[A screenshot of an excerpt from an academic journal. The text lists four numbered questions asked by an Institutional Review Board (IRB) to evaluate a study’s ethics. The author answers “no” to whether risks were minimized, “no” to whether risks were justified in relation to benefits, and “no” to whether informed consent was adequate. Lastly, the author questions the equitable selection of subjects, noting that the selected area in Baltimore guaranteed all subjects would be from a lower economi
[A scan of a vintage instructional diagram. It features illustrations of paint cans, showing consumers how to mix white lead with linseed oil and turpentine for home surfaces. It explicitly includes mixing directions for “Interior Plaster, Wall Board and Woodwork.”]
[A reproduction of a December 1928 magazine cover titled “The Dutch Boy Painter.” The image depicts a smiling Santa Claus next to a young child, together they are painting a small toy house, with the child dipping a paintbrush into a nearby bucket.]
[A screenshot of an excerpt from an academic journal. The text lists four numbered questions asked by an Institutional Review Board (IRB) to evaluate a study’s ethics. The author answers “no” to whether risks were minimized, “no” to whether risks were justified in relation to benefits, and “no” to whether informed consent was adequate. Lastly, the author questions the equitable selection of subjects, noting that the selected area in Baltimore guaranteed all subjects would be from a lower economi
The Ethics of the Kennedy Krieger Lead Removal Study
Between 1993 and 1995, an influential medical research facility, the Kennedy Krieger Institute, conducted a controversial public health study in Baltimore, Maryland. The medical community had understood the impacts that lead poisoning had on children since the early 1900s, establishing that it was a severe public health crisis in the 1920s. Yet, rather than beginning advocacy for the eradication of lead from homes altogether, researchers began to search for cheaper, partial lead paint removal methods. To gather the data, the institute needed human subjects to live in partially treated, potentially hazardous environments.
To facilitate the experiment, researchers encouraged landlords to rent specific lead-contaminated homes to families that had younger children. For families experiencing poverty in Baltimore, securing safe and affordable housing was a never-ending struggle. So when researchers facilitated the repair of rowhouses, many families saw it as an opportunity, unaware of the risks they were about to put themselves at. Families were not clearly told that the lead removal was intentionally left incomplete, nor was it mentioned that their children were about to be housed in an environment where toxic lead dust was still present. The day-to-day processes of the experiment involved the routine collection of dust and soil samples. Families unknowingly signed up for these trials, consenting to blood draws, believing that their children were receiving standard medical care, unaware that their children’s bodies were being actively utilized in testing the limits of lead exposure to young bodies. Their blood was the primary instrument used in measuring the success or failure of the cheap repairs, tracking blood lead levels.
Even when blood tests began to reveal rising lead levels in some children, like Ericka Grimes, researchers were slow to inform parents, allowing exposure to progress in order for data to be collected. Keep in mind that lead is a potent neurotoxin, a poison that destroys brain tissue, causing irreversible cognitive damage and developmental delays. Researchers attempted to justify the study, arguing that families would likely have been exposed to higher levels of lead in untreated Baltimore housing either way. In a landmark 2001 ruling (Grimes v. Kennedy Krieger Institute), the Maryland Court of Appeals rejected this defense. Stating that “a vulnerable child will not be used to test potentially hazardous theories,” ruling that parents “may not consent to have a child submit to painful or potentially life-threatening research procedures that hold no prospect of benefit to the child.” Nonetheless, these Baltimore children could not consent to this environmental research, leaving them entirely defenseless.
As such, the Kennedy Krieger study continues to stand as an example of medicine’s monstrous history. Illustrating how the pursuit of cost-effective public health data can exploit desperate communities. Subjecting children as acceptable variables in a clinical study, this study aimed to prioritize scientific advancement over the long-term medical well-being of its most vulnerable subjects.
Sources:
Buchanan, David R., and Franklin G. Miller. "Justice and Fairness in the Kennedy Krieger Institute Lead Paint Study: The Ethics of Public Health Research on Less Expensive, Less Effective Interventions." American Journal of Public Health, vol. 96, no. 5, 2006
Grimes v. Kennedy Krieger Institute, Inc. 366 Md. 29. Court of Appeals of Maryland, 2001.
Markowitz, Gerald, and David Rosner. Deceit and Denial: The Deadly Politics of Industrial Pollution. University of California Press, 2002.
Shamoo, Adil E. "Ethically Questionable Research with Children: The Kennedy Krieger Lead Abatement Study." Accountability in Research, vol. 9, no. 3-4, 2002