Remembering Thalidomide

What do these names have in common: Distaval, Contergan, Kevadon, Tensival, Softenil, Asmaval, Valgraine? Something meretriciously soothing about them suggests the medical ad-man, and in fact they’re some of the 35 or so trade names once used round the world for the drug thalidomide. Looking at that drug’s tragic history from the sales end like this (and it did start out as a freely purchasable medicine) is a helpful reminder that the delinquency behind it was much more commercial than scientific. Thalidomide was aggressively and mendaciously marketed at every stage, in defiance of the gathering evidence against its safety. Really its trade name should have been Moneymaker (like the commercial tomato variety, but with a good deal more justice). One small but characteristic instance of this: when Distillers Company (Biochemicals) Limited, which had bought the British rights to thalidomide from Chemie Grünenthal, was told by its own pharmacologist, George Somers, that a new liquid formulation of the drug had proved thalidomide babydangerously toxic, the Managing Director muffled the information in a notable euphemism – “I understand that it has not yet been possible to develop a formulation which compares favourably in terms of toxicity with our tablets” – and the liquid version was put on sale just the same (in July 1961).

That the testing on animals had been unhelpful is true enough, but only in so far as such tests are inherently unhelpful. True, the Chemie Grünenthal laboratory had tested the drug only for efficacy and toxicity in mature animals, and not for effects on their offspring. But almost certainly that omission made no difference. Notoriously, it proved difficult both during and after the scandal to confirm thalidomide’s teratogenic effect in animals. Thus the physician who first suspected and made known the harm being done by the drug, William McBride, tested it for that specific harm on mice and guinea pigs, and got no results. It made him doubt for a time the soundness of his own suspicions. The actor Mat Fraser, survivor and brilliant scourge of thalidomide, is surely right in saying that animal tests actually delayed the withdrawal of the drug. The human evidence, by contrast, was prompt and conclusive, but it was not acted upon.

Anyway, the animal kingdom was indeed scoured for results, often with enormous doses of the drug (“we just stuffed it into them”, McBride said), before the ‘right’ species were eventually found: New Zealand rabbits and certain non-human primates. By 1966, a hundred or more papers had been published on such hit and miss animal tests. A review of this unsavoury literature concluded that, since the different species varied so much in their responses to the same drug, “it is rather difficult now, as ever, to apply in humans the experimental findings.” The writer in this case was a scientist on the staff of Chemie Grünenthal, so he was not exactly impartial; still, his article appeared in the very respectable peer-reviewed journal Arzneimittelforschung, and its conclusion seems very well justified. The Sunday Times book about thalidomide, Suffer the Children (1979), quotes it with ironic reservation, but admits readily enough the complementary fact about animal tests, that negative results provide no reliable guidance either:

the biochemical variations between human and animal species are so great that even if a drug shows no ill effect in animals, it may still do so once human use begins… When we describe a drug as “safe”, therefore, what we should really say is that it is a drug that has not yet been found unsafe.

The animals, in short, can tell us nothing that we really need to know.

These unhappy recollections of thalidomide are prompted by yet more medical ‘disasters’ in the news. In January, one participant died during tests in France for the company Bial of a painkiller/tranquilliser; a few weeks later, the drug Pacritinib, developed for the treatment of blood cancer, similarly proved to have, as the FDA put it, “a detrimental effect on survival” (I collect these weird euphemisms). This last misfortune was felt to be especially shocking because it happened in a ‘phase 3’ trial: i.e. after two earlier stages of clinical tests in humans. Evidently it is agreed that human tests at least can be expected to provide reliable guidance – and correspondingly that nobody should be much surprised at being misled by the results from animals. This is no doubt right, although unfortunately, as Suffer the Children says, and as records of adverse reactions in patients continually show, no drug can ever be called absolutely safe.

Bial’s representatives have insisted, truthfully I’m sure, that they followed all the right procedures. They have even cited the Declaration of Helsinki, that honourable legacy of the Nuremberg Medical Trials which laboriously, revision after revision, protects the interests of research ‘subjects’ from abuse, provided they’re human. And it’s worth saying a bit more about that remarkable document. Here are some of its principles: that subjects should not be asked to take risks for research they don’t stand to benefit from, that the interests of research should “never take precedence over the rights and interests of individual research subjects”, that the subject’s consent or dissent should be respected even where it cannot be classified as “informed”, that “vulnerable” (= easily exploited) groups need particular protection. Note how all these principles exactly fit the situation of non-human animals. In fact the Declaration is a great monument to speciesism, haunted by the animals that it doesn’t (dare?) mention, except the perfunctory once: “The welfare of animals used for research must be respected.” Since the drug which Bial had been testing on its animals was a pain-killer, with all that implies as to the nature of the tests, even that one crumb of compassion from Helsinki’s table probably didn’t do them any appreciable good.

There’s an ugly sense in the Sunday Times book (and more generally) that the painful glare of human suffering properly puts the suffering of other animals into complete darkness, and even that willingness to plough through laboratory animals is to be taken as an index of proper medical humanitarianism – though that’s never made explicit, of course. (It fits George Bernard Shaw’s shrewd suggestion that vivisection shows the ancient superstition of propitiatory sacrifice living on into modern times.) Thus, speaking about another of Grünenthal’s products, an antibiotic called Supracillin, the Sunday Times says,

Somers of DCBL spent a great deal of time trying to verify Grunenthal’s claim that Supracillin would not destroy the hearing of cats. To Mueckter’s displeasure [Muekter was head of Grunenthal’s research laboratory], he managed at last to show that the claim was entirely baseless. [italics in the original]

All the emphases here are designed to contrast the scientific diligence of Somers with Muekter’s hustle (“great deal of time”, “managed at last” “entirely baseless”); what all this thoroughness meant for the cats is unmentioned, probably unthought of. That word “entirely” is especially chilling.

A more recent account of the thalidomide affair (Stephens and Brynner, Dark Remedy, Cambridge, Mass., 2009) is able to take a longer view, and does indeed attempt a general “moral”, as follows: “Wherever there is an absence of compassion, individual or collective, a lesser human attribute will fill the vacuum.” There’s a slightly bogus suggestion here that a real law (in psychopathology? cybernetics?) has been uncovered, matching the one in physics, but there’s also some useful if obvious truth. Better to say, probably, that the more immediate and urgent motives – notably the commercial motive and careerism – will always tend to drive out more removed ones like compassion and even ordinary caution. (And that seems to be the lesson the U.K. government was taking when it passed the 1968 Medicines Act, with its new array of regulations.) But like their predecessors (and like the Medicines Act itself) these authors don’t include animals in the scope of their “compassion”. Unhappily illustrating their own ‘law’, they allow horror, fear, indignation, to drive out disinterested pity.

If it had been impossible for some reason (decency, perhaps) to use animals in medical research, we would certainly by now have made far greater progress in human models of one sort or another than we actually have, and accordingly in medical safety. William McBride himself subsequently wrote, “we will have more thalidomide-type tragedies in the future, perhaps not on such a large scale, but as man is different from other animal species it is likely that, no matter how thoroughly new drugs are tested on animals, species differences or synergistic actions [i.e. unpredicted whole-body responses] will occasionally betray us.” Thalidomide remains uniquely dreadful among medical disasters, but we have not changed the situation or the attitudes which made it possible.

 

Notes and references:

The picture at the top, Thalidomide Baby (oil on acetate), is used by kind permission of the artist, Josephine Storer of Oxford Brookes University’s School of Art and Design: this strong and most poignant image has saved me having to attempt in words the sorrow and sympathy which ought to preface any discussion of this subject.

Suffer the Children: the Story of Thalidomide, was written by Phillip Knightley, Harold Evans, Elaine Potter, and Marjorie Wallace, and published by Andre Deutsch. Quotations are from pp. 22, 23, 61, 88, 274. The Sunday Times newspaper, I should recall here, played a crucial and even heroic part in exposing the scandal and getting justice for the people affected by the drug. The quotation from Dark Remedy: the Impact of Thalidomide and its Revival as a Vital Medicine is from p.201. Both these books are well worth reading, and the second (as its title shows) talks about thalidomide’s controversial reappearance as a treatment for leprosy and some cancers.

The final quotation is from a letter which McBride wrote to the Daily Telegraph in 1973, as re-printed in Richard Ryder’s Victims of Science, NAVS, 1983, pp.174-5.

Pharming Today

A chart showing the numbers of animals used in experiments in U.K. universities during 2014 (the most recent reportable year) puts Oxford University top, with its grand score of 226,739 – ahead of its nearest rival Edinburgh by about 25,000.

It may be that Oxford University’s scientific leadership takes quiet satisfaction in this result, if they’ve noticed it, as tending happily to confirm the University’s pre-eminence in biomedical science. After all, wasn’t this what their new building was for, to secure Oxford’s traditional place as the nation’s prime Laboratory, South Parks Roadcentre of animal research? However, as posted on the Oxford Students for Animals facebook page (and many others), the new information is headed ‘How many animals has your university killed?’, so it’s evidently not intended to please the contestant institutions, or the students whom they train in the practice. Accordingly there’s a defensive (but temperate) comment underneath it, from a medical scientist at Nottingham. He compares the lives of the U.K.’s laboratory animals favourably with those of animals on factory farms, and ends with this advice: shut the meat industry down FIRST before you try and curb the use of animals for discovering the drugs that cure our diseases.”

In one form or another, it’s a very familiar defence or put-off – as old, perhaps, as the vivisection debate itself (though not for that reason either right or wrong). It was certainly in use when the question first came before the British Parliament by means of a Royal Commission in 1875-6. Among those who tried it was the man who later became Oxford University’s first professor of Physiology, John Scott Burdon Sanderson. Part of his evidence tending to show that laboratory animals didn’t need legal protection was that ‘game’ animals were much worse off: the man had been a keen hare-courser, so of course he would have known what he was talking about. In 1927 the same argument was used by H. G. Wells in an article for the Sunday Express, in whose pages George Bernard Shaw soon afterwards demolished its moral logic thus: “This defence fits every possible crime from pitch-and-toss to manslaughter. Its disadvantage is that it is not plausible enough to impose on the simplest village constable.” Pitch-and-toss, incidentally, was a game of mixed skill and chance, played with coins, and was at one time illegal as a form of gambling, if played in the street: not as bad as picking pockets, no doubt, which in turn was not as bad as … etc., etc., until the argument comes to rest just short of mass murder.

Still, the defence is being made in this present instance by a researcher at Nottingham University, an institution which, though itself a user of animals in research (scoring a modest 17,924), does also accommodate the laboratories of the excellent Fund for the Replacement of Animals in Medical Experiments (FRAME). It therefore surely deserves a more considered reply than the Shaw quotation, and I shall try to give at least part of one.

Why, then, don’t anti-vivisectionists turn their attentions to the far greater suffering (numerically, certainly, and perhaps also in most other respects) endured by factory-farmed animals?

The first thing to say is that of course they do. I’ve used the word ‘turn’ to highlight the sleight of hand in the argument; most, if not all, anti-vivisectionists can and do have both wrongs clearly in view concurrently, as well as a whole range of others. It’s all one subject, though individuals and organisations may specialize within it: hence the one collective term by which Peter Singer identified it in the first sentence of Animal Liberation in 1975, “the tyranny of human over non-human animals”.

But vivisection is, besides, bound in with factory farming in a more particular and unpleasant way. The move from husbandry to mass-processing of farm-animals has been made possible at every stage by scientific research, including biomedical research. (Burdon Sanderson himself devoted his early vivisectional research to disease in cattle.) When Ruth Harrison first showed the public what was happening on Britain’s farms, in her book Animal Machines (1964), she made this fact very clear: “every batch of animals reaching market is a sequel to another experiment or part of an experiment.” The livestock farm and its farmer were being made dependants of the laboratory and the scientist. How far this has gone since then can be read in any issue of Farmers Weekly.

For even while Ruth Harrison was publicizing the wretched effects of this development, other voices were busily promoting it. One such was a 1965 volume in the ‘Teach Yourself’ series (of all innocent publishing brands), entitled Modern Poultry Keeping. The word ‘keeping’ has an old-fashioned suggestion of husbandry about it, but any readers of this book foolish enough to be expecting to teach themselves a job in agreeably rural surroundings, perhaps amateurishly collecting eggs in a basket, like the wholesome woman on the old Ovaltine tins, were indignantly corrected. It was now a “highly specialized business calling for men [N.B.] with a wide technical knowledge”. Raising table-poultry, for instance, “consists wholly in rearing birds that will carry the maximum amount of flesh in the shortest possible time, at the lowest cost.” You need maths, biology, and a good grounding in what the book calls “light engineering” to get that right – or someone else does, to get it right for you. And of course that “technical knowledge” also includes knowledge of the pharmacopoeia: oestrogen pellets to ‘caponize’ the would-be cockerels, antibiotics against disease, and so on.

Then there’s animal behaviour. The Nottingham scientist specifies this in his comment, reasonably enough, as one of the things that cannot be studied without the use of real animals, and indeed it’s been responsible for some of the most cruel and shameful scenes in laboratory history. Another book contemporary with Animal Machines, P. L. Broadhurst’s Science of Animal Behaviour (1963), reviewed some of these scenes, but not apologetically; on the contrary, the author took the view that the “exploitation in the service of man of the behavioural resources of animals has  cowhardly begun.” In particular he looked forward to a time when the “pitifully small” role so far played by animals in food-production would be greatly expanded, using the knowledge gained in the laboratory of what they can be induced or compelled to do: not just to make food out of themselves at minimum expense, that is, but also to pick fruit or mind machinery, or more generally to be what his book, with naïve but untouching enthusiasm, calls “slave labour”.

So much for agriculture as envisioned from the laboratory. That things on the farm are only as bad as they are, and not as they might have been (and may yet be), can at least partly be attributed to the ‘curbing’ of such dreams at source. It’s very much harder to correct them once they’ve become real.

*     *     *

The man usually regarded as the founder of experimental physiology, the Frenchman Claude Bernard – a bust of whom stood on our own Burdon Sanderson’s mantelpiece in Oxford – proudly described and championed his science’s characterizing spirit as “éminemment conquérant et dominateur”. That spirit of tyranny was glaringly evident in Bernard’s own work, so much so that one of his assistants subsequently wrote, “I cry off, and am prepared to see not only science, but even mankind, perish rather than have recourse to such means of saving it.” Unfortunately Bernard’s version of the scientific spirit has survived through more than 150 years of vivisection right up to the hideous attempts of recent years at xeno-transplantation and even (not in the U.K.) the transplanting of animal heads. It’s not only farming which is pervertable by science such as this. No doubt biomedical research has produced valuable knowledge and great benefits. But some of that research, both the valuable and even more tragically the worthless, has been at a cost to animal lives, and to human decency, which no real or speculative benefit to ourselves should have been allowed to justify. So far from leaving such research to itself for a while, it’s our duty to all animals, including ourselves, to do continuously everything we can to curb it.

 

References:

G. B. Shaw is quoted from Shaw on Vivisection, ed. Bowker, 1949, p.35; Animal Machines, 2013 (2nd edition), pp.37-8; J. I. Portsmouth, Modern Poultry Keeping, pp.2 & 5; Science of Animal Behaviour, p.132 & foreword; Claude Bernard and George Hoggan are quoted in John Vyvyan, In Pity and in Anger, 1988, pp.46 & 77.

 

Corno di Bassetto Unmasked

Here are some answers to the questions arising, in the previous post, from a quoted paragraph which started with pugilism and ended with vivisection, and which was written by the music critic calling himself Corno di Bassetto.

Firstly, the person: Corno di Bassetto was the pen-name used by George Bernard Shaw when he wrote music criticism for the Star newspaper from 1888 to 1890. Although Shaw was then a relatively young man, and had not yet written any of the plays for which he is now mainly known, his personality as a writer and thinker is already recognisable even in that short extract (reproduced below) – notably in its contempt for merely conventional and unthinking social attitudes, and its unapologetic egotism. Corno di BThis last trait often appears in Shaw’s dramatic heroes and heroines as a mark of the mature and independent character – the sort of character that decides for itself what is right or wrong, rather than inheriting the decision from its surroundings.

That leads on to the second question I asked (and now wish I hadn’t, because it’s very difficult to provide a lucid and concise answer): what is the moral logic that takes him in that fine impassioned paragraph from half-defending pugilism to denouncing vivisection? That there is such a logic in Shaw’s mind, the last sentence clearly implies. Here is the paragraph again (for its Christmas-related context, see the previous blog):

I have no illusions about pugilism or its professors. I advocate the placing of the laborer in such a position that a position in the ring will not be worth his acceptance, instead of, as it now is, a glorious and lucrative alternative (for a while) to drudgery and contempt. I have not the smallest respect for the people who call the prizefighter a brute, without daring to treat him like one, but who will treat him much worse than one (than their hunter, for instance) if he remains a laborer for wages. I object to gamblers of all sorts, whether they gamble with horses, fighters, greyhounds, stocks and shares, or anything else. I hate foxhunting, shooting, fishing, coursing (a most dastardly pursuit); and I would, if I had the power, make horse traction in the streets, with all its horrors, as illegal as dog traction is. Furthermore, I do not eat slaughtered animals; and I regard a man who is imposed on by the vulgar utilitarian arguments in favor of vivisection as a subject for police surveillance. No doubt, all the other journalists who disapprove of prizefighting are equally consistent.   [The Star, 27 December 1889]

At the time of writing, prize-fighting seems to have been one of those discretionary illegalities which might be prosecuted or not according to the zeal of local magistrates. The objection was mainly to the professional element (i.e. literally to prize-fighting), and to the gambling which was associated with that. Shaw reminds his readers that there are many other sorts of gambling which are quite acceptable to the law, including that which goes on daily in the Stock Exchange. Two of his earliest plays (Widowers’ Houses and Mrs Warren’s Profession, written in the next decade) expose exactly that sort of anomaly: the polite classes living ignorantly or at least negligently on the proceeds of practices which they condemn as vicious in their inferiors. Pugilism itself was certainly associated with lawlessness of various kinds. But, just as the stocks and shares, however conventionally respectable, are still a variety of gambling, so Shaw regarded vivisection as a polite variety of lawlessness: as he was later to write (in his preface to The Doctor’s Dilemma), “the exemption of the pursuit of knowledge from the laws of honor is the most hideous conceivable enlargement of anarchy.” The vivisector and his apologists, then, are as proper a “subject for police surveillance” as the pugilist and his low-life entourage.

But what about the other varieties of animal abuse which he denounces in between: the hare coursing and the rest; how do they fit in?

We have to return for a moment to prize-fighting. Shaw knew quite a lot about the sport, having been friends with an enthusiast (a poet, so he says), who showed him round. He had even written a novel about a prize-fighter, Cashel Byron’s Profession, published in 1886; later on he turned it into a short play, in blank verse, titled The Admirable Bashville. So he was well aware of the new ‘Queensbury Rules’, and the changes which they had introduced, including the rule that gloves should be worn. This rule in particular was aimed at making the sport less luridly violent and therefore more acceptable to the law. But Shaw argued (I won’t explain how) that it had in fact put a premium upon the knockout blow, and thereby made fighting less scientific and more sensational – just as appealing to the taste for cruelty, therefore, as the former bare-knuckle style had been.

Now, Shaw was always convinced that the practice of vivisection could only be explained at source by that same human taste for cruelty. Once established, of course, the practice would be followed merely as professional orthodoxy by the unthinking “routineers”, as he called them. It would be accepted likewise by the biddable lay public who would wish to know as little as possible about what was implied in it. But cruelty was its primary inducement. So when The Admirable Bashville was published in 1901, and Shaw appended to it a ‘Note on Modern Prizefighting’, he made a rather sensational comparison between the two professions, much as Corno di Bassetto had put stocks and shares provocatively alongside gambling on prize-fights:

The legalization of cruelty to domestic animals under cover of the anaesthetic is only the extreme instance of the same social phenomenon as the legalization of prizefighting under cover of the boxing glove. The same passion explains the fascination of both practices; and in both, the professors – pugilists and physiologists alike – have to persuade the Home Office that their pursuits are painless and beneficial.

However, the boxer wants his profession to seem “thrillingly dangerous and destructive”, but to be in fact as harmless as possible, whereas the physiologist wants the opposite: a free hand to cause injury, but the appearance or reputation of harmlessness. “Consequently,” says Shaw, “the vivisector is not only crueller than the prizefighter, but, through the pressure of public opinion, a much more resolute and uncompromising liar.”

When Cashel Byron, in this stage version of the story, is chided by the romantic Lydia Carew for practising a cruel profession, he defends himself by saying he has at least “slain no creature for my sport”. And if fighting is ungentlemanly (Lydia is distinctly a ‘lady’), it at least compares favourably with “Groping for cures in the tormented entrails of friendly dogs”. In short, the moral logic that carries Corno di Bassetto from prize-fighting to vivisection, via hunting, coursing, meat-eating, etc., is this: cruelty and violence may be easier to notice and dislike in the forms which we ourselves don’t get anything out of, but they’re sordid and shameful wherever they occur, and whoever it is that’s practising them. Or as Shaw says in that preface to The Doctor’s Dilemma, where he attacks vivisection over many pages, “We are, as a matter of fact, a cruel nation; and our habit of disguising our vices by giving polite names to the offences we are determined to commit does not, unfortunately for my own comfort, impose on me.”