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In the late 1950s and early 1960s Dr. Ewen Cameron, then one of the world's most respected psychiatrists, conducted a series of CIA-funded studies on mentally ill patients at the Allan Memorial Institute in Montreal. An unlikely beneficiary of the CIA's Cold War paranoia about Communist "brainwashing," Cameron performed long-term studies that included frequent, sometimes twice-daily electroconvulsive therapy, the administration of LSD, "psychic driving" studies, in which subjects underwent sensory deprivation and were exposed to hours of repetitive tape-recorded messages, and "sleep therapy" studies, in which they were drugged into unconsciousness for weeks, sometimes even months.
The Cameron mind-control experiments were profoundly damaging for Cameron's subjects and deeply embarrassing for psychiatry. Yet they also taught some lasting lessons on the ethics of clinical research. One of the most important of these lessons is the particular vulnerability of people with mental illnesses, and the dangers of relying solely on voluntary consent as a means of protecting them. Cameron, a consulting psychiatrist at the Nuremberg Trials of Nazi war criminals, was quite familiar with the Nuremberg Code governing the conduct of ethical research involving human subjects. Indeed, all his research subjects signed consent forms, authorizing the medical staff to do whatever they thought necessary for their medical care. Consent, however, was clearly an insufficient safeguard for the protection of Cameron's subjects, many of whom were seriously damaged by his research. This is a lesson that both the Canadian Health Protection Branch (HPB) and many psychiatric researchers today seem to have forgotten.
In Canada today, mentally ill patients taking part in a common type of research study are required to take the risk of going weeks or months without being treated for their illnesses. Instead of treatment, they receive a placebo: pills or capsules containing no active drug. Predictably, these patients are then often exposed to the pain of their untreated illnesses. Patients with major depression might well face months of despondency, guilt, sleeplessness, and thoughts of suicide. For patients with schizophrenia, a research study could mean weeks or even months of acute psychosis, with hallucinations, delusions, profoundly confused thinking, and the potential for violence.
Why do psychiatric researchers intentionally give mentally ill patients substandard treatment? Remarkably enough, because Canada's Health Protection Branch requires it. Like the...