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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

 

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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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Unethical Bioethics
Peter Aleff, 2097 Cottonwood Drive, Vineland, NJ 08361, USA,
prevent@retinopathyofprematurity.org   January 2012      Total 11,297 words

 


My letter to President Obama to request a DoJ investigation

Unethical Bioethics Part 1   (4,159 words)
Medical suffocation experiment predictably killed 23 premature babies

>>>  Unethical Bioethics Part 2   (3,449 words)
The world’s longest-running involuntary euthanasia program  

Unethical Bioethics Part 3   (1,619 words)
Blinding babies by nursery light and by official obfuscation 

Unethical Bioethics Part 4   (2,528 words)
The Commission's “Moral Science” report contradicts its own conclusions

 

 
 

Part 2: The world’s longest-running involuntary euthanasia program


New knowingly preemie-killing American nursery guidelines

 

Like some of the infamous Human Radiation Experiments, this latest parent-deceiving and Tuskegee-style cure-withholding SUPPORT experiment produced its own toxic fallout. That fallout is deadly even beyond the 23 “extra” babies killed plus those disabled who are yet to be counted, and it now contaminates the American pediatric doctrine. Shockingly, the reported fatal results from the low-oxygen group have meanwhile become in the U.S. the basis of even harsher new guidelines for withholding more oxygen from preemies. These new guidelines are designed to again suffocate many more babies to protect them from blindness, in a total reversal of the medical profession’s often asserted “first do no harm” motto.

 

For instance, an article by Laura Landro in the Wall Street Journal of July 19, 2011, stated that

"Some neonatal intensive care units are cutting back on the high levels of oxygen traditionally given to premature babies. (...)  Nurses used to be taught that babies should have a blood oxygen saturation level of 99 per cent and appear glowing pink and healthy", Ms. Rikli says. "It was hard for some nurses to accept reducing blood oxygen levels to the 85 per cent range, despite research linking higher levels to blindness."  

(See http://online.wsj.com/article/
SB10001424052702303795304576453932145525052.html)

 

Similarly, the San Luis Obisco News quoted on August 6, 2011, the Medical Director of the local intensive care nursery as saying that "newer guidelines just coming out lower the amount of oxygen given to preemies even further." (See http://www.ksby.com/news/local-doctor-explains-how-
giving-preemies-less-oxygen-may-save-their-eyesight/)

 

However, the advocates of these tighter restrictions on breathing help omit to warn that the recent SUPPORT experiment of tinkering with oxygen levels had with high odds killed 23 "extra" babies in the low-oxygen group, and that the experimenters had announced as their result:

"Our data suggest that there is one additional death for approximately every two cases of severe retinopathy that are prevented.”

There is no version of medical ethics or of real ethics that would accept to kill one baby to save two others from blindness. How would you describe this proposal on any consent form for the parents of the many babies to be so used in this ongoing killing spree started by the new guidelines? Unfortunately, this new nation-wide suffocation experiment will go on unmonitored, and no doctors will explain to the parents why they are withholding, Tuskegee-style, the easily available cure for many of his or her ills from their fragile child.

 

U.S. laws forbid doctors to make such potentially fatal decisions on behalf of their research subjects or patients. Yet, these reported new guidelines are now again intensifying the decades-old practice of withholding the life-saving oxygen “subsidy” from the weakest preemies to save them from having to grow up blind. A possible explanation for these knowingly lethal guidelines may be that they are in tune with the current resurgence of eugenicist thinking in modern medical genetics, and with the sprouting in the U.S. political discourse of assorted neo-Darwinian proposals to be tough on the weak.

 

Applying these new suffocation guidelines in practice will again lead to stunning “extra” death tolls of “weaklings” in the multiple thousands per year, comparable to the medical mass slaughter of 150,000 preemies cited above for the first two decades of strict oxygen withholding. These new “extra deaths” will also further set back the U.S. from its already dismal ranking in 34th place for infant mortality by country, just behind Croatia and Cuba.

 

Medical researchers abroad against U.S.-style systematic suffocation

 

Compare this gung-ho rush in the U.S. towards tighter oxygen withholding, despite its known fatal outcomes, with the opposite approach of the NeOProM experimenters in Australia, New Zealand, and England. After the joint safety analysis of the ongoing parallel experiments, including the SUPPORT results, showed higher mortality rates in the low-oxygen saturation groups, they closed their enrollments early. (The Canadian Oxygen Trial’s final data collection for primary outcome measures is scheduled for June 2012 and was thus not ready to be included in this preliminary analysis, but they have also already stopped enrollment.)

The researchers from the other three countries above recommended at http://www.nejm.org/doi/pdf/10.1056/NEJMc1101319 (page 1681 right, published on April 28, 2011) to stay away from that clearly lethal low-oxygen saturation in practice:

“Until longer-term data on survival and morbidity are available, we consider it prudent not to target an [oxygen saturation] of 85 to 89 per cent.”

Yet, in contrast to this ethically and legally required recommendation to help patients survive in those other countries, the new guidelines in the U.S. now effectively advise nursery doctors here again that they should kill preemies rather than let them grow up blind.

 

Indeed, the lives of preemies have long been cheap in U.S. intensive care nurseries, as shown by the above cited mass-asphyxiations and their high infant mortality rate.

Just compare the public indifference towards the 2010 medical paper about the systematic suffocation of 23 American preemies with the public reaction to the 1991 press reports about Saddam Hussein’s Iraqi soldiers having ripped 22 Kuwaiti preemies from their incubators and left to die. This purported atrocity so inflamed the US public that it was said to have swayed the war-deciding vote for the first Gulf War in the U.S. Congress, even though those preemies later turned out to have been fictitious. By contrast, the 23 real preemies killed right here and now were not even acknowledged outside the clinical literature.

 

The ongoing routine abuses of American preemies also cause less uproar than sporadic revelations that animals were abused in medical research. For instance, when various Harvard medical research facilities were recently found to have killed nine animals through negligence and improper handling, there were public protests and demands to consider suspending research activities at both Harvard Medical School and Harvard University. (See http://www.thecrimson.com/article/2012/1/23/Animals-Testing-Lab/)  

 

But when the SUPPORT experimenters deliberately suffocate 23 human preemies they don’t even have to say “sorry”, and some of their most influential enablers proclaim that the current safeguards against such research abuses are generally adequate. This reveals the actual value American doctors assign to the lives of preemies, never mind their much publicized “heroic” efforts to save “miracle babies”.    

 

The above cynic might also point out that American doctors are less likely to get sued for the death of a preemie than for the blindness of a survivor. This “better dead than blind” preemie-killing strategy by stricter oxygen withholding may therefore be in those American doctors’ perceived rational interest although clearly not in that of their patients.

 

Sleeping watchdog agencies

 

Unfortunately, the U.S. Office for Human Research Protections fails not only to protect subjects from harm in actual research, as illustrated by the 23 “extra” babies killed in the SUPPORT experiment and by that Office’s lack of reaction to alerts about it. That OHRP also does not protect anyone from the harm caused by the uncritical application of flawed or misinterpreted research to produce misleading guidelines.

 

There is no safeguard in the U.S. healthcare system against knowingly harmful treatment practices such as the current tightening of the lethal oxygen withholding. This new turn of the oxygen throttle now worsens again the “living hell” for many children when their guideline-duped and Tuskegee-forgetting nursery doctors become even more stingy than before in giving them this easily available remedy for their breathing problems and obediently kill them instead with their waterboarding-like torture.

 

Nor is there any functioning quality control in the U.S. for the research that leads to such destructive guidelines. The U.S. Office for Research Integrity has a poor track record for detecting flaws in medical research and seems to rely mostly on the publishing journals’ traditional system of peer review while ignoring alerts from outside their small clique. This system is based on insiders’ groupthink and offers no barrier against misreporting of results or outright fraud.

 

The ORI also cannot conduct its own investigations or even initiate any at the affected universities but can only oversee those launched there. And when they do confirm misconduct, they give the convicted bad-apple researchers at most a slap on the wrist by barring them from future funding by the National Institutes of Health. This process is said to probably miss most major misconduct, as told by a well-informed ORI consultant to a recent British conference on research misconduct (http://www.nature.com/nature/journal/
v481/n7381/full/481237b.html).

 

If that Office for Research Integrity does anything at all, it appears to have no discernible impact. In November, 2010, the Journal of Medical Ethics analyzed 788 clinical papers that had been retracted between 2000 and 2010 and found that 197 of them, or 25 per cent, had been pulled for research frauds. India and the U.S. both topped the list of frauds as a proportion of all retractions from these countries, with 34 and 32 per cent, respectively. These high levels of fraud were virtually the same in both countries although, for over 20 years by now, the U.S. had its ORI to supposedly promote research integrity and to deal with research misconduct whereas no equivalent agency exists in India. This lack of difference in the results led an editorial in the 11/30/2010 Telegraph - Calcutta to conclude that “this study provides no evidence that ORI’s existence has led to a lower scale of misconduct” (http://www.telegraphindia.com/1101130/jsp/nation/
story_13238575.jsp).  

 

Moreover, the articles that get voluntarily retracted are just the tip of the iceberg. Their number does not include any of the plainly bad research that should have been retracted but was not. This unacknowledged fake research continues to pollute the integrity of the medical doctrine, sometimes with disastrous and long-lasting consequences as in the massively preemie-killing medical approach to ROP.

 

However, evaluating which of the many not retracted results are obviously suspect or simply don’t support the stated conclusion and should therefore be repudiated, preferably even before they get published, seems to exceed the abilities and even aims of that Office. Despite the frequency and staggering human cost of peer-reviewed bogus medical research, there appears to be no functioning mechanism for detecting even obvious research frauds or misinterpretations and neutralizing their dangerous fallout.

 

Eugenic roots of oxygen withholding mania

 

For instance, that Office has ignored repeated alerts about blatant research frauds in the clinical literature about ROP, including the 18-hospital Cooperative Study of Retrolental Fibroplasia and the Use of Oxygen experiment in the mid-1950s that started the still continuing oxygen withholding mass carnage and that you find documented at www.retinopathyofprematurity.org/
23oxygenstudyfrauds.htm

 

The Nuremberg Code and its successors require that all researchers must be familiar with the relevant scientific literature before they propose any experiment on human subjects. The designers of the current child suffocation experiments had clearly not complied with this imperative. They not only ignored a large body of scientific writings about light damage to the eye, they also misread the initial Cooperative Study that introduced the routine oxygen withholding. Any attentive reader of that description can see that the reported data did not support the alleged conclusion. This conclusion claimed that the oxygen withholding had reduced the incidence of ROP without affecting the mortality, but it is easy to find out that the systematic asphyxiation had killed most of the babies who would otherwise have survived with damaged eyes.

 

It is also clear from the paper itself that this authoritatively proclaimed wrong conclusion was an intentional deception, and its context within the then still influential eugenics movement to improve the human species sheds light on the reason for this maybe well-meant but ideology-misguided and still today doctrine-contaminating and consistently harmful deceit.

 

This movement had shaped much medical thinking during the first half of the 20th century, based on the pseudo-science of eugenics which was then considered the cutting edge of medical progress. Its advocates openly proposed the killing of "hereditary defectives", particularly the withholding of life-saving medical treatment from "physically defective infants" in cases when, in the doctor's opinion, the treatment "can only save the life by making it a daily and hopeless misery". See http://retinopathyofprematurity.org/20oxygeneugenics.htm for the documentation of this and the next six paragraphs.

 

One of the major targets for eugenicists had been the elimination of blindness which some of them declared to be almost 100 percent hereditary although the actual proportion was closer to seven percent.

 

The president of the Eugenics Research Association from 1918 to 1928 was a celebrated ophthalmologist and president of the American Ophthalmologic Society. He repeatedly pushed for legislation to either sterilize or incarcerate all people with impaired vision and to “hunt down” all members of their extended families to prevent any of them from having children who might become blind. He argued that all blind people were burdens to the taxpayers, and also that "it is unjust to the blind to allow them to be brought into existence simply to lead miserable lives”.

 

The influence of this “better-dead-than-blind” activist remained strong among American ophthalmologists long after his death. At a 1948 meeting, the designers of that 1950s Cooperative Study of oxygen withholding stated their belief that “defective germ plasm” was responsible for the blinding, and they proposed to achieve their eugenicist goal of eliminating it by being “less zealous in preserving these defective persons”.

 

Rigging the initial oxygen withholding and euthanasia-starting experiment

 

The principal means of preserving the lives of the weakest preemies was and still mostly is to give them life-saving supplementary oxygen. Because oxygen had this well-deserved reputation as a life-saver, the advocates of not preserving the “defectives” launched a smear campaign against that breathing help as an

“... undeserved subsidy” that removed the baby’s “stimulus to [the] private enterprise” of breathing on his or her own, whereas the British National Health Service’s “oxygen on the State (…) saved the individual from having to work his best to live”.

Although the eugenicist reason for the withholding of that “subsidy” was not again publicly mentioned in the medical literature of the time that I consulted, its lethal legacy still dominates most intensive care nursery routines around the world to this day and may have contributed in the U.S. to the above “new guidelines” for again throttling the oxygen faucets more severely.

 

Once oxygen was firmly associated with this definition as “socialist subsidy”, the advocates of eliminating the “defective germ plasm” behind the blinding launched that 1950s multi-hospital Cooperative Study in which they withheld virtually all breathing help from almost all the 1,420 preemies in the participating hospitals for the first 48 hours. By then 634 of those preemies had died, for a death rate of 45 per cent, versus 32 per cent in the first seven days at one of the participating hospitals in the two years just before that oxygen withholding. 

 

This drastic suffocation protocol killed thus about 184 “extra” babies before the researchers enrolled only the 786 survivors and so excluded all those prior deaths from their analysis. With this trick, they weeded out from their sample the most fragile preemies with the most vulnerable lungs who were also the ones with the most vulnerable eyes. They found therefore, predictably, very few cases of blindness among the so selected survivors since they had killed most of the babies who would otherwise have grown up blind, plus a great many others indiscriminately mowed down with them.

 

Their heavy thumb on the risk-weighing scale allowed the experiment designers to misleadingly proclaim that oxygen withholding had reduced the blinding without affecting the mortality among the enrolled infants, and that it was therefore safe to withhold the oxygen “subsidy” from the needy infants. For a discussion of this knowingly false conclusion, see www.retinopathyofprematurity.org/01summary.htm and http://retinopathyofprematurity.org/Bioethics1955oxygen.htm.

 

This grossly misleading but authoritatively announced forged result contradicted all logic and experience because oxygen had been given freely and routinely to preemies as a much appreciated life-saver for many decades before the first babies ever suffered from ROP.

 

Despite this long positive history of oxygen for preemies, the trumped-up charges against this life-saving gas made the Cooperative Study of oxygen withholding and the selling of its alleged results possible. Its uncritical acceptance helped to launch the hidden but systematic and world-wide preemie-suffocating euthanasia program that its crypto-eugenicist designers had so deceptively triggered and that is estimated to have killed 150,000 preemies in its first two decades.

 

This estimate is likely low because an extrapolation from the few then available data yields about just over twice that number for that period in the U.S. alone, see http://retinopathyofprematurity.org/26allegedstudyresults.htm. In any case, whatever the actual death toll may be, the doctrine that imposed this euthanasia program against the weakest preemies in the name of science is a crime against humanity, but nursery doctors around the world apply it blindly to this day.

 

Even the theory behind this lethal doctrine is plainly fake because it had been known since 1924 that the retina consumes oxygen at a higher rate than any other tissue in the body and that it has its own system for autoregulating its oxygen supply. That supply is therefore independent from the arterial blood saturation. Although meanwhile some data exist about some connections between these in adults, no one knows how the oxygen supply in the still developing retinal vessels of an early preemie correlates with that supply in the peripheral artery where alone it can be measured. See http://retinopathyofprematurity.org/28laterdeaths.htm.

 

Measuring only the latter, even with the latest and fanciest computer-assisted pulse oximetry technology, gives therefore no information about the oxygenation of the preemies’ retinal vessels where alone this parameter would count, according to the oxygen theory for ROP. Searching for data about the retinal oxygenation only in its arterial counterpart resembles therefore the proverbial drunk who lost his wallet in the dark alley but searches for it under the street light because there he can see better.

 

The alleged connection between “liberal” oxygen subsidies and preemie-blinding has deceived doctors for over half a century by now and led most recently to the ethically impossible but widely approved NeOProM and SUPPORT child suffocation experiments. Moreover, the new American guidelines to again decrease the oxygen levels for preemies, despite the known lethal consequences of this tighter rationing, suggest now that the eugenicist strain of American medical ideology which led to that rationing in the first place is still active and gaining new strength.

 

Indeed, ROPARD.org, the official medical fundraising organization for more research about “ROP And Related Diseases”, claims without any supporting evidence on its website home page that “ROPARD research has begun to identify a genetic link between premature birth and retinal detachment.” Similarly, a recent retrospective study of preemie twins, published in the November, 2006, issue of Pediatrics, pretends again to have determined that genes are a major factor in ROP. Its authors state that a component of their analysis

“... factored in the potential effects of unidentified factors” from a list of five suspected variables not available from their data set, in addition to unknown unidentified factors. By modeling the effects of these nongenetic components, we were able to determine that 70.1% of the variance in liability to ROP was attributable to genetic factors alone.”

This precise-appearing assertion is plainly fictitious. Those authors’ "known" factors, such as the co-variates of gestational age and duration of supplemental oxygen use, are statistically inseparable from each other as well as from the incidence or severity of ROP. They can therefore not be mathematically controlled for, as the authors pretend to do, by separating out their postulated influence on the blinding.

 

Moreover,  the authors’ claim to have controlled their results for several named unknown plus any “unknown unidentified nongenetic factors” is by definition bogus. If one wants to control statistically for a factor then one must know this factor and its effects to so quantify them. Anyone who pretends to control for unknown and even “unidentified unknown” factors without even revealing how this magic could be performed matches ipso facto Webster’s definition of a quack: “one who pretends to skill or knowledge which he does not possess.”

 

This peer-reviewed academic nonsense has the scientific value of a horoscope because its authors try to dress up their hunches and prejudices with elaborate-looking computations the way astrologers do. Yet, this self-evidently neo-eugenic medibabble was prominently published in the flagship journal of the American Academy of Pediatrics and then gullibly echoed in medical news releases around the world to show that eugenics is back. This resurgence helps to explain the new U.S. guidelines for suffocating preemies to protect them from having to grow up blind and then spreading their updated version of the 1950s “defective germ plasm”.

 

Meanwhile, despite the continuing and ostensibly learned confusion about proper oxygen levels for preemies, some of which you can appreciate at http://retinopathyofprematurity.org/29futilityandharm.htm, the entire epidemic of baby-blinding could easily be ended if intensive care nursery doctors would consent to change their light bulbs.

 

Continue here to Part 3:
Blinding babies by nursery light and by official obfuscation 

 

 
 

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