stressed—for the first time—the necessity of double-blind, placebo-controlled clinical trials.[15] In his 1955 paper, Beecher only speaks of placebo effects on specific occasions when he is contrasting them with drug effects.[16] 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

Works

Journal articles

Papers

Books

Additional sources

Notes and References

  1. Henry K. Beecher: The Introduction of Anesthesia into the University . Gravenstein, J. S. . Anesthesiology . January 1998 . 88 . 1 . 245–253 . 9447878 . 10.1097/00000542-199801000-00033 . 5944101 . free .
  2. News: Henry K. Beecher, Doctor in Boston – Won World Fame for Work in Anesthesia and Ethics . . July 26, 1976 . Fowle, Farnsworth . 26 . August 25, 2009 .
  3. Beecher . Henry K. . Ethics and Clinical Research . New England Journal of Medicine . 274 . 1354–1360 . June 16, 1966 ., . 24. 10.1056/nejm196606162742405 . 5327352 . 2566401 . republished with commentary in the series Public Health Classics in Harkness . Jon . Lederer . Susan E. . Wikler . Daniel . Laying Ethical Foundations for Clinical Research . Bulletin of the World Health Organization . 79 . 2001 . 365–372 . 4. 11357216 . 2566394 .
  4. Kopp, Vincent J., M.D. Henry K. Beecher, M.D.: Contrarian (1904–1976) . September 1999 Newsletter, American Society of Anesthesiologists.
  5. Moreno, Jonathan D. Undue Risk. 2000. page 241
  6. Beecher, H.K., Ethics and Clinical Research. New England Journal of Medicine. 16th June 1966
  7. Gary Belkin, Death Before Dying: History, Medicine, and Brain Death (Oxford, UK: Oxford University Press, 2014), 3.
  8. 'Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death: A Definition of Irreversible Coma.', JAMA 205, no. 6 (5 August 1968): 337–40, https://doi.org/10.1001/jama.1968.03140320031009.
  9. Truog, Robert D., Nancy Berlinger, Rachel L. Zacharias, and Mildred Z. Solomon. 'Brain Death at Fifty: Exploring Consensus, Controversy, and Contexts'. Hastings Center Report 48, no. S4 (2018): S2–5. https://doi.org/10.1002/hast.942.
  10. Koch, Egmont R.: Documentary "Folterexperten—Die geheimen Methoden der CIA", one part at GoogleVideo (English: Torture Experts—The Secret Methods of the CIA), a documentary on German public 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
  11. Alfred W. McCoy, "Science in Dachau's shadow: Hebb, Beecher, and the development of CIA psychological torture and modern medical ethics," Journal of the History of the Behavioral Sciences, Volume 43, Issue 4, September 2007, 401–417, doi:10.1002/jhbs.20271, https://www.uio.no/studier/emner/jus/ikrs/KRIM2950/h11/undervisningsmateriale/McCoy.pdf.
  12. U.S. Naval Technical Mission in Europe, Technical report no. 331-45: "German aviation medical research at the Dachau concentration camp" (Oct. 1945), Harvard Medical Library in the Francis A. Countway Library of Medicine
  13. Book: Yapko, Michael D.. Trancework: An Introduction to the Practice of Clinical Hypnosis. 2012. Routledge. 9780415884945. en.
  14. T. C. Graves. Commentary on a case of Hystero-epilepsy with delayed puberty. The Lancet. 196. 5075. January 2, 2014. 1920. 1135. 10.1016/S0140-6736(01)00108-8.
  15. Stoddart, Charlotte, How placebo effect went mainstream, Knowable Magazine, June 27, 2023
  16. Andersen. Lars Ole. 2005. A Note on the Invention, Invisibility and Dissolution of the Placebo Effect. Gesnerus. 62. 1–2. 102–110. 10.1163/22977953-0620102005. 16201323. 10.1.1.582.8811.
  17. Web site: Louise Reisner-Sénélar (2009) The Danish anaesthesiologist Björn Ibsen a pioneer of long-term ventilation on the upper airways.