A Woman in History with Lessons for New Generation of Wounded Warrior Researchers

I would like to share a nice blog article by my fellow cause blogger, PPandMe.  She recently blogged about an icon of Americas equality movement– Dr. Dorothy Haight.  It is appropriate to mention Dr. Dorothy Haight not only because of her contributions to the fabric of the American ideals of equality under the law, but because of her willingness to address difficult and complex issues that touched on class, race, and educational status.   

Dr. Haight was first and last, a champion of moral and ethical treatment of those most in need of protection.  

PPandMe mentions Dr. Haight’s work on the Belmont Report in response to governmental research and withholding of treatment to impoverished farm workers who had contracted an easily curable disease.  The Belmont Report gained acclaim in the medical community as a benchmark in ethical standards for medical research.  The Report parsed down the Hippocratic Oath down to easy to apply rules of research — first, do no harm; second, protect those who need it the most.

The Belmont Report was co-written by Dr. Haight, and was response to a Health and Human Services study conducted from the 1930s until the early 1970s on poor, African-American farmers, who had contracted syphilis.  They were enrolled in a study on the effects of syphilis, and were given free general medical care, but were not counseled on treatment options for the disease and/or provided medication that would have cured their condition.  Many died from it, and other passed the easily curable condition onto their children via congenital syphilis.  Eventually, the United States settled a claim by the families, and compensated them for their failure to treat, and withholding of treatment. 

This was a watershed moment for ethical governmental research that led the way for modern-day “informed consent” and challenged researches to take a more active role in treatment and prevention.

Why do I find this story an interesting topic for a Wounded Warrior blog?  Because it is a bellwether moment for research.  What the Belmont Report means for me is embracing  research that is substantively more proactive and progressive in nature.  Not for the sake of research, but because it is the right thing to do.   

The Belmont Report moved research, and researchers to acknowledge that they must do more than observe and report, that they have an ethical obligation to do no harm, and to protect those most at need.  They could not simply observe and report — they must prevent and treat.

When I returned from Iraq, I began to hear stories from my buddies who had served with me about unexplained ailments and difficulty in getting diagnosis and treatment.  The returning Veterans of modern conflicts are reporting exposure to a plethora of unfriendly things from their time in combat, such as depleted uranium. 

The Department of Veterans Affairs, under the leadership of Secretary Eric Shinseki and Deputy Secretary Gould  have taken pro-active steps to expand compensation to Veterans for things like exposure to Agent Orange, and as of last year, for Veterans of the First Gulf War, the Department of Veterans Affairs now compensates for complex maladies associated with service in the Gulf War theater. 

Last year, they stood up a Task Force to develop the policy of compensation and issued a report for this era of Veterans.

The perceived modus operandi has been for the government to compensate for these issues after the science catches up with the complaints, rebuild the record, and back-pay the claimant — an expensive way to do business. Compound this poor business model with the ethical quandary this presents, and there is not a problem, but a new opportunity.  An opportunity to make another break-thru moment in government research. 

We see Service members returning from Iraq and Afghanistan with similar reports of exposures and complex medical issues.  Do we invest in the science now and push the researchers now to start the process in order to ensure that we are not creating another generation of Veterans who will, twenty years later, stand at the doorway of the VA with tattered medical record in hand and  a series of unexplained illnesses?

Is this an ethical imperative for the medical establishment to take a leap forward in their thinking in the same way that the Belmont Report did?  It is beginning to look that way. 

There has been historic progress that cannot be overlooked.  For the first time, VA worked with the DoD in researching potential battlefield exposures while combat operations were still underway.  

This new era of collaboration is timely given the increasing debate about toxic exposures from “burn pits” in Iraq, written extensively about by groups like IAVA in their 2011 Policy Agenda and DAV.

The moral leadership of today, much like the researchers who pushed for the Belmont Report,  are pushing the establishment from observe, report and eventually compensate, to prevent and treat.  Although history can repeat itself – if our leadership looks back to figures like Dr. Haight — it will not