The University of California, San Francisco has issued a public apology after conducting an investigation into experiments performed by two faculty members in the 1960s and '70s on prisoners, some of whom were mentally ill. In many cases, there was no record that the prisoners had provided informed consent.
The experiments included exposing the men to pesticides and herbicides, both by injection or application on the skin. In one experiment, according to a report issued by the university this week, men incarcerated at the California Medical Facility in Vacaville had small cages filled with mosquitoes placed on their arms so researchers could observe "host attractiveness of humans" to mosquitoes.
The experiments were done by Dr. Howard Maibach and Dr. William Epstein, both faculty members in the school's dermatology department, according to the university. Epstein, a former chair of the department, died in 2006. Maibach is still a member of the department.
The university's apology came after Maibach, responding to the report's findings, defended some of the experiments and said a former UC San Francisco president and ethicist told him the prisoners, some suffering from mental illness, could consent to the experiments. Maibach said he regretted his part in the research but argued it also "provided several benefits to the prisoners."
The university's inquiry into the research was the first report issued by its Program for Historical Reconciliation, which was created to look into questions or concerns about the university's role in unethical conduct in biomedical and clinical research.
In it, researchers found the two professors for years experimented on about 2,600 incarcerated men at the Vacaville facility, including many who were either being assessed or treated for psychiatric issues. The experiments continued until 1977, when the state called for all human subject research at state prisons to stop.
None of the subjects had medical conditions that would have benefited from the experiments, the university said.
"UCSF apologizes for its explicit role in the harm caused to the subjects, their families and our community by facilitating this research, and acknowledges the institution's implicit role in perpetuating unethical treatment of vulnerable and underserved populations — regardless of the legal or perceptual standards of the time," said Dan Lowenstein, executive vice chancellor and provost for the university. "Truth-telling and rebuilding trust are foundational to our commitment to reconciliation work and, in that spirit, we must acknowledge the failures in our history in order to identify a path forward."
The university's inquiry into the experiments focused mainly on Maibach, who remains in the university's School of Medicine as a professor of dermatology.
After attempts were made to reach Maibach for comment, his son, Edward Maibach, replied to an email inquiry and said his father was unable to respond after having suffered a stroke on Dec. 13.
In the email, Edward Maibach, who is a researcher and professor at George Mason University, said his father had attempted to cooperate with the inquiry into his research by the Program on Historical Reconciliation but was unable to meet in person with the committee or the report's authors. He also was not given access to the documents used by the committee.
In the statement, Edward Maibach also criticized the report's findings.
"The committee treated its inability to find documentary evidence that most of the research conducted at Vacaville complied with contemporaneous requirements for human subject research as evidence that there was no compliance," he wrote in a statement to The Times. "This is untenable, in light of the fact that the research that the committee was investigating was conducted more than forty and (in many cases) fifty or more years ago. In this context, the absence of relevant documentary evidence proves nothing."
In a letter he sent to colleagues in response to the report, before he had a stroke, Maibach expressed dismay at having taken part in the research and noted that the ethical standards of the '60s and '70s were different to those of today.
"What I believed to be ethical as a matter of course forty and fifty years ago is not considered ethical today," Maibach wrote. "I regret having participated in research that did not comply with contemporary standards."
In his letter, Maibach also noted that when questions first surfaced about the ethics of the research, UC San Francisco did not have an ethicist on hand. He then met with the university president, an ethicist, who at the time told him he believed the prisoners could consent to the experiments.
"Based on my frequent conversations with him, I believe that the ethicist believed unequivocally that these volunteers could provide informed consent," he wrote in the letter. "He felt that these volunteers could say yes or no — in their own judgment."
Maibach did not identify by name the president he consulted with.
In the letter, Maibach often referred to the men involved in the experiments as "volunteers" and made no mention that many of them were being treated for psychiatric diagnoses.
He also defended his work, arguing that he would explain the procedure to prisoners, perform the procedure on himself, and then ask whether they had any questions. He also said he believed the experiments and work "provided several benefits to the prisoners," including getting free dermatologic care from him at UC San Francisco after their discharge and being paid for their participation.
In a letter to staff, Jack Resneck Jr., chair of the UC San Francisco dermatology department, commended Maibach for expressing remorse in the letter but said he "unfortunately also defends the experiments."
Although ethical standards have evolved, Resneck noted, there was already awareness in the medical community regarding the need for informed consent, especially that of incarcerated people.
After Nazi doctors conducted experiments on prisoners in concentration camps during World War II, Resneck pointed out, the Nuremburg Code of 1947 discussed the importance of voluntary consent.
"This has particular relevance to the research at (the Vacaville facility), where subjects were not only incarcerated, but were also selected from an institution that housed many under treatment for psychiatric diagnoses," he wrote.
The report also found that Maibach and Epstein coordinated their testing of the prisoners through a nonprofit organization, which enabled them to bypass a school requirement to report their research to UC San Francisco's human subjects committee, the Committee on Human Welfare and Experimentation, which was established in 1966.
The university noted that both men were trained at the University of Pennsylvania by Albert Kligman, a dermatologist who was found to have conducted unethical and disrespectful research on mostly Black men in prison.
"Maibach and Epstein brought Kligman's methods to California when they joined UCSF faculty," read a statement from the San Francisco school.
Although the racial makeup of Maibach and Epstein's subjects was not clear, Resneck said in his letter to staff that some of Maibach's writings "perpetuated the biologization of race."
"Even if this research may have been accepted by some in its time, it is essential that we now acknowledge the harms that were done and the inconsistency with our UCSF values," Resneck wrote.
Maibach in his letter to colleagues wrote that race at the time of his research was "ubiquitously used in patient descriptions," but he now has "come to the understanding that race has always been a social and not a biological construct."
Asked whether the university was considering discipline in light of the report's findings, a spokesperson said UCSF was "still in the process of considering the recommendations and determining appropriate next steps."
In light of the report, a committee has recommended the findings be made public and for the university to launch an oral history of the project with some of the men who were subjected to the experiments between 1955 and 1977.
