Misinformed Consent


By Vern Bryk  © April 2019


Ethically speaking, what do you owe a test subject in terms of information? That’s a critical concern when the test will affect the subject’s mental health. Note that we did ponder this at the outset, long before the tragedy. So the question was not just ex post facto handwringing.

       The trouble with full transparency in this case was the problem of suggestibility. If you tell someone you are testing for a specific emotional reaction, then you are inadvertently steering that person toward that reaction, which skews the reliability of your results. This issue held great pertinence for us in that we weren’t testing just for the reaction, but how the subject interprets the reaction.

       For example, exposure to THC, either through inhalation or ingestion, causes certain psychological and physiological effects. If you are a regular user of marijuana, you know how to attribute these effects. But let’s say your exposure was inadvertent or surreptitious, that you start to feel a certain way without knowing why. How would you attribute that feeling without knowing the cause?

       Answering that question was a key objective of the test, which meant that the subject’s unawareness was essential. And the THC analogy is apt in that we were going to administer an anxiogenic compound to the subjects, a chemical specifically designed to induce anxiety.

       Why would we do that?

       Here it should be noted that we were strictly a testing firm hired by a research organization that had been hired by someone else. Contractors hired by other contractors. This isolation layering is not uncommon and serves several purposes. It encourages specialization and expertise and helps preserve confidentiality. Every layer only knows what it needs to know for its part. The blindness to the big picture can also improve the integrity of results. If I don’t know the preferred outcome, I cannot unconsciously steer toward it.

       In this particular project, we suspected that some branch of the military was the top layer. The various documents detailing the objective and methods employed the bureaucratic language and affinity for abbreviations and acronyms typically found in government communications. But the real tipoff was that every document contained a list of people and/or organizations authorized to view it. This is not something that we would see from CDC or NIH.

       That said, military involvement would not flag it as ethically suspect. If its goal was to save lives of American soldiers on the battlefield, they why would we be opposed? We should also note the tremendous contributions of military research to the medical field, including trauma care, prosthetics and much more.

       And, yes, we were aware of past abuses, specifically the U.S. Army testing at Edgewood where more than 7,000 soldiers were exposed to various chemicals, including nerve agents such as VX and sarin, and psychoactive drugs such as LSD and PCP. Though these tests strike us as repugnant today, they were nonetheless conceived with good intentions.

       One of the program directors believed that psychochemical warfare could eliminate the need for the wholesale slaughter of human beings and the massive destruction of property resulting from conventional warfare. Minimizing the horrors of war seems a laudable goal, though obviously, minimizing the necessity for war seems a more optimal solution.

       Those previous tests ended around 1975, and subsequent outrage and investigations suggested that similar abuses would not be repeated. With that assumption, we saw no ethical obstacles to participation. And we saw no red flags in the initial documents or testing instructions. Of course, our moral antennae remained on alert, as we would also be administering a psychoactive chemical to volunteers.

       Those volunteers were provided to us by the research contractor and had been assigned pseudonyms for purposes of confidentiality. The pseudonyms were apparently contrived by someone with a sense of humor, given that all the subjects were named after rock stars. Or perhaps the humor was a stratagem to make it all seem more innocuous. We assumed the volunteers were soldiers by their manner, haircuts, and proclivity to saying “sir.” Plus, they were all young males.

       Yes, we were mindful of the parallels—administering psychoactive chemicals to soldiers. But we had been assured that the anxiogens were mild in nature. The research organization also provided two paramedics who would remotely monitor and record physiological responses to the anxiogen from an adjacent room. If necessary, they would administer tranquilizers to counteract the effect of the anxiogen. Our responsibility was to observe and record cognitive and emotional responses, which we would do through interviews and video capture by hidden cameras.

       The paramedics arrived in a private ambulance and it was agreed that in the event of medical emergency, they would transport the test subject to a nearby medical facility for treatment. Under no circumstances were we to involve municipal first responders.

       The other curious aspect of the test was the direction to administer the chemical by aerosol inhalation, as they a had already tested efficacy by other means of administration. To that end, we were provided with an electronically controlled aerosol emitter employing prepackaged cannisters of the chemical, thus preventing any inadvertent contamination or dilution of the chemical at our end.

       This method of administration affirmed our suspicion of military purpose, as aerosol dispersal would be the only practical way to deliver chemical exposure to an enemy on the battlefield. During this conversation, one of my colleagues suggested that, by providing proof of concept, we would also be assuring the government that it had a new means of suppressing dissent, a new means of controlling its population. We laughed and suggested that he should be writing mystery novels. He was not amused.

       As previously noted, a primary consideration was what explanation would be provided to a naturally curious test subject, an explanation that would avoid the problem of suggestibility while still establishing something resembling informed consent. The issue generated much debate amongst ourselves and with the sponsoring research organization. Amongst ourselves we also argued the obvious question of whether anyone in uniform can truly provide informed consent by nature of their occupation.

       Nonetheless, we still felt satisfied with the subsequent compromise. A scent would be added to the aerosol. Several scents would be employed. The test subject would be told that the purpose of the test was to evaluate the effect of various scents on mood, disposition, and morale.

       In other words, they were being told that they would be exposed to a chemical that might affect their emotional state. We were only deceptive on the nature of the chemical. We felt this was ethically a reasonable solution. Again, we were told it was a mild anxiogen.

       The first battery of tests was fairly straightforward, determining efficacy from an engineering and physiological perspective. What level of concentration in air, measured in parts-per-million, was necessary for an effect to occur? How much time exposure at different levels of concentration was required for an effect to occur? Did the inhalation cause any respiratory problems? Did inhalation cause any discomfort or pain, as would be encountered with an irritant?

       The subsequent rounds dealt with the psychological effects. These were determined by our visual observation from a separate room and by our questions to the subject asked over an intercom. How does this scent make you feel? In other words, we were asking how the anxiogen affected him without revealing his exposure to one.

       There was little doubt that aerosol inhalation was an effective means of introducing an anxiogen, as determined by our question/answer conversations and confirmed by the paramedics’ monitors that clearly exhibited the physiological effects of anxiety in terms of pulse rate, respiration rate, and so on.

       Once it was confirmed that anxiety could be induced by inhalation of aerosolized anxiogen, the next question was how the subject would interpret those feelings. Without being given any specific suggestions, they were typically confused. When they said they felt scared, we asked what they were afraid of. They didn’t know, providing only vague answers. Something is not right. Something is going to happen.

       The test chamber had a window to the outside. Sometimes they would go to the window looking for an explanation for their anxieties. Something is out there. Something bad. Or someone is out there, someone who is going to do something bad. There was a self-reinforcing aspect to this. That is, the chemically induced anxiety was augmented by confusion over its cause.

       The next phase of the testing was to provide the subjects with potential focal points for their induced anxieties to see if they would seize upon such focal points as an explanation for their fears, an explanation they eagerly wanted. They wanted to identify the danger they felt.

       The first focal points were presented as verbal cues, typically in an off-hand manner. Example: “I hope we can wrap this up before the storm comes. The weather guy on TV said it’s going to be a bad one.”

       Test subjects under the influence of the anxiogen who heard this cue stared out the window fearfully looking for the storm front, often claiming to see it off in the distance. One claimed to see a funnel cloud, even though it was a pleasant day. He asked if the lab had a basement or a safe room.

       We then transitioned from verbal cues to physical objects for potential focal points. We started with three: a small, decorative, brass incense burner from India; a small, lacquered, wooden box that had Japanese language characters drawn on the top; and a small dried, gourd from Mexico onto which had been painted the image of a rotund woman wearing a high hat. They were placed in the test chamber singly, not together, and nothing was noted about their presence in the room. They were just there, with no attention directed toward them.

       We found that in all three cases, the test subject did not even notice the object before anxiogen exposure, but became fixated with the object shortly after exposure. In the case of the incense burner, which had a top, and the box, which had a lid, the subjects exhibited intense curiosity combined with wariness. They wanted to know what was inside the burner or the box. But they approached both with trepidation, as if there might be something inside that would jump out at them.

       The gourd woman provoked the most anxiety, however. The subjects were afraid to even approach it, and actively moved to distance themselves from it. We quickly deduced that this effect was due to the presence of a face. Something with a face would present more fearfully because it represented a living character, something capable of intention, in this case, a perceived malevolent intention.

       So the next two objects we presented also had faces. One was a stuffed gorilla toy meant for a child. The other object was also a toy, a large, rubber tooth with a smiling face. The tooth held a tooth brush. It was a toy designed by a dentist to remind children to brush their teeth.

       Under the influence of the anxiogen, both objects generated fearfulness on the part of the subjects. They were afraid to approach either one, and instead, moved as far away as possible, even scrunching themselves into a corner.

       At this point, several hypotheses had seemed proven:

       1. Anxiety can be artificially induced by means of aerosol exposure to a known anxiogen.

       2. When a subject experiences artificially induced anxiety, they will desperately try to understand the cause of it.

       3. When you provide a focal point object, the test subject will seize upon the object as the source of the anxiety.

       We felt that we had achieved the stated test objectives, but the contracting organization wanted to take it to one more level. They wanted to know to what extent a focal point could intensify the reaction. That is, can an overtly threatening focal point amplify the reaction without increasing the dosage of the chemical.

       The first choices for threatening focal points were those that might cause anxiety in a normal individual not under the influence of an anxiogen, a fake spider and a fake mouse. These objects would be initially hidden in the test chamber but subsequently delivered into view by remote control.

       We expected a strong reaction to this variation of the test, but were surprised at how strong it was. Subjects not only fled into a corner, they screamed, wailed, trembled, wept, sobbed, and hyperventilated.

       At this point, we decided that the tests must conclude. We were no longer just evaluating emotional reactions, we were actively engaged in psychological torment. But they wanted one final test performed, this time with a real mouse.

       We were dead set against this and a long argument ensued. To this day I cannot explain why we surrendered other than to propose that debates are not about who has the stronger argument but who has the more forceful will. Relentlessness always provides an edge.

       The live mouse experiment went exactly as I had predicted, with the subject screaming in absolute terror, as if confronting a horrible death. I was so disgusted, I couldn’t even watch.

       Then the screaming stopped.

       I opened my eyes to see the two paramedics rushing into the test chamber. One carried several syringes, the other a defibrillator. They worked on the subject for several minutes. Then they put him on a gurney and took him toward the ambulance. I jumped in the way, yelling, demanding to know the man’s condition, as if I didn’t already know. They pushed me out of the way, saying they would handle it. Then they sped off in the ambulance.

       In their haste, they had not turned off the remote monitors in their observation room, and the subject was still outfitted with their sensors. It was clear that the man had died from cardiac arrest. He literally had been scared to death.

       My staff and I stood stunned and shaken, not knowing what to do next. I called my contact at the sponsoring research organization and gave a description of the events I had observed. He calmly, bureaucratically, responded that he would pass on the information to his superiors and that someone would get back to me in the morning.

       When we returned to our facility the next morning, we found that it had been entered during the night. But it was not a breaking and entering. Someone either knew the passcode to the electronic entry system or knew how to hack such a system.

       We found that all computer files relating to the tests had been erased. Not just deleted, but erased in non-recoverable fashion. All physical papers, equipment, and materials relating to the tests had been removed. Moreover, there was the distinctive odor of bleach in the air, indicating that the entire space had sanitized to remove all fingerprints and DNA traces of the subjects and paramedics and to eliminate from surfaces all traces of the test chemical.

       None of our other files had been disturbed and nothing else had been damaged or altered. They even reset the security system upon leaving. It was like they had never been there. Like nothing had happened. And we had no evidence to suggest otherwise.

       I was unable to reach my contact at the research organization, and realized I never would.

       As we milled around glumly, numb, disturbed, trying to process what happened, a vehicle arrived outside and a messenger entered the facility with an envelope. He left without asking for a signature. The envelope contained two items. One was a page from the original contract with a highlighted passage. Buried in the fine print boilerplate that we had overlooked was language authorizing them to conduct their nighttime clean up raid. Without realizing it, we had given our consent to it.

       The second item was a bank check for the exact fee we had agreed upon to perform the tests. They were, as they assured us upfront, honorable men. They did not stiff us.

© Copyright 2019 by Vern Bryk