Abstract
Kaare Rodahl, a scientist with the US Air Force’s Arctic Aeromedical Laboratory, spent much of the 1950s traveling to villages in the Alaskan Arctic to conduct research on cold acclimatization. Four decades later, it was discovered that during one such study, he had administered radioactive isotopes of iodine-131 to over one hundred Alaska Native research subjects without their knowledge or consent. This news broke just as Alaska Native communities were attempting to recover from a series of revelations surrounding other instances of Cold War radiation exposure. In response, two major federal investigations attempted to determine whether Rodahl had adhered to ethical regulations and whether his actions could be expected to have a lasting health impact on former research subjects. The National Research Council, framing the study as a singular event in the Cold War past, found that research subjects had been ‘wronged, but not harmed’. The North Slope Borough, a powerful Alaska Native municipal government, countered this finding with their own investigation, which identified both the study and the subsequent federal inquiries as facets of the still-unfolding process of American settler colonialism in Alaska. In doing so, the North Slope Borough contested the authority of federal agencies to set the terms by which ethics could be retrospectively judged. This article argues that exploring how competing ethical regimes represent the relationship between violence and time can help us better understand how institutionalized bioethics reproduces settler colonial power relations.
‘Once again’, Jeslie Kaleak Sr. declared in May 1993, ‘Native people have been used as unknowing guinea pigs in scientific experiments’ (Stapleton, 1993: A3). Kaleak was the mayor of the North Slope Borough, a powerful municipal government that represented the residents of a vast region stretching from the Brooks Mountain Range to the Arctic Coast. Kaleak had just learned that between 1955 and 1957, Norwegian physiologist and physician Kaare Rodahl had administered radioactive isotopes of iodine-131 to over one hundred Iñupiaq and Gwich’in individuals – most of them residents of the North Slope – without their knowledge or consent. The Associated Press contacted Rodahl in Oslo and asked him to respond to the allegations. He was frank about the purpose of his work: ‘we felt that if we could make a study of the Eskimos to find out how they got along’, he explained, ‘we could perhaps learn from them so that we could do the same as they do’ (The Globe and Mail, 1993: A11). 1 At the time of the study, Rodahl had been employed by the Arctic Aeromedical Laboratory (AAL), an American Air Force institution located just outside of Fairbanks. The role of the laboratory was to enable the militarization of the Alaska Territory (Farish, 2013).
By the 1950s, American military officials had become concerned that the Soviet Union might launch an invasion through Alaska. The staff of the AAL were tasked with developing scientific and technical knowledge that would prepare the American military for cold weather combat. With this goal in mind, AAL researchers studied Alaska Native peoples in search of racial differences that might explain their capacity to thrive in Alaska’s ‘hostile’ climate. Rodahl was committed to this research agenda (Farish, 2013). During his time at the AAL, from 1950 to 1957, he conducted field and laboratory studies on the physiological characteristics and dietary patterns of Iñupiat and Athabascans. He also provided incidental medical care in many of the villages he visited, particularly when he felt that doing so would encourage residents to participate in his studies (Rodahl, 1963). During several of these encounters, Rodahl instructed research subjects to ingest iodine-131 radioisotopes, just as he had occasionally offered them medicines or vaccinations. The ambiguous nature of these interactions allowed Rodahl to blur the boundary between research and care and obscure his scientific goals behind a façade of therapeutic intent.
Iodine-131 – still a relatively new technology in the 1950s – is a radioisotope tracer that can be used to observe thyroid activity. Rodahl had hypothesized that the thyroid gland might play a role in cold adaptation and be the site of the theoretical racial difference that he was searching for. But in the end, Rodahl found no evidence to suggest that the thyroid gland played a role in cold adaptation, nor did he uncover any racial differences in thyroid function (Rodahl and Bang, 1957; Farish, 2013). The study, which was published only as an AAL technical report, was shelved. Rodahl left Alaska soon after and eventually returned to Norway to pursue other professional opportunities. He likely did not expect that he would ever be called upon to justify his actions during the thyroid function study.
However, four decades later, Rodahl would find himself involved in a heated dispute over how research ethics should be judged in retrospect. A series of formal investigations were initiated in response to the revelations surrounding the thyroid function study. These inquiries, the first run by the Advisory Committee on Human Radiation Experiments (ACHRE), the second by the National Research Council/Institute of Medicine (NRC), and the third by the North Slope Borough (the Borough), aimed to determine what had happened in the North Slope in the 1950s and to make sense of what that history meant for North Slope residents in the 1990s. During these investigations, experts gathered testimony from former AAL researchers and research subjects, sifted through scientific evidence, and attempted to measure the possible health impacts of iodine-131 exposure. In doing so, they configured the relationship between time and harm in distinct and specific ways. According to the ACHRE and NRC, the thyroid function study might have caused physical harm in the past and those effects – the consequences of radiation exposure – might persist into the present. Part of the aim of their investigations was to determine whether or not this was likely. However, for the Borough, Rodahl’s actions might have caused harm in the past, but they could also cause different types of harm in the present and future, including psychological distress caused by doubting one’s own memories of past encounters with physicians and researchers. In this way, according to the Borough, colonial violence enacted through biomedicine caused harms that could persist, transform and multiply over time. This was an experience of harm that was not legible through the bureaucratic and scientific lens of institutionalized bioethics.
Bioethics, operating through institutional review boards and other bodies that share a similar mandate, has often failed to afford research subjects protection from harm. Instead, it has tended to offer powerful institutions and researchers protection from accusations of malpractice (Koch, 2012; Radin, 2018; Schrag, 2010; Stark, 2011). Institutionalized bioethics, consolidated in the aftermath of the Tuskegee Syphilis Study, also often focuses on questions of consent at the expense of questions of justice (Reverby, 2009: 194). And as scholars have shown, a crucial facet of the power of bioethics lies in the apparent universality of its values and systems of regulation (Benjamin, 2016; Garrison, 2013; Radin, 2018; TallBear 2013; Tsosie 2007). However, as Radin and Kowal (2015) have demonstrated, multiple ‘ethical regimes’ in fact operate within specific historical, political and cultural contexts. When bioethics is employed in colonial contexts, then, it does more than protect researchers and institutions, it also legitimizes the values of the colonial state. With this in mind, it becomes clear that when contemporary Indigenous communities issue their own research protocols and design independent systems of review, they are refusing the notion of universal ethics and situating research ethics as a site for the expression of autonomy or sovereignty (Benjamin, 2016; Garrison, 2013; Radin, 2018; Simpson, 2007, 2014; TallBear, 2013, 2017; Tsosie, 2007). Drawing on this work, I argue that focusing on the relationship between violence and time can help us to better understand how bioethics reproduces settler colonial power relations.
Wolfe (2006) has argued that settler colonialism is a ‘structure not an event’. It consists of sets of power relations oriented towards the eventual elimination of Indigenous peoples. Elimination need not involve genocide, but can instead be pursued through various forms of assimilation, including the relegation of Indigenous cultures, legal systems and languages to the past. Typically, when arguing against characterizations of Indigenous peoples as primitive or disappearing, scholars have drawn on Fabian’s work to insist that Indigenous peoples are coeval and inhabit contemporary time (Fabian, 1983; Rifkin, 2017: viii). However, as Rifkin (2017) has argued, the imposition of a universal temporal frame — inclusion in a shared sense of past, present and future – is also a feature of settler colonialism. Because settler colonial power dynamics endure, the notion of a ‘shared present’ most often implies that time will be structured according to ‘settler institutions, interests, and imperatives’ (Rifkin, 2017: viii). Following Rifkin, the aim of this article is not to excavate an ‘authentic Indigenous conception of time’ that is ‘incommensurable’ with and ‘hermetically sealed’ off from settler time (Rifkin, 2017: 3). Instead, it will show how settler temporality operates under the banner of bioethics to subsume and erase Indigenous temporalities and experiences of colonial violence.
In the 1950s, Rodahl and his contemporaries had also engaged in their own form of temporal ethical reasoning. I begin this article by analyzing Rodahl’s research in Alaska and the vision of the future that he relied upon to justify it. Although he may not have realized it, Rodahl’s work took place during a pivotal moment in Alaska’s history, one that set the stage for a dramatic political transformation. By the 1970s, a powerful Alaska Native rights movement had fundamentally altered the balance and organization of political power in Alaska. After explaining this process, I demonstrate how Alaska Native political leaders, particularly in the North Slope, responded to a series of revelations about a disturbing episode of Cold War radiation experimentation. Revelations about the ‘Project Chariot’ experiment motivated deeper investigations that led to the discovery of the thyroid function study. The final sections of this article discuss the subsequent ethical investigations and track how the ACHRE, NRC, and the Borough competed for the authority to situate the thyroid function study in a particular narrative of the past. In doing so, they raised questions about what counted as the relevant context, historical or otherwise, for the study. For the ACHRE and the NRC, it was the Cold War, but for the Borough, it was settler colonialism. The Borough also characterized the ACHRE and NRC inquiries as part of the colonial process. As federal agencies, the Borough insisted, the ACHRE and NRC could not be trusted to evaluate the past actions of scientists who represented another federal agency.
The Borough’s position can be understood in terms of the politics of recognition. Efforts to synonymize indigeneity and primitivity have often gone hand in hand with the ‘recognition’ of still-existing Indigenous communities as racial minorities within a neoliberal multicultural present (Byrd, 2011; Kauanui, 2016; Povinelli, 2002; Wolfe 2006). This form of recognition, as Kauanui (2016) has demonstrated, aims to eliminate ‘the native as native’, eliding the specificity of Indigenous peoples’ experiences by collapsing colonization into racialization and reframing the pursuit of sovereignty as a call for inclusion and equality (Byrd, 2011; Coulthard, 2014; Kauanui, 2016; Povinelli, 2002; Wolfe, 2006). As such, recognition actually operates ‘as the field of power through which colonial relations are produced and maintained’ (Coulthard, 2014: 17). 2 The ACHRE and the NRC replicated this form of recognition by acknowledging the legitimacy of Iñupiat grievances only insofar as those grievances could be understood through modes of evaluation designed to redress the exploitation of marginalized peoples at the hands of Cold War biomedical researchers. In rejecting the temporal reasoning characteristic of institutionalized bioethics, Iñupiat leaders engaged in an act of ‘refusal’ (Simpson, 2014). The Borough not only rejected the findings of the ACHRE and NRC, but also raised ‘the question of legitimacy’ and asked, ‘What is their authority to do so? Where does it comes from? Who are they to do so?’ (Simpson, 2014: 11). This suggests that when writing histories of bioethics that ask, ‘What were the standards of the time?’, we might also ask ‘Whose standards are we speaking of?’ and ‘Whose time?’
North to the future
While working on his medical degree in the late 1940s, Rodahl briefly served as a consultant on Arctic nutrition with the US Air Force, a role which brought him to the Alaska Territory for the first time. He later recalled that he had been impressed by the ‘availability of several interesting ethnic groups’ for potential study and with the research infrastructure that the Air Force was developing (Rodahl, 1963: 7–8). In the summer of 1950, Rodahl received a telegram from Washington offering him a job developing the new Department of Physiology at the AAL. It was exactly the opportunity he had been waiting for (Rodahl, 1963: 7–8; Farish, 2013).
The years Rodahl spent in Alaska were professionally productive. Beyond his scientific publications, he wrote prolifically for popular audiences about his time in the North. He crafted memoirs, short stories, serialized non-fiction pieces and a novel in a style that combined adventure tale, popular scientific account and ethnographic study (e.g., Rodahl 1953, 1963, 1979). He admired polar explorers and, perhaps seeking to emphasize the similarity of his endeavors to those of his forbearers, he tended to portray his fieldwork as a test of his rugged self-sufficiency (Rodahl, 1963: 5). Describing the process of packing for his first expedition in the fall of 1950, Rodahl explained that he and his wife Joan, who worked as his assistant, would have ‘no one but ourselves to rely on’ (Rodahl, 1963: 16). This was a hyperbolic flourish. By framing his knowledge production practices this way, Rodahl erased the complex sociality that made his work possible.
Rodahl depended upon an existing network of Alaska Native Service (part of the Bureau of Indian Affairs) teachers and doctors, missionaries, the staff of Air Force installations and Alaska Native village residents. He and Joan would embed themselves in village life, building relationships that made Rodahl’s research possible and that gave him material to fill his books. In the ominously titled Last of the Few (1963: 9), he explained this tactic clearly:
For two years we were to work among them … to travel and hunt with them …. We were to learn about their past, their traditions, culture, customs, and taboos, which would help us to predict what the future has in store for their race. We were to listen to the magic rhythm of their drum dance, take part in their whaling feasts, see the witch doctor work … take care of their sick, deliver their babies, and help them bury their dead.
Rodahl knew that his research could only succeed if he ingratiated himself to Alaska Native communities. In order to betray the trust of Alaska Native peoples, he first had to build it.
Rodahl’s first research trip brought him to Kaktovik, a village of some thirty people located on Barter Island in the northwestern Alaskan Arctic. He had chosen to start his research in Kaktovik because of the presence of a small air base near the village (Rodahl, 1963: 15–19). Upon Rodahl’s arrival, an Air Force medic took him to meet the village chief. Rodahl explained that he wanted to conduct physiological research on local residents. His writings do not suggest how much detail he offered the chief about his intentions. What is clear, however, is that he offered incentives for participation. ‘In return’, Rodahl remembered, he had promised that he would provide ‘medical care and any other service that they might need’. According to Rodahl, the chief was eager to secure this promised compensation and convinced village residents to submit to Rodahl’s full battery of tests (Rodahl, 1963: 23).
These tactics – relying on existing colonial networks, assuming that local leaders could offer collective consent, and offering only vague descriptions of research – were commonplace. In fact, they were tacitly and sometimes officially endorsed by Rodahl’s colleagues and his superiors at the AAL (Oswalt, 1956). Medical researchers frequently traveled in teams to remote parts of Alaska, collecting blood or data and expressing simply that that their intention was to ‘find out why people get sick’ or to conduct public health surveys, without clearly delineating between different forms of research (Radin, 2017). 3 In the late 1940s, public health officials had also launched a statewide tuberculosis diagnostic campaign. As a result, for many Alaska Native communities, the sporadic appearance of physicians and scientists who insisted that village residents submit to x-rays, blood tests and other physical examinations was not unusual (Fortuine, 2005; Meredith et al., 1998). There was nothing particularly novel, then, about Rodahl’s presence or his patterns of behavior.
Nonetheless, in his writings, he took pains to foreground his commitment to the provision of medical care and emphasize the supposed friendships he had developed with Alaska Native individuals. He mentioned the use of iodine-131 only once, but suggested that the study had been health-related. ‘We had been to Anuktuvuk Pass’, he recalled, ‘to draw blood samples for an experiment with radioactive iodine in connection with a study of endemic goiter’ (Rodahl, 1963: 187). 4 Rodahl would repeat this same argument decades later, despite clear evidence demonstrating that the study was solely focused on the detection of racial differences in thyroid function and, as the ACHRE would later put it, ‘offered no prospect of medical benefit’ (ACHRE, 1996: 599). Why, if Rodahl felt that his work was ethical, did he obscure the truth about this particular experiment? And why, if he was sure that his work was important, did he feel the need to justify his presence by emphasizing his therapeutic intentions?
Rodahl, like many colonial agents, understood ethics through the ‘temporal and modal structure’ of ‘the future anterior’. He was willing to ignore that his professional goals necessitated harming Alaska Native peoples because he imagined that, as Povinelli (2008: 510) puts it, ‘the meaning of … suffering’ could be judged only ‘from the perspective of a future interpreter’. In other words, Rodahl obscured his actions because he felt sure that they would become justified in the future. A generation of Cold War human biologists were preoccupied with salvaging biospecimens from ‘isolated’ Indigenous communities that they believed were ‘disappearing’. As Radin (2013, 2014, 2017) has argued, these scientists believed that specimens had ‘latent’ value that would only be revealed in an ‘as-yet-unknown’ biomedical future. For Rodahl, the ethical status of research encounters was also latent. He believed that his actions could only be judged once the future had unfolded.
The future Rodahl anticipated – the one in which his actions would become justified – involved the cultural assimilation of Alaska Native peoples. Rodahl occasionally positioned himself as a critic of American colonialism. However, he took issue with the process, rather than with the project itself. He insisted that colonial officials should be teaching hygiene and encouraging economic development and only then ‘little by little give them the rest of our cultural values, as they become ready for the language, literature, art, higher education’ (Rodahl, 1963: 200). The disappearance of Alaska Native cultures seemed, to Rodahl, to be inevitable (Farish, 2013). He concluded his memoir with a glance toward the future: ‘[W]hen all is said and done, maybe these people will survive us and live to water the flowers on our graves’ (Rodahl, 1963: 200). However, this statement reads as a provocation, a joke suggesting that Rodahl thought this was the unlikeliest of all outcomes.
By the time Rodahl arrived at the AAL, Alaska had been firmly established as a defense outpost, but it was also increasingly a destination for white American settlers. By the mid-1950s, the Alaskan statehood movement was gaining momentum, due in part to the support of settlers who relentlessly lobbied Congress and the Senate (Whitehead, 2004). For Alaska Native peoples, the passage of the Alaska statehood act in 1959 would inaugurate an era of collective struggle for self-determination (Huhndorf and Huhndorf, 2002; Skinner, 1997). Alaska Native activism ushered in a new political order and generated new forms of Indigenous sovereignty within the boundaries of the settler state. 5 This political reality bore little resemblance to the future that Rodahl had imagined for Alaska Native peoples in the 1950s.
Science and self-determination in the Alaskan Arctic
With the Alaskan Statehood Act of 1959, the state government was granted the right to select just over 100 million acres of land for its own jurisdiction and economic use. This decision completely disregarded ongoing land claims. Alaska Native peoples were quick to object (Skinner, 1997: 83). The land claims process remained at a standstill until 1967, when the Atlantic Richfield Oil Company struck a massive petroleum deposit at Prudhoe Bay. Realizing that unresolved land claims would stall oil extraction, the state government initiated negotiations, which culminated in the 1971 Alaska Native Claims Settlement Act (ANCSA), the largest land claim in American history. According to the terms of ANCSA, $962.5 million dollars and forty-four million acres of land were transferred to thirteen regional, for-profit, Alaska Native corporations. Alaska Native peoples were given shareholder status in these corporations. ANCSA represented a significant expansion of self-governance. It also made self-governance dependent upon continued economic growth and left unanswered important questions surrounding issues like tribal sovereignty. It was, and has remained, controversial (Huhndorf and Huhndorf, 2002; Skinner 1997; Swensen, 2015; Tuck, 2014).
Residents of the North Slope were among the most critical of ANCSA, because they felt it offered them too little control over the pace of economic development in their territory. In 1972, Iñupiat political leaders petitioned the State of Alaska to declare the North Slope a first-class borough. The petition was successful and the municipal government subsequently took jurisdiction over regional taxation, education, planning and zoning. It became the largest municipality in the United States, encompassing some 89,000 square miles. Within a few years, the Borough’s capacity to tax the infrastructure associated with the oil industry also made it one of the country’s richest regional governments (Hensley, 2009; Knapp and Morehouse, 1991; McBeath and Morehouse, 1980) By the 1990s, then, the Borough was politically and economically powerful and adept at negotiating with settler institutions of law and governance.
North Slope residents had also become deeply familiar with the workings of colonial science. They had experience both resisting harmful interventions and developing strategic alliances with scientists who shared their interests. Such experiences had been instrumental in building a sense of collective political identity (McBeath and Morehouse, 1980; Stuhl, 2017; Williams, 1996). For instance, in 1958, the Atomic Energy Commission (AEC) had launched Project Chariot, a plan to create an artificial Arctic harbor at Cape Thompson by detonating several atomic bombs. The AEC’s aim was to open mining and shipping access to coal deposits in the region. The residents of Point Hope, a nearby Iñupiat village, were outraged. Iñupiat from communities across the North Slope organized to protest against the plan. Some members of the Alaskan scientific community, concerned about possible environmental damage, also voiced their opposition. In 1962, in the face of mounting pressure, the AEC sidelined Project Chariot indefinitely (Kaufman, 2016; Kirsch, 2005; O’Neill, 2007; Stuhl, 2017).
However, the story was far from over. In September 1992, news broke that, just prior to the cancellation of the project, the AEC had contracted scientists with the US Geological Survey to dump radioactive sand in a creek near the proposed Project Chariot site. This experiment had been part of the AEC’s effort ‘to determine the extent to which water passing through irradiated soil would dissolve the fallout radionuclides and transport them to aquifers, streams, and ponds’ (O’Neill, 2007: 278–279) and in doing so, prove that the environmental impact of Project Chariot would be insignificant. Dan O’Neill, a white Alaskan writer, had been working on a book about Project Chariot and had filed a Freedom of Information Act request for related documents. Realizing what he had found, O’Neill shared the documents with the residents of Point Hope. For years, they had suspected that the high rates of cancer in their community were connected to Project Chariot and they suddenly had evidence suggesting that these fears were well-founded (O’Neill, 2007: 281–282).
Senator Frank Murkowski (R-Alaska) arrived in Point Hope just a few days after the first newspaper stories about radioactive waste appeared. He was confronted by residents who demanded a full assessment of the environmental damage and health risks. The Department of Energy (the successor to the AEC) agreed to clean up the site, but maintained that the waste did not pose any danger to those who lived in the area (O’Neill, 2007: 283). As Fortun (2001) has shown, when experts – legal, medical, scientific – respond to an environmental disaster, they first transform it into a measurable problem, one simple enough to be managed and given a discrete endpoint. As a consequence of this form of accounting, ‘continuing disaster at the local level … [is] systematically discounted’ (Fortun, 2001: 7).
The same pattern emerged in the North Slope. Federal agencies insisted that Project Chariot was resolved, but the residents of Point Hope were skeptical and expressed frustration that their concerns were being dismissed (Francis and Richardson, 1992). They were left wondering why federal authorities had the power to decide what constituted a satisfactory solution to a problem. They refused membership in a shared temporal frame by criticizing the efforts of politicians and federal agencies to place brackets on their experience of what Nixon (2013) has termed ‘slow violence’, harm that unfolds incrementally and often invisibly. An article in the Tundra Times, the major Alaska Native newspaper, summarized the situation: ‘Throughout rural Alaska, people are now asking the same nuclear questions people in Point Hope have been asking for years: [W]hat else aren’t they telling us?’ (Richardson, 1992). They would not wait long for an answer.
Exposing Cold War legacies
The thyroid function study was exposed as a result of efforts to manage the literal and figurative fallout of Project Chariot. In May 1993, a group of international scientific experts and public officials from circumpolar nations gathered in Anchorage for the Workshop on Arctic Contamination. The meeting had been convened to evaluate the environmental legacies of the Cold War in the Far North and to develop reparative strategies. Murkowski was one of the first speakers. He opened his presentation by remarking: ‘If the Cold War can be likened to a wild party … [then] we’ve reached the morning after’ (Molnia and Taylor, 1994: 9). This metaphor was significant. It acknowledged that damage had been done, but confined it to the past by drawing a distinction between past harms and their present consequences. Murkowski expressed regret over past violence, but also implicitly denied that violence was still taking place. This was typical of post-Cold War inquiries into ‘historical injustice’, which tended to treat evil as something that existed solely in the past, eliding ongoing violence (Bevernage, 2015). This form of transitional justice was forward-facing, even as it engaged with the past. As a result, those who could not or would not ‘leave the past behind’ were treated as ‘non-simultaneous’ for refusing to fully participate in ‘the process of nation building or reconciliation’ (Bevernage, 2012: 16).
During the Project Chariot investigation, Murkowski had heard a ‘perplexing rumor’. Many North Slope residents had told him that they had been used as research subjects in radiation experiments. These rumors sent him down an investigative path that led to documents relating to the thyroid function study. Murkowski quickly contacted the National Research Council and requested that its members launch an inquiry (Molnia and Taylor, 1994: 11). He also addressed the media. Murkowski condemned the study, stating that ‘nobody should ever be treated like a human guinea pig’ (Tundra Times, 1993). Eileen Panigeo Maclean, a state representative and the president of the Inuit Circumpolar Council, did not mince words, asking, ‘How many more incidents of intentional government poisoning of Native people are still undisclosed?’ (Stapleton, 1993: A3). It seemed that there was always another incident to be uncovered, another past harm on the horizon.
The media contacted Rodahl and he issued a confusing and contradictory set of claims. He insisted to CNN that the work of the AAL had been urgent and important. ‘This was in 1950 to 1957’, he explained, ‘at the time when the Cold War was at its coldest’. He reminded his interviewer that cold acclimatization research was seen essential for protecting American military personnel who, at the time, had anticipated engaging in maneuvers in the Arctic. Rodahl was struggling to communicate what it had meant to occupy the ‘future anterior’. He was trying express that in the future he had anticipated, his research would have become justified. He also insisted that the study had posed no risk to research subjects (Globe and Mail, 1993: A11). The thyroid function study, according to Rodahl, was inconsequential from a health perspective and was supposed to have become necessary from a military perspective.
He then changed his story. Speaking to ABC radio, Rodahl claimed that CNN’s report was ‘misleading’. He told ABC that he had administered iodine-131 to Alaska Native peoples because they were suffering from endemic goiter, a condition caused by a dietary iodine deficiency. ‘We did this solely for the sake of the Eskimos’, he said, ‘because we were doctors’ (Globe and Mail, 1993: A11). It had been, he insisted, his ‘ethical duty’ as a physician (Tundra Times, 1993). Perhaps it had dawned on Rodahl that, in a moment when the Far North was reckoning with the harmful legacies of the Cold War, appealing to the sense of urgency that had surrounded militarization might not garner sympathy. Perhaps he had realized that Indigenous rights and grievances were being taken more seriously in Alaska and elsewhere, and that his work might be viewed more favorably if he could show that it had benefited Alaska Native peoples (Barkan, 2002; Million, 2013; Niezen, 2003; Radin, 2018). Regardless, it was clear that Rodahl was ill-equipped to navigate in a world where his expected future had failed to materialize.
The ACHRE and the thyroid function study
In January 1994, President Bill Clinton created the ACHRE in response to reports that the federal government and federally-sponsored institutions had conducted human radiation experiments during the Cold War. These experiments had disproportionately involved marginalized and racialized populations. The task of the ACHRE was to investigate these incidents, assess whether compensation was warranted, and recommend ethical standards that would, in the future, prevent abuse and ensure transparency (Moreno, 2001). The thyroid function study was a small part of this broader investigation and was therefore framed as but one example of a broader pattern in which federally-supported researchers had victimized vulnerable people and had grossly, or even willfully, underestimated the risks associated with radiation exposure.
The ACHRE report also offered the beginnings of a description of what had transpired during the thyroid function study. Over the course of two years, the ACHRE report explained, Rodahl and his colleague, Gisle Bang, a Norwegian pathologist working for the AAL, had enlisted 84 Iñupiaq research subjects from Wainwright, Fort Lay, Anuktuvuk Pass and Point Hope and seventeen Gwich’in research subjects from Fort Yukon and Arctic Village. They had also enrolled nineteen white servicemen from the AAL to serve as a control group. Each subject was then given a dose of iodine-131 in capsule form (ACHRE, 1996: 598–599). At the time, the AEC had been enthusiastically promoting the biomedical potential of radioisotopes and, as Creager (2015: 263) has explained, ‘generally represented [radioisotopes] as safe as long as its regulations and guidelines were followed’. In fact, before starting the study, Rodahl had undergone AEC training on handling and administering iodine-131 (ACHRE, 1996: 600). It is difficult to know whether Rodahl had intended to adhere to AEC regulations or if he was uninterested in them from the beginning. Either way, the realities of conducting research in Alaska made it impossible to structure his study according to AEC guidelines.
Rodahl planned to use a dosage of 50 microcuries, which was the standard approved by the AEC at the time (ACHRE, 1996: 600). But iodine-131 has a short half-life and Rodahl could not prevent it from decaying during travel from Fairbanks to remote villages. The actual dosage he administered therefore varied a great deal. In some cases, it was as low as 9 microcuries. In other cases, he administered doses as high as 65 microcuries (Rodahl and Bang, 1957: 3, 81). After each subject had swallowed their capsule, Rodahl and Bang measured their thyroid activity using a scintillation counter and took samples of their blood, urine and saliva (ACHRE, 1996: 598–599). Rodahl then returned to the villages several more times to test 46 of the subjects for seasonal variations in thyroid activity (Rodahl and Bang, 1957: 2). It is not clear what the logic behind the selection of the smaller sample was, but it may have been a matter of convenience. The study, according to the ACHRE’s analysis, was rife with such methodological flaws. In Anuktuvuk Pass, for instance, some of the research subjects later reported that they had not been part of the first round of tests – they had been away from the village for seasonal hunting trips – but that they had been tested during the second round (NRC, 1996: 17). However, the primary mandate of the ACHRE was to report on ethics, not assess the scientific merit of Rodahl’s work.
By the time the ACHRE submitted its final report in October 1995, the NRC investigation was already underway. Deferring to the NRC, the ACHRE did not do an onsite investigation in Alaska, but nonetheless concluded that the intention of the thyroid function study had clearly been experimental, not therapeutic (ACHRE, 1996: 599). Given this fact, ‘if the subjects in this experiment did not understand and agree’ to participate, ‘then they were used as mere means to the ends of the investigators and the air force’ (ACHRE, 1996: 601). This was a consequential ‘if’. The lingering question, as the ACHRE saw it, was fundamentally about informed consent. This was a question that the NRC would take up in full.
Wronged, but not harmed
In June 1994, the NRC appointed a committee drawn from the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine to begin its inquiry. Their report was released in January 1996, and it offered an analysis of ‘whether the study was conducted in accordance with generally accepted guidelines in the 1950s’ and whether any lasting health risks should be expected among participants (NRC, 1996: ii–vii). In practice, this meant assessing Rodahl’s actions in terms of harms, which involved ‘the necessity of the research, the expected results, the risk-benefit analysis, and minimization of risk’, and wrongs, which involved ‘the fairness of subject selection, adequacy of information given to prospective subjects, and the voluntariness of the subjects’ consent to participation’ (NRC, 1996: 5). The NRC’s conclusion, that the research subjects had been ‘wronged, but not harmed’, depended upon maintaining a sharp distinction between the two terms.
The committee found that the study had not caused immediate injury or generated a significant risk of future illness. They made this assessment by examining Rodahl’s technical reports, AEC guidelines that had, at least in theory, determined dosages, and existing scientific literature that assessed the impact of various forms of radiation exposure on an individual’s lifetime risk of developing thyroid cancer (NRC, 1996: 27–32). Regardless of whether these judgements were accurate according to medical standards, as the Borough’s report would later point out, the NRC had used a particularly narrow definition of harm.
In formulating its definition, the NRC relied on the reports of the Atomic Bomb Casualty Commission (ABCC) (NRC, 1996: 31). Beginning in 1946, members of the ABCC had studied the survivors of the bombings at Hiroshima and Nagasaki to track the health impacts of radiation exposure. The ABCC silenced the voices of atomic bomb survivors by abstracting them into biomedical data (Lindee, 1994). Nonetheless, through the production of data, ‘what happened to the survivors – the slow and invisible internal pathologies of their bodies over the decades – was gradually made visible and real’ (Lindee, 1994: 255–256). But because the bodies of atomic bomb survivors had been studied so extensively, the NRC committee felt that they had sufficient data to assess potential harms without conducting medical examinations in Alaska. This became a source of serious contention. The ABCC data had been used to make Alaska Native peoples’ suffering less visible and less real, and the issue of harms, as far as the NRC was concerned, was settled.
Assessing whether study participants had been wronged, however, proved more ambiguous. The Nuremberg Code, first published in 1947, specified that medical researchers had to acquire the freely-given consent of all research subjects, inform them of the purpose of experiments and explain any accompanying risks. The Department of Defense had adopted the Code in 1953, but applied it inconsistently. ‘Many medical researchers’, the NRC report explained, ‘… believed that because the Nazi experiments were so egregiously flawed … that the Nuremberg Code … [applied] only to ill-intentioned research.’ Despite this, the NRC committee concluded that the Code had applied and that Rodahl, along with other researchers at the AAL, had broken it (NRC, 1996: 4). But the committee qualified this conclusion by explaining that ‘cultural and language differences’ had ‘affected the consent process’. Rodahl’s transgressions, in their estimation, existed primarily in his failure to account for the impact of these differences, rather than in acts of ‘actual deception’ (NRC, 1996: 4–5). The NRC used descriptions of Rodahl’s interactions in villages as evidence to support this claim.
For example, in Wainwright, one resident recalled that Rodahl had approached him to act as an intermediary, because he spoke English well. Rodahl had explained that he wanted to conduct a study and the man had brought Rodahl’s request to the village council. He insisted that ‘the word “radiation” was never mentioned … and that he thought the capsules were to improve the villagers’ health’. The NRC committee also interviewed eight surviving study participants in Wainwright. None of them ‘could remember receiving an explanation of the experiment, or being told they could refuse to participate’. The only information they were given was ‘to come to a schoolhouse where they were to see physicians’. The NRC noted that it was ‘unclear whether … [they] received a complete explanation of the nature of the study, its potential risks, or the use of radiation in the study’ (NRC, 1996: 16–17). This agnostic conclusion directly contradicted the testimony of study participants, who insisted that they had not received a complete explanation of the study or been told that radiation was involved.
In Fort Yukon, several of the study participants had been employees of the local hospital and had been involved in other AAL studies prior to the thyroid function study. One of them agreed to speak with the NRC committee. He recalled that he had participated in exchange for payment and because he was ‘curious about what they might do’. He was sure that Rodahl had never used the word ‘radiation’. He further explained that he had ‘read a book about Marie Curie many years before’ and ‘understood what radioactivity was at the time’. In response to such claims, Rodahl told the NRC, via telephone, that ‘he did not consider the I131 to be radiation …. It was a medical tracer and was given in such small amounts that he did not need to explain it to the research subjects as a radioactive substance’ (NRC, 1996: 19, 84–85). 6 The NRC committee was not critical of this claim, perhaps feeling that it represented an honest misunderstanding. They were, however, troubled by Rodahl’s decision to provide medical care in conjunction with or in exchange for research participation.
Rodahl maintained that his presence had been ultimately beneficial. He insisted that ‘villagers would come running to meet him and … would immediately want their ailments treated’ (NRC, 1996: 84–85). Other AAL researchers also told the NRC committee that they had offered medical care to villagers because ‘there was so little available’ and that they only conducted studies after treating urgent illnesses and injuries. Based on these stories, it seemed to the NRC committee that Rodahl and other researchers at the AAL had unintentionally ‘created confusion about whether a particular intervention was research or treatment, and … bolstered the authority of researchers to obtain participation’ (NRC, 1996: 53–54). But from the perspective of former study participants, blurring the boundaries between research and care constituted intentional deception and a breach of trust (NRC, 1996: 83–85). By the 1990s, many North Slope residents also saw such actions as part of an ongoing pattern of colonial violence.
Controversy and confrontation
This was made abundantly clear during the meeting that the NRC committee hosted in Fairbanks in July 1994. It was attended by several former research subjects, former AAL researchers and employees, and interested members of the public. Of the Alaska Native individuals who testified, many articulated explicit connections between research and colonialism. They insisted, for instance, that Alaska Native peoples had been healthier before the arrival of white people and that ‘increasing domination by Western culture’ was causing illness (NRC, 1996: 24–24). They expressed specific concern about high rates of cancer, chronic illness and birth defects, which they suspected were connected to participation in research involving radioactive substances, environmental contamination and the consumption of irradiated food. (NRC, 1996: 84–85). These issues, the attendees at the meeting argued, were part of the same larger pattern.
Attendees also pointed out that AAL ‘experiments on Natives were performed … [only] to help the US military and the general welfare of whites’. Such research could never have benefitted Iñupiat (NRC, 1996: 24–25). This was and remains a common complaint. Non-Indigenous researchers who study Indigenous peoples have often formulated research questions that fail to reflect the priorities of Indigenous communities or that undermine Indigenous peoples’ senses of collective identity, claims to sovereign rights or knowledge of their origins (Reardon, 2004; Reardon and TallBear, 2012; TallBear, 2013). Residents of the North Slope felt that their grievances had been met with ‘at best patronizing indifference and at worst lethal disregard’. These concerns, according to the NRC committee, were evidence of widespread ‘confusion about a host of Arctic contamination issues’, but were not ‘directly related to the AAL thyroid function study’ (NRC, 1996: 24–25). The NRC committee seemed determined to treat the question of wrongs much like it had that of harms, as precisely-calculable and narrowly-defined.
In doing so, the committee failed to recognize that Alaska Native peoples were, in fact, explaining the context of the study. It mattered who got to decide which historical events were related and unrelated. The NRC emphasized that they recognized ‘the intensity of the Cold War pressures’ that had driven Rodahl’s decisions (NRC, 1996: 6). As such, the NRC report insisted: ‘The AAL researchers held a genuine belief, justifiable at the time, that the research they were conducting was both harmless and necessary’ (NRC, 1996: 61). The NRC felt that even if Rodahl’s research had not become justified, it had been reasonable for him to expect that it would, effectively arguing that Rodahl’s imagined future was a legitimate reason to betray the trust of Alaska Native peoples. Rodahl had worked within a particular temporalized ethical regime, one which, even decades later, remained legible and justifiable through the lens of institutionalized bioethics. Colonial biomedicine and the ethical regimes that accompanied it were not primarily accountable to those whose bodies were used to produce biomedical power and knowledge.
In this context, it is unsurprising that Alaska Native peoples began to question the sincerity of the investigation. The NRC report noted that many Alaska Native individuals characterized the investigation as ‘suspect’ and ‘half-hearted’ and resented the NRC’s failure to visit villages and offer medical examinations. Lingering ‘mistrust’, the report concluded, would be difficult to resolve (NRC, 1996: 25). This admission meant that the NRC had failed in one of its primary objectives. When the investigation began, the committee members had received a letter from Murkowski, in which he explained the impetus behind the inquiry:
Unfortunately, the Iodine 131 tests … even if they were safe, well intentioned, and conducted with the standards of the day … have contributed to an atmosphere of conflict and mistrust between the indigenous peoples of the Arctic and the community of scientists and researchers who work in the Arctic. That is troubling and unfortunate, because science is critically important to Alaska and its future (NRC, 1996: viii).
Murkowski had hoped that an investigation would help to mend the relationship between Alaska Native communities and biomedical researchers (NRC, 1996: viii). However, the NRC’s investigation suggested that Alaska Native peoples’ ‘mistrust’ was more immediately directed towards the federal government and federal agencies than the biomedical research community. And as was becoming clear, the residents of the North Slope had their own ‘standards of the day’, which Rodahl had not adhered to.
Borough officials argued that the NRC’s investigation was further evidence of the federal government’s mistreatment of Alaska Native peoples. In February 1996, the mayor of the Borough, George Ahmaogak, Sr, expressed his frustration to the Tundra Times: ‘they didn’t… examine any of the victims who are still living’. Ahmaogak’s choice of words – victims, rather than ‘participants’ – could not have been accidental. As he saw it, all the NRC had done was ‘run some numbers and decide that nobody was harmed’. He explained that the Borough would launch its own investigation with the help of a well-respected Anchorage law firm, Birch, Horton, Bittner, and Cherot (BHBC). Ahmaogak concluded his statement by criticizing the NRC’s methods once more: ‘it looks like we’ll have to do the work they weren’t willing to do to get conclusions that are based on medicine, not arithmetic’ (Tundra Times, 1996). The Borough was willing to trust medical researchers, but only if their efforts were reparative and served the interests of North Slope residents. Consistent medical attention, the Borough’s report would argue, reduced the fear and anxiety that former research subjects experienced (BHBC, 1997: 11–13).
Activists in Alaska also pressured the federal government to issue a more satisfying response to the thyroid function study. Stephen Conn, the executive director of the Alaska Public Research Interest Group, a non-profit advocacy organization, wrote to President Clinton to criticize the results of the federal inquiries. The investigations had not considered, he remarked, the ‘failure of the Indian Health Service … to obey its Federal trust responsibilities’ (Tundra Times, 1995a). Since 1942, the United States Supreme Court had held that the federal government had a fiduciary relationship to the Indigenous peoples living within the borders of the United States. Maintaining the health and wellbeing of Alaska Native peoples was, legally speaking, the government’s responsibility (Tundra Times, 1995a).
Federal agencies showed little willingness to acknowledge wrongdoing. In January 1996, the Air Force had stated that they ‘disagreed with the conclusion that the experiments were conducted without informed consent according to the standard of the time’. Kenneth Mossman, a radiation biologist who had been a member of the NRC committee, added that, in his view, ‘the researchers were good people who did what seemed to be appropriate for the times’ (Leary, 1996: B6). In response, the Borough filed a group claim for $428 million against the Air Force, Department of the Interior, Department of Energy, and the Department of Health and Human Services (the Public Health Service and the Indian Health Service) on behalf of some seventy individuals in the North Slope who had been involved in military experiments (Tundra Times, 1995b). Conducting their own investigation, then, was intended to provide both peace of mind for former research subjects and evidence that might be used to support a legal case.
Psychological fallout
The Borough employed BHBC to coordinate the legal, ethical, and medical aspects of the investigation and to produce the final report, which was issued in January 1997. Throughout the process, BHBC collaborated with the North Slope Borough Citizen’s Advisory Board Committee, a group of Borough officials and village residents, some of whom had been AAL research subjects, which helped to direct the study and communicate findings to local communities (BHBC, 1997: 4). The report offered a thorough critique of Rodahl’s actions and of the subsequent investigations, as well as a detailed description of the results of medical examinations and interviews with former research subjects.
The Borough’s report situated the thyroid function study within the structures of settler colonialism, focusing on broader power dynamics and enduring sets of obligations far more than either the ACHRE or NRC had done. It was impossible, the report argued, to judge Rodahl’s behavior ‘without understanding the delivery of healthcare to the villages as it existed in the 1950s’ (BHBC, 1997: 21–25). Rodahl’s testimony and his writings had shown that he was aware that village residents were eager for medical care. Visits from itinerant physicians had been a well-established aspect of health services and as a result, many residents submitted to procedures ‘without questioning where doctors were from or whether the doctor might have an agenda of their own’ (BHBC, 1997: 19). The report explained that ‘the thyroid activity experiment appeared no different from any other public health checkup’. Moreover, the interviews conducted by BHBC suggested that village residents had feared that refusing to comply might result in the withdrawal of medical care (BHBC, 1997: 55–56).
At the very least, Rodahl had privileged his scientific objectives over the provision of medical care. In one case, Rodahl discovered that a research subject had an enlarged thyroid and signs of thyrotoxicosis. He made a note of it in his records, but did not inform her of her condition. ‘She remembers that the AAL doctors touched her neck, listened to her chest, and gave her pills to swallow’, the Borough’s report explained, ‘but she never heard from the researchers again.’ She subsequently became seriously ill – her weight dropped to 90 pounds and she suffered a miscarriage. It was only after a physician in Utqiaġvik diagnosed and treated her condition several years later that she regained her health (BHBC, 1997: 50).
The particular relationship that Alaska Native peoples had – or were supposed to have had – with the federal government made these transgressions even more serious. The Borough’s investigators were particularly disturbed that Alaska Native Service physicians had facilitated Rodahl’s work without conducting an analysis of the ‘physical and psychological risks’ that might be involved. There was no evidence ‘of intervention before or after the experiments on the part of the civilian agencies responsible for the welfare of … [Alaska Native peoples]’ (BHBC, 1997: 50). The NRC, according to the Borough’s report, had ‘essentially substituted one federal government study for another, again requesting that participants should “trust the government” on whether physical risk had been involved’ (BHBC, 1997: 13). The Borough was unwilling to accept this.
The NRC had also employed a definition of harm that was too narrow to encompass the experiences of North Slope residents. The Borough’s report emphasized that uncertainty surrounding the possible health impacts of the study was itself a form of harm. Study participants and their family members were suffering from various forms of psychological distress. Interviews confirmed that study participants attributed their past illnesses to the thyroid function study or worried that they would become ill in the future. Many were concerned that they had or would develop radiation-related heritable conditions that they would pass to their children (BHBC, 1997: 82–83). Their bodies, it seemed to them, held a kind of latent risk that was hard to identify, contain or remedy. ‘This’, the report explained, ‘is the “psychological” fallout … that comes from the failure to … fully inform participants … of the true nature and risks involved in the experiment’ (BHBC, 1997: 15). The Borough’s report also demonstrated that ‘psychological fallout’ was not isolated to study participants and their families.
What did it mean to experience the past as unreliable? And, what did it mean to continuously reconsider how to feel in the present or plan for the future, as the past was being revised? This kind of anterior speculation made the past itself into an unfolding condition of risk, an unmeasurable variable that threatened to disrupt the calculus that biomedical regimes demand of modern subjects. The concept of risk has been linked to the emergence of regimes of ‘anticipation’, which compel individuals to take action or submit to particular biomedical interventions in order to manage risk (Adams et al., 2009). Anticipatory regimes can produce new pressures and anxieties or even new forms of dread. However, in this case, the Borough’s report located harm in the impossibility of fully inhabiting such temporalized biomedical subjectivities by engaging in appropriate acts of prevention or preparation.
For many residents of the North Slope, the revelations surrounding the thyroid function study made them question what they remembered about their previous research participation and interactions with physicians. Memories that had previously seemed innocuous became sources of anxiety. During interviews, many individuals mentioned ‘other occasions when they were “given” radiation’. There had been so much research conducted in North Slope villages during the Cold War that residents could not ‘segregate their participation in … [Rodahl’s study] from participation in other human experiments’ (BHBC, 1997: 15). For instance, one individual wrote to the North Slope Borough about his experience at the AAL:
There were five of us from Gambell that spent whole week at Ladd Field … going thru cold weather test … We were given Iodine-131 and put in a small room lined with lead foil naked and wired to all of our openings ears, mouth rectal underarms … until we shiver from temperature drop (BHBC, 1997: 98).
He believed that he had been given iodine-131, even though his experience differed drastically from those who had been a part of the thyroid function study. The report noted that this particular individual ‘was not likely given Iodine-131’, but offered his statement as further evidence of widespread psychological distress (BHBC, 1997: 98). The actions of the AAL physicians, the report concluded, had left residents of the North Slope feeling ‘violated and humiliated’ (BHBC, 1997: 56). For the NRC, the possibility that individuals misremembered the past had been an obstacle, one that made evaluating the study more difficult and conclusions more ambiguous. However, for the Borough, the instability of memory was constitutive evidence of psychological harm.
In a section titled ‘Fear in context’, the Borough’s report discussed issues, including environmental contamination and body burdens, that the NRC had dismissed as unrelated to the thyroid function study. Although federally sponsored research had offered assurances that ‘levels of radiation, though elevated, are not at levels that should cause them concern’, the Borough’s report explained that the government’s ‘lack of credibility’ meant that these findings were not taken seriously (BHBC, 1997: 82). ‘Alaska Natives’, the report elaborated, ‘have formed their own conclusions and passed those conclusions on to other Alaska Natives both within and outside their villages’ (BHBC, 1997: 116). This situation, according to the Borough’s report, was ‘directly relevant to an understanding of the psychological impacts of the disclosures about the Iodine-131 study’ (BHBC, 1997: 15). The thyroid function study, according to this logic, was not a discrete event that had occurred in the past. It was an ongoing feature of a larger structure that shaped the lives of North Slope residents and its consequences – its harms – could only be evaluated by situating it in a historical narrative that acknowledged the enduring violence of settler colonialism.
Restitution and refusal
In March 1996, the Committee on Governmental Affairs, chaired by Senator Ted Stevens (R-Alaska), held a hearing to follow-up on the recommendations of the ACHRE. Stevens introduced the first witness, George Ahmaogak, as his ‘good friend, from my State, from Barrow’. Ahmaogak told the Committee that the residents of the North Slope were ‘fearful and angry and confused’. He spoke briefly in Iñupiaq, then paused for a few moments to let his words hang in the air. He then explained himself in English:
If you do not understand what I just said, then you can begin to appreciate what happened when the government doctors arrived in our villages back in the late 1950s. I just asked … if you would like to participate in a medical experiment. Remember this was a time … when a visit from a doctor was a rare and treasured event. … It was a time when our people assumed that the government would only act in our best interests. (Committee on Governmental Affairs, 1996)
The doctors who arrived had abdicated their ‘responsibility for the health of these native villagers’. The Borough was conducting a full investigation to ‘document any illnesses connected to these experiments, as well as the fear and anxiety they have caused’, Ahmaogak explained. ‘I hope you will not be fooled’, he cautioned, ‘into thinking that some vague apology will make up for these shameful acts.’ The residents of the North Slope were owed ‘more than an apology’.
The Air Force had agreed to defer responding to the Borough’s claim for compensation until after the investigation was complete (Daily Sitka Sentinel, 1996: 6). Negotiations dragged on for several years, but in October 2000 the Department of Defense agreed to pay a $7 million settlement. Each study participant, or their descendants, would receive $67,000 and another $1.36 million would go directly to the North Slope Borough (Bishop, 2000). The settlement was announced during a ceremony at the Inupiat Heritage Center in Utqiaġvik. Several high-ranking Air Force officials attended and delivered a public apology for the ‘cultural insensitivity’ shown by the AAL researchers in the 1950s. Air Force General Counsel Jeh Charles Johnson addressed the crowd: ‘I can tell you that our standards of medical ethics have evolved to a level … that such a thing could never happen again. The leadership of the Air Force has recognized that this chapter in our history was wrong. I am here to do what I can to try to make it right.’ Then, apology letters personally signed by Air Force Secretary F Whitten Peters were handed to each former research subject (Peninsula Clarion, 2000).
Scholars have referred to the 1990s as the ‘age of apology’ (Gibney et al., 2008; Reverby, 2009; Wyeneth, 2001). Debates surrounding the possibility an official apology for the notorious US Public Health Service syphilis study at Tuskegee were taking place just as the Borough was seeking ‘more than an apology’ for the thyroid function study (Reverby, 2009). But to suggest that the Borough’s investigation was merely an effort to have their particular instance of suffering recognized by federal authorities would be an act of ‘misrecognition’ (Simpson, 2014). The AHCRE, NRC, and eventually, the Air Force had recognized Iñupiat grievances as representative only of the ‘standard errors’ that characterized Cold War biomedical research (NRC, 1996: 5). As the Air Force’s apology had made clear, this framing fit neatly within a narrative of bioethical progress. In doing so, it erased the specificity of Iñupiat claims about the enduring nature of colonial violence. Institutionalized bioethics, operating through federal agencies, had attempted to consolidate the power of the colonial state to set the terms by which research encounters could be judged in retrospect. Iñupiat, however, had refused to legitimize institutionalized bioethics as an adequate tool for engaging in retrospective ethical evaluations. Instead, the Borough had successfully sought compensation for a broken agreement between sovereign bodies.
Informed consent, in this context, might be thought of as a kind of treaty. It is an agreement that both parties enter into freely, but that also sharply favors the colonizer. 7 When Ahmaogak spoke to Congress in Iñupiaq, he implicitly questioned whether informed consent could capture the complex ethical context and uneven power dynamics of the thyroid function study. During the Borough’s investigation, one research subject explained that she had been a minor when the study took place and insisted that her parents could not have consented on her behalf. They could not, she emphasized, so much as ‘write their name[s]’ in English (BHBC, 1997: 60). Lyons’ (2010) concept of ‘x-marks’, the generic symbols that the representatives of Indigenous communities who were unable to write in English made on treaties, offers a framework for understanding such interactions. According to Lyons, x-marks are a ‘sign of consent in the context of coercion’, a choice one makes ‘when there seems to be little choice in the matter’. They symbolize both Indigenous peoples’ agency and the extent to which the ‘political realities of the treaty era’ limited that agency (Lyons, 2010: 1). Treaties, however, are always also tacit acknowledgements of the existence of Indigenous sovereignty and thus leave open the possibility that settler colonial political realities will change (Tuck, 2014). The ‘more than an apology’ that the Borough received, then, represented more than an acknowledgment of past ethical transgression. It also signified an acknowledgement of ‘colonialism’s ongoing existence and simultaneous failure’ (Simpson, 2014: 7) alongside Iñupiat sovereignty in the North Slope.
Despite generating a major federal inquiry, the thyroid function study has gone largely unmentioned in the historical literature on human subject research (with the notable exception of Farish, 2013). It is worth considering why this is the case. The term ‘Tuskegee’ has remained salient because it invokes structural racism and medical indifference, which have persisted as disturbing features of contemporary biomedicine (Reverby, 2009). ‘Tuskegee’ also represents a particular ethical regime. For bioethicists, ‘Tuskegee’ has become something of an analytic category, a metric against which ethical abuses during medical research are measured (Reverby, 2009). In fact, I suspect that the thyroid function study has escaped attention because historians have seen it just as the ACHRE and NRC did, as a less-severe version of a ‘standard error’. Campbell and Stark (2015) have recently argued that the notion of the ‘vulnerable human subject’ is itself a product of bioethics, one that limits the subjectivities available to former research subjects and curtails the interpretive possibilities for historical inquiries into the history of human subject research. As a result, they suggest, we may be reading the accounts of research subjects as though their experiences necessarily involved coercion and therefore missing opportunities to understand the diverse ways that researchers and subjects have related to one another. Similarly, allowing bioethical definitions of harm to shape analyses of the past has allowed historians to overlook the role of bioethics in upholding settler colonialism and prevented us from taking seriously forms of violence that emerge and transform over time. Tracking how competing ethical regimes frame the relationship between violence and time, then, can help us better understand the mechanisms through which bioethics reinforces settler colonial power dynamics. Doing so may also allow us to imagine forms of reparative justice that address the still-unfolding realities of settler colonial violence and Indigenous sovereignty.
Footnotes
Acknowledgements
Thank you to Jennifer Brown, Rosanna Dent, Catherine Mas, Sarah Pickman, Suman Seth, Naomi Rogers, and the anonymous SSS reviewers for their generous and insightful feedback. Participants in the Holmes Workshop at Yale University and attendees at the History of Science Society Annual Meeting and Queen’s University’s History of Medicine Week helped me to think through the arguments presented in this article at various stages. I am particularly grateful to Alka Menon, Joanna Radin, and Marco Ramos for their encouragement and sustained engagement with this piece as it took shape.
Funding
The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This material is based upon work supported by the National Science Foundation under Grant STS-1556710.
