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Abstract & Summary

Table of Contents
ROP description
Eugenics against oxygen

Slandering oxygen >>>

Oxygen study frauds  
Alleged study results
Later deaths
Futility and harm
Fluorescent ROP lamps
Damaging irradiance
Preemie vulnerabilities
Studies of light and ROP
Frauds in LIGHT-ROP
Coverup stonewalling

 

Related items

Protect your baby

Baby-blinding lights
LIGHT-ROP Manual
Macular degeneration
Preemie Pain
Parent Concerns

Re-Tuskegee

Bioethics LIGHT-ROP

Bioethics SUPPORT

Bioethics own violations

Bioethics Consent

Bioethics 1955 Oxygen

Unethical Bioethics 1

Unethical Bioethics 2

Unethical Bioethics 3

Unethical Bioethics 4

Hypocritical Nature

False Medical Denials

Pre-Nuremberg Bioethics

Protect Humans in Research

Avaaz Petition to WHO

 


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Footnotes :
 

[1]  Silverman WA. Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, Chapter 7: "Oxygen Treatment Practices in Premature Infant Care", 43-51, see page 45

 

[2]   This comparison actually appears in the final report from the bogus study of oxygen: KINSEY EV. Etiology of retrolental fibroplasia and preliminary report of cooperative study of retrolental fibroplasia. Trans Am Acad Ophthalmol Otolaryngol 1955: 59: 15-24, see page 18 left.

 

[3]  As reported by Silverman WA. Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, Chapter 4: "The Oxygen Hypothesis", page 28.

 

[4]  This 1897 report by a Dr. DeLee is quoted in Jeffrey P. Baker’s “The Machine in the Nursery”, op. cit., on page 119.  The two diagrams of preemie incubators are published in the same book, pages 72 and 83, and credited to “Transactions of the American Pediatric Society 5 (1893).

 

[5]   Silverman WA.  Incubator-Baby Side Shows. Pediatrics, August 1979, 64: 2: 127-141, see Fig. 13. of the Incubator-Baby exhibit at the Century of Progress Exposition, Chicago, 1933-34, and Dr. Silverman's comment in the caption: "Note the oxygen tank standing beside each incubator. It is interesting to recall that the use of oxygen in the management of premature infants at the Sara Morris Premature Infant Station in Chicago was introduced in 1931. Over a three-year period (1931-1933), 346 of 792 infants admitted to [the] Sara Morris unit were placed in the newly developed Hess infant oxygen bed (oxygen was administered for more than 24 hours, occasionally as long as six weeks, in concentrations of 40% - 55%).  The new oxygen policies were credited, in part, for improved survival over the previous period from 1922 to 1929."

 

[6]  Hess JH. Oxygen Unit for Premature and Very Young Infants.  American Journal of Diseases of Children, April 1934, 47: 916-917, see page 917 for birth weights.

 

[7]  Vignec AJ, Moser A, Ellis R. Angelos P. Current Trends in Premature Care. New York State Journal of Medicine, 1952, 52: Pt. 2: 1764-1769, see page 1766 left, bottom, and right, middle.

 

[8]  Silverman WA. Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, Chapter 4: "The Oxygen Hypothesis",  pages 27-29, quote on page 28.

 

[9]  Evans PJ. Retrolental Fibroplasia. Transactions of the Ophthalmological Society of the United Kingdom, 1952, 71: 613-16, quotes on pages 613 bottom, 614 top, and 615 middle.

 

[10]  Campbell K. Intensive Oxygen Therapy as a possible cause of Retrolental Fibroplasia: A Clinical Approach, The Medical Journal of Australia, July 14, 1951, pages 48-50, quote on page 49 right.

 

[11]  Silverman WA. Retrolental fibroplasia: a modern parable. Grune & Stratton, Inc., New York, 1980, Chapter 4: "The Oxygen Hypothesis", see page 25.

 

[12]  Crosse VM, Evans PJ. Prevention of Retrolental Fibroplasia. A.M.A. Archives of Ophthalmology, July 1952, 48: 83-87, quotes on pages 86 bottom and 87 bottom.

 

[13]  Langs R. The Listening Process, Jason Aronson, London, 1978, as cited in Godwin R. Dimensions of the American Political Mindscape, The Journal of Psychohistory, Summer 1993, 21: 1: 79-96, see page 84.

 

[14]  Starr P. The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry. Basic Books, New York, 1982,  see chapter on "Symbolic Politics, 1943-1950", 280-289, see pages 284, 285, and 287 bottom.

 

[15]  Post LT. The Art of Medical Practice. Address of the Guest of Honor at the Annual Session of the American Academy of Ophthalmology and Otolaryngology in October 1953, Transactions of the American Academy of Ophthalmology and Otolaryngology, November/December 1953, 841-47, see page 842 top left: "Socialized medicine, an actuality in some countries and a serious threat in this, is a terrible blow to the art of practice."

 

 


 


 

  

 

  

 Baby-harming medical research

 

about baby-blinding retinopathy of prematurity

by H. Peter Aleff, 2005 to 2009

 
 

 

2.2: Smear propaganda against life-saving oxygen

Oxygen was the ideal scapegoat. Incriminating it would exonerate the nursery doctors from all responsibility for the clearly iatrogenic blinding because if they had given the babies too much of it they had done so only with the laudable intention to save their lives. This argument would offer them the easy defense that the disease was an unfortunate but difficult-to-avoid side effect of premature birth. 

In addition, controlling the flow of oxygen would provide doctors at long last with a real role in the nurseries which were then dominated by skilled nurses. Some doctors described these experienced nurses as "opinionated"[1] because they talked back and did not blindly obey their orders. The power to prescribe or withhold oxygen, however, would establish doctors as the indispensable navigators between the Scylla of eye damage from too much oxygen and the Charybdis of death and brain damage from too little[2], based on the implied and still often unquestioned medical assumption that these risks are on the same level. 

To make the charges against oxygen stick, despite its long track record as saver of many lives, and despite the nurses’ daily experience how well it helped the tiniest preemies in their often desperate breathing struggles, the eugenics advocates needed a large clinical trial. The function of that trial was not to learn anything about ROP but only to condemn oxygen publicly with the inquisitorial might of infallible medical science. The ex cathedra results from a big show trial would allow them to hide under a candy-coating of fake data the distasteful substance of the intended euthanasia program.

The late Dr. William A. Silverman, a neonatologist much involved in the early debate about ROP, chronicled in his 1980 book Retrolental Fibroplasia: A Modern Parable, how the first such trial came to be held. According to him, Dr. Leroy Hoeck, director of the intensive care nursery at the Washington, D.C., Gallinger Municipal Hospital, mused to Dr. Arnall Patz, a young ophthalmologist resident from nearby Baltimore, Maryland, that high oxygen concentrations given to the babies might be involved in their blinding.

That conversation must have taken place not long after the May, 1949, publication of Payne’s euthanasia recommendation because Silverman reports that Patz “dropped the matter for a while”, initially dismissing that idea as unlikely on theoretical grounds. Then, “in late 1949”, Patz changed his mind and began to design a clinical trial to test the influence of oxygen on ROP in the intensive care nursery. He proposed to assign premature infants in alternate order to incubators with either routinely high or low oxygen enrichment[3]

That oxygen-restricting proposal flew in the face of everything then known about premature babies and oxygen. Oxygen had been routinely administered to them for many decades to help their immature lungs until they were ready for room air, and it was given as a matter of course since it was such a clearly beneficial life-saver. 

Already the 1893 “Transactions of the American Pediatric Society” show diagrams of preemie incubators with items labeled “connection for oxygen supply” and “oxygen pipe”, and a medical report from 1897 mentioned also continuous administration of pure oxygen as one of the routine resuscitation techniques for preemies[4]

These proofs of earlier oxygen use date from 47 years before the first baby ever suffered from ROP, and 61 years before Reese and his like-minded colleagues would suddenly declare this then longstanding habit of giving the babies oxygen to be the culprit for the then recently started epidemic of preemie-blinding. 

Throughout these years, pictures of preemie incubators often showed an oxygen bottle next to them[5]. Also, Dr. Julius Hess, one of the pioneers of modern neonatology, described in 1934 how he had routinely kept preemies in atmospheres of 40% oxygen which was at times increased to 50 or 55%, and in some cases even in a mixture of 5% carbon dioxide with 95% oxygen.  Some of the survivors weighed as little as 790, 865, 890, and 970 grams at birth[6]. None had or ever developed ROP.

Similarly, a 1952 article about Current Trends in Premature Care that summarized the experience gained over the years with oxygen praised it as one of the most effective weapons against respiratory problems that should be applied without waiting for the baby to develop breathing difficulties:

"Suction, gently applied, to keep the air passages clear, and the administration of oxygen are two of our most effective weapons in dealing with respiratory problems. (...) Except for the larger prematures who need no assistance, the burden of proof as to respiratory competence rests with the patient and unless within the first twenty-four to thirty-six hours we are convinced that he is able to maintain adequate respirations unaided, he remains in the incubator. The aim is to anticipate and not to wait for clinical signs to appear."[7]

However, with all this routine use of oxygen in nurseries across the country and around much of the world, not one baby anywhere had ever developed ROP before 1940 and the arrival of the new bright lamps in American nurseries. And no baby born overseas got ROP before 1946 when these lamps began to become available there. 

Even retrospective studies among older blind people had turned up no previously missed cases of ROP from before that time, so there was no logically defensible way how this entirely new condition could suddenly have been caused by the long familiar and regularly administered oxygen.

Despite this long history of oxygen as a non-blinding life saver and its perfect alibi in the case of ROP, Patz and Hoeck received the requested grant for their oxygen-restricting study with relatively little discussion. Silverman described how the reviewers at the National Institutes of Health initially criticized that grant application as:

“... weak in scientific merit and with extreme concern by the pediatric referees that ‘... these guys are going to kill a lot of babies by anoxia to test a wild idea.’  Patz and Hoeck satisfied the objections of the referees by stating ‘to avoid having deaths from lack of oxygen, every baby in the low oxygen group would be maintained at a healthy pink color. The $4000 was granted.

The nursery trial proved to be difficult for the investigators. Patz found that ‘the nurses were convinced that we were going to kill the babies in the low oxygen group, and indeed, at night some of the older nurses would turn the oxygen on for a baby who was not receiving oxygen, then turn it off when they would go off duty in the morning.’”[8]

Although the grant givers were easily won over, the objections of reviewers and nurses against oxygen withholding demonstrated that the until then unblemished reputation of oxygen as a safe and effective life saver had to be changed first before the idea of blaming it could become acceptable. 

Accordingly, some proponents of oxygen withholding began an international smear campaign against that until then so beneficial gas. There is no need for conspiracy theorists to imagine here some elaborately planned plot orchestrated by a sinister cabal with silly code names in dark underground garages. Instead, we can openly observe in the medical literature of the time how that campaign unfolded. 

The discrediting of oxygen appears to have been driven by spontaneous expressions from a few individual doctors who shared the same ideology and “doctor knows best” attitude. They also read and heard the same views and interpretations in their journals and meetings. It seems that this small group of medical opinion leaders had the willing ears of their receptive colleagues, and the internal ricochets of that group’s echoing their buzz about oxygen appear to have reinforced their mutual convictions.

One of the most profuse among those early oxygen-accusers was Dr. Philip Jameson Evans, a prominent ophthalmologist in Birmingham, England. He expressed in March 1951 his views about the infant's need for "an oxygenated blood supply acquired by its own efforts", and he continued, in words that sound as if he had borrowed them from the earlier eugenics advocates:

"Prior to 1930 [sic - please note that ROP began only in 1940] oxygen was not given so frequently as a routine or for such prolonged periods, or at so nicely uniform a level as today. Now [the infant] lives in a constant atmosphere of moderately high oxygen concentration (...) and certainly without the stimulus to private enterprise: hence an inertia results as we find in other human activities when over-subsidized. (...) They have oxygen 'on the State' (...) Perhaps this is only one further instance of the modern trend to save the individual from having to work his best to live, and perhaps our treatment is in fact the reason why this disease has now appeared."[9]

In July of that same year, Dr. Kate Campbell, a neonatologist from Melbourne, published an article in The Medical Journal of Australia in which she said “colleagues returning from overseas” had suggested that oxygen might be responsible for the eye damage.  She then described that her own general comparison of three nurseries with different means for paying the costs of oxygen seemed to confirm this suspicion.  She concluded that preemies should not receive any oxygen supplements unless they turned blue from its lack, and if that happened because of a congenital cardiac defect, then “vain efforts should not be made to improve the infant’s colour with oxygen”[10]

Silverman notes in his account of this earliest published clinical indictment against oxygen that Campbell’s informants had visited Birmingham, England[11], so her findings appear to have been inspired by Evans’ anti-subsidy rantings.

A year later, Evans and Dr. Mary Crosse, his like-minded colleague in Birmingham, continued the slander against oxygen, this time in the respected American journal Archives of Ophthalmology, as edited by Reese:

"Prior to the modern technique of oxygen administration, the premature infant fought out its struggle for oxygenation. (...)  It seems that, as in domestic and national policies, a prolonged subsidy paralyzes the ability to struggle which would otherwise have had the opportunity to develop, and that the disease has, in fact, been artificially induced by a well-intentioned, but misguided, change in the management of such cases.  That a return to a less indulgent care of the premature infant prevents the disease should be appreciated as soon as possible, and cannot be too quickly undertaken."[12]

This labeling of oxygen as a subsidy made it ideologically intolerable to the many doctors who still shared the eugenics movement’s aversion against any help for the struggling.  Add to this that during those McCarthy-era communist-hunting years in America, it was not necessary for charges of leftist connections to be proven to be widely believed.  In any case, Evans’ rhetorical insinuations against the until then "life-saving" gas found a ready reception in American medical circles, as the actions of their members would show. 

In a textbook example of what psychologists call projective identification and action discharge of disturbing internal stimuli, a condition common in  political debate where people who feel threatened mistake the symbol for the real thing it represents[13], the American community of nursery doctors reacted to this red-painting of oxygen like a bull to red cloth.  The American Medical Association had just spent $1.5 million in 1949 and $2.25 million in 1950 to defeat President Truman's National Health Insurance proposal, in what was back then the most expensive lobbying effort in American history. 

Their advertisements had linked British-style National Health Insurance with socialism and even with fabricated Lenin quotes[14], and the political fever inflamed by this type of slander continued to run high for years later.  For instance, the Guest of Honor at the 1953 Annual Session of the American Academy of Ophthalmology and Otolaryngology declared that socialized medicine was "a terrible blow to the art of practice" and a "serious threat"[15].  This emotional and political context made it easy for the American pediatric leaders to continue linking that socialist threat with the oxygen that Evans and some of his colleagues had already connected to the socialist evil of “subsidies” dispensed by a loathed system. 

 
 

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