Context:  A Member of Parliament in the United Kingdom has called for a statutory inquiry into medical research carried out on Indian-origin and South Asian women decades ago in the city of Coventry.

Key Points

• The MP said that there were concerns over the use of radioactive isotopes in chapatis that were fed to the women as part of a study purportedly on combating iron deficiency among South Asian women in the city.

• It was claimed that the women’s consent was not sought and proper information on the experiment was not given to them.

About the study

• As part of a study, in 1969, around 21 Indian-origin women, identified by a general practitioner (GP) in Coventry, were given Chapatis containing Iron-59, a radioactive iron isotope.

• The women had sought medical help from the GP for minor ailments but were then, without their knowledge, made part of a research trial to address the issue of widespread anaemia (a disease caused by iron deficiency).

• Chapatis containing Iron-59 were delivered to participants’ homes.

• After eating the chapatis, women in the study were taken to the Atomic Energy Research Establishment, where their radiation levels were measured to judge how much iron had been absorbed.

• The UK’s Medical Research Council (MRC) said the study proved that Asian women should take extra iron because the iron in the flour was insoluble.

Was the study ‘ethical’?

• Public criticism led to the MRC establishing an independent Committee of Inquiry.

• This committee’s report in 1998 said that low levels of radiation can be dealt with by the human body up to a certain threshold.

• It added, that many do not accept this view and say that the damage to human DNA due to any level of radiation is more severe.

• The report suggested that the nature of the studies did not appear to be unethical.

Concerns

• questions of consent,

• understanding in the light of giving consent, and

• the degree to which the risks were explained to the participants or even taken into account by researchers.

Prior judgements

• Researchers also made some prior judgements about the benefits and costs of the study without keeping the participants at its centre, in line with the paternalistic nature of science (and wider society at the time).

Informed consent

• The MRC no longer had the list of the study’s participants.

• A public call for participants to come forward also did not yield results.

Misleading portrayal

• While the procedures for such experiments are much stricter today, back then the need to provide written explanations to participants or get their written consent was not necessary.

• It caused considerable unnecessary concern among Asian people and that their portrayal was seriously misleading.

What are radioactive isotopes?

• Radioactive isotopes are unstable forms of an element that emit radiation to transform into a more stable form.

• Such isotopes have unstable nuclei, i.e. the proton to neutron ratio is such that they contain excess energy in the nucleus.

• This excess energy is dissipated spontaneously through radiation – the emmission of energy through waves or particles.

• Depending on the amount and the specific kind, radiation can have various long term health effects on human beings.