In 1995, President Bill Clinton issued a formal apology to the indigenous people of north and central Alaska used in the U.S. military’s iodine studies between 1955 and 1957. The purpose of the experiments was to find out what made Alaska Natives so well conditioned to live and thrive in extreme arctic temperatures in the hopes of eventually transferring those traits into an Arctic super-soldier in the Cold War Era.
“"When the government does wrong, we have a moral responsibility to admit it," Clinton spoke. “Today, by making ourselves accountable for the sins of the past, I hope . . . we are laying the foundation stone for a new era. . . . We will no longer hide the truth from our citizens."
With his apology, the President introduced the National Bioethics Advisory Committee, which was tasked with developing research policies to ensure travesties like these never happen again.
In all, 120 subjects were used in the Iodine 131 Experiment: 19 servicemen, 84 Inupiat Eskimos, and 17 Athabascan Indians. The ages of the Natives varied from 16 to 90 years old and the servicemen were 19 to 37. Among the original 79 Inupiats, was my great-grandfather Joe Aveoganna, an Inupiat Eskimo from the northern village of Wainwright, who died in 1969 at the age of 77.
The story begins in 1951 when the U.S. Air Force established the Arctic Aeromedical Laboratory (AAL) at Ladd Air Force Base (now known as Fort Wainwright) just outside of Fairbanks. The objective was to conduct a broad range of studies to improve U.S. military capabilities specifically for the Arctic environment. The Iodine 131 Thyroid Function Study was just one of the many research projects conducted in Alaska.
Using results from animal studies, researchers discovered in 1943 that animals exposed to cold for extended periods of time showed changes in thyroid structure and function. In 1953 they suggested that the thyroid was linked in the ability of humans to adapt to cold temperatures. The Atomic Energy Commission (which later became the Department of Energy) authorized the use of Iodine 131 through its “Isotope Distribution Program” and approved human experiments to begin nationwide. The AAL began Iodine experiments under that program in Alaska from 1955 to 1957.
The first tests took place in the Inupiat villages of Wainwright and Point Lay in August of 1955. Inupiat Eskimos of Anaktuvuk Pass were tested in September and the Athabascan villages of Fort Yukon and Arctic Village were visited in October. Doctors later returned to most of the villages to continue testing 46 original subjects to compare seasonal differences over the next two years. The Inupiat village of Point Hope was visited in February 1957 but due to incomplete records, participants and details of the study could not be determined.
Subjects were required to swallow a capsule containing Iodine 131. Samples were then taken from their blood, urine, and saliva to measure changes in their thyroid activity. Overall, the study included six different Iodine experiments with a total of 200 doses administered to the subjects.
The experiment was similar to studies being conducted in the U.S. during that time in terms of dosage and risk. However, there were two practices done in Alaska that differed from the Lower-48 experiments. First, some Native groups were tested more than once with several people receiving as many as three doses. Second, Alaskan subjects included women who were pregnant or lactating. Though the participation of pregnant or nursing women was not illegal at the time, it was highly discouraged by the Department of Environmental Conservation because of the high radiation transfer rates from mother to child.
Based on the results of the study, it was determined that the thyroid did not play a role in the ability of the human body to withstand cold temperatures. After the Iodine study was completed the AAL continued a variety of studies and human experiments until the laboratory was shut down in 1967.
It was not until a 1993 conference on the Cold War legacy in the Arctic that the AAL thyroid function study received attention. Questions were raised whether it placed the people involved at risk and whether the research had been conducted within accepted guidelines for research using human participants.
As a result, Congress asked the National Research Council and Institute of Medicine to conduct an evaluation of the AAL’s Thyroid Function Study. In response, a committee was formed in June 1994, which included an on-site investigation of the experiments. In 1996 the National Academy Press published the Committee’s final report.
Within one month of forming, the Committee assembled in Fairbanks Alaska and held an open public hearing July 7 and 8. Due to the short notice and financial constraints, many Natives who were involved in the original study or their descendents were unable to attend. There was also concern that the committee had not taken enough time to contact all participants and that they should have made the effort to travel to all concerned villages.
Participants who were able to attend the hearing made several valid points. Testimonies included that the experiments conducted on themselves or family members did not have any medical benefits to the Native people of Alaska, and only benefited the U.S. military and the general welfare of western civilization. The testimonies also raised ethical questions about authorization and consent in how Natives were selected for the study.
Though the federal government began to declassify AAL records in the 1990’s, many were incomplete or remained classified. There is also no available documentation to prove that any of the Natives were told the nature of the experiment and whether they gave their consent to participate. The only available evidence came from the personal testimonies of the participants themselves and the principal attending physician during the studies, Dr. Kaare Rodahl.
Based on these testimonies it was determined that researchers relied on elders or leaders of the community to recruit volunteers. There was no actual knowledge of how the village elders recruited participants and how they explained the nature of the experiment. It is unclear whether the villagers were told to participate by the elders or whether they were asked.
In either case, it is very likely that the leaders themselves did not fully understand the experiment. Minors were also used as subjects without proper parental consent. Only a few of the Natives understood that they were participating in research while the majority thought they were receiving beneficial medical treatment; a common belief at the time as medical care was limited or non-existent in rural communities.
Doctors rarely traveled to villages in the 1950s and Natives customarily welcomed doctors to their communities, due to the need for medical care. Dr. Rodahl said when his plane landed, the villagers would come running to meet him and the other physicians, and immediately want their ailments treated. He said the Natives trusted them. As a result, Natives became an easy target for medical exploitation.
At the time, most of the test subjects spoke little, if any, English. One of the original participants from Arctic Village told the Committee that she and the members of her family, including the tribal leader, spoke no English at the time, so they just nodded at everything the doctor said.
A brother and sister from Arctic Village, who were 20 and 17 when they participated in 1952 confirmed that no one in their village spoke English at the time and that their blind mother was also chosen as a subject. An Athabascan man from Fort Yukon said he was an employee of the private hospital there. He said he was selected four times to participate in separate AAL studies, including a study which required the surgical implantation and removal of sponges. That study was in July 1956 to December 1956 and included implanting sponges in test subjects to test the study of arteriosclerosis - the thickening and hardening of the walls of the arteries. He spoke English and understood about radioactivity and said he was not told about radiation and was paid to be in the studies. Thus, the Committee believed that the experiments were conducted without informed consent, even according to the standards of the time.
The Air Force did not provide any test subjects with medical follow-up to monitor the long-term effects of the study. The Bureau of Indian Affairs and the Indian Health Service, all of which had the responsibility over the health issues of Alaska Natives, also did not provide any follow-up care. Each of the agencies involved in the testing knew that subjects had been exposed to other radiation including atmospheric radiation fallout since the 1940s, which would increase their risk of cancer.
The daughter of a woman participant from Arctic Village testified that her mother had cancer in the early 1950s and was chronically ill, yet she was chosen for the study. She said that the AEC tested the community for exposure to radiation from atomic testing, particularly from eating caribou that had eaten contaminated lichens. She said one woman in her village died who had also tested with the highest level of radiation accumulation.
A Point Hope representative expressed frustration to the Committee because there was no information on who had participated in the Iodine study from his community. He explained that his village had a high rate of cancers, birth defects, and illness. Point Hope was also the site of the Project Chariot radiation study in the 1960s, and the villagers were also worried about the effects of radiation from Russian radioactive waste disposal in the ocean where they fish and hunt.
There were many studies of Alaska Natives done throughout the 1950s and 1960s. One of the studies that had already begun prior to the Iodine study was measuring the radiation levels in Alaska Natives from fallout from nuclear testing in the Pacific Ocean. In the thyroid study, the AAL knowingly administered radiation to an already high-risk group of people. A physician from the Chief Andrew Isaac’s Health Center of the Tanana Chiefs reported that 11 cases of thyroid cancer since 1969 existed in hospital records and two people had died as a result.
Yet the Committee concluded that, in all probability, the study caused no physical harm to the subjects. The average risk among the population that participated in the AAL study was about 1 in 3,000. The greatest risks of thyroid cancer appear in the people who received multiple doses. In particular, the women of Anaktuvuk Pass and Arctic Village had a calculated risk of 1 in 800 and 1 in 700. Thyroid cancer is a rare form of cancer that occurs in about 5 cases per 100,000 people per year.
Even though there was disagreement in regards to the possible risks, the Committee report urged the federal government and the Air Force to conduct follow-up examinations. Particularly in subjects who were younger than 20 at the time of the study because they had the longest sustained risk of developing cancer.
The Mayor of the North Slope Borough shared his concerns about the AAL study. He told of his people’s worries regarding the different radiation problems his people were exposed to: the Iodine 131 study, Project Chariot in Point Hope, and Russian dumping of nuclear waste in the Arctic Ocean. The mayor also asked the Committee to travel to other affected villages and talk to all of the surviving subjects, and he requested to review the draft of the final report. He said he needed to learn why his people were dying of cancers and other illnesses.
The committee denied all of his requests, stating that panel member availability, timing of the study, and funding prevented the Committee from traveling to each village. They claimed to have made a good-faith effort to contact and obtain information from each known living subject. The draft report was not made available to the North Slope Borough or any other outside group, because ‘it was against policy’.
The Committee determined that because information on the radioactive nature of the Iodine was not disclosed, the military and Native subjects were not completely informed about the nature and risks of the experiments. Thus, the subjects had been wronged by the AAL. The Committee based its conclusion about the ethics of the study on the Nuremberg Code, a 10-point list of principles that was issued in 1947 after closely examining the legal and ethical aspects of human experiments carried out by Nazi physicians during World War II. The Code focuses primarily on the subject’s informed consent. It requires subjects to have decision-making capacity and to be able to consent freely and subjects must be able to withdraw from participation at any time.
Throughout the public session, Natives voiced their frustration that white authority figures had repeatedly betrayed their people. The tension between the cultures was clear when one participant asked the AAL principal investigator if they thought Natives were even human.
The North Slope Borough filed a group claim on behalf of 70 Inupiat Eskimos on May 2, 1995. The claim demanded $428 million dollars — $348 million for personal injury and $80 million for wrongful death. Of the 79 original test subjects from the North Slope Borough, 32 were still living at the time of the claim. For the others, the Borough sought compensation for their survivors and estates. The exposure has led to diseases and other damages such as cancer, fear of cancer, strokes and “loss of enjoyment of life,'' the claim said.
The Advisory Committee on Human Radiation Experiments was appointed by President Clinton in 1994 to conduct an extensive inquiry into past government human radiation experiments and intentional releases of radiation that occurred between 1944 and 1974. The 1,000-page final report found that the government conducted approximately 4,000 radiation experiments throughout America.
Tens of thousands of individuals were involved, most of them Alaska Natives, American Indians, or African Americans. Most of the subjects had no knowledge that they were participating in radiation research. The Committee recommended that a government apology be made to people who received no direct medical benefit from participation in research and provide compensation for those who suffered physical injury as a result.
House and Senate negotiators agreed to include $7 million dollars to a defense-spending bill to compensate Alaska Natives. Aides to the late Senator Ted Stevens, chairman of the Senate Appropriations Committee at that time, said the money was being included at the request of the U.S. Air Force in order to settle the claim filed by the North Slope Borough.
Some of the Alaska Natives who testified believed that Native people seemed healthier long ago and that health difficulties seemed linked with the rapid and sometimes dramatic changes caused by increasing domination by Western culture that began in the 1940s. It is impossible to completely disentangle the people's reactions to other research that was conducted and other aspects of their contact with the incoming dominant culture and the changes caused in their traditional lifestyle.
In hindsight, the secrecy ethos of the Cold War did much to breed mistrust of government, not just in Alaska but throughout the nation. The Alaska Natives' strong response to learning of the AAL Thyroid Function Study was born out of years of mistrust, a mistrust that will not be simple or easy to rectify.