Following a very interesting historical introduction in its own right from David, James provided a fascinating biography of Henry Knowles Beecher. The extensive research conducted by James was amazing, but even more impressive was the interpretation of the presented photographs, clippings, and records that helped build the story about Beecher’s complex ego and contributions to medical science.

Beecher is known for many discoveries in medicine but perhaps the most well known is his role in establishing a foundation for medical research ethics that are still relevant today. Yet a closer look at the man revealed many inconsistencies regarding his own ethical conduct of research, leaving open questions about whether or not Beecher was truly a pioneer in medical ethics, an opportunist, or an outright hypocrite.

One theme that resonated throughout the talk was that Beecher, born as Henry Umanst, was always on the outside looking in. He changed his name to Beecher to provide the illusion that he was a member of the Boston Brahmins but never was accepted as such. In his interactions with the U.S. government, including the army and CIA, he consistently attempted to be included in the top-secret inner circle, but never was fully trusted. Possibly these experiences pushed him to self promote more than usual, and this self –aggrandizement further contributed to his isolation but also made his efforts more visible and significant.

Beecher was a pioneer in anesthesia but was not a good clinician and in fact one of the funny quotes was “Beecher was half asleep and the patient was half awake.” His skills were in observation and documentation of everything that he saw. He also was one of the first to use statistics to describe his observations and therefore come up with more robust and substantive conclusions about data. These skills, combined with the relative newness of anesthesiology as a medical field, allowed him to be on the forefront of many research findings including the establishment of pentobarbital as a dangerous anesthetic agent for volume depleted patients, findings that emotion is an important element of pain, discovery of the importance of body temperature during anesthesia, and his role in establishing the definition of brain death. Even before his foray into medical ethics, as the first Chief of Anesthesiology at MGH and the leader of a major MGH research effort in Anesthesia, Beecher had established himself as a significant contributor to the science of anesthesiology.

Particularly controversial was Beecher’s work to document Nazi human experimentation. Beecher received the Dachau reports. Did he ask for it or was it given to him? Possibly as a scientist he wanted to see if any useful information came from human experimentation in concentration camps. He was fascinated by this and documented these reports in great detail. Did he use this information in his own research? Beecher was also heavily involved in the U.S. government’s attempts to develop a “truth serum,” which later became linked to LSD. He even conducted what today would be considered to be highly unethical experiments at MGH to test such agents on local-area college students.

As his productive research career wound down, Beecher became more interested and vocal about medical ethics, writing a publication in JAMA in 1959 entitled “Experimentation in Man” that stated informed consent is impossible – it is just too complex. In a subsequent 1966 NEJM article – “Ethics and Clinical Research” he published 22 experiments by many leading researchers (but not himself!) that detailed the lack of informed consent and risks that outweighed potential benefits. There was substantial fallout in the lay public as evidenced by Boston Globe headline “Are humans being used as guinea pigs not told?” This and other exposés led to Shulman’s notion that we need to put investigators under watch, a concept that led to modern-day IRBs.

He went on to become head of the MGH’s IRB but subsequently was removed as Chair of Anesthesia at MGH. Near the end of his career in 1969 he was working at the Countway Library – editing and modifying records of his own contributions to shape his own legacy. In the end, it was clear to all in attendance at our meeting that this is a remarkable story of a complex and imperfect man. His talents and ego were intertwined in such a manner that is difficult to separate them but the end result was understanding and change that was effected by his contributions to medicine.