Attachment 3-A

February 11, 1948 letter from Dr. Stokes to Dr. Colin McLeod
[Excerpt]

                     1740 Bainbridge Street,
                     Philadelphia 46, Penna.

Dr. Colin McLeod,                       11 February, 1948
488 East Avenue,
New York, N.Y.

Dear Colin:

Owing to the importance of our human studies in hepatitis and to
the fact that little opportunity was afforded in Washington for
full discussion of their rationale, I am writing to clarify some
of the points involved.

I believe it is important that funds should be available through
Congress for the purpose of reimbursing volunteer prisoners who
may be sufficiently disabled as a result of the studies to
prevent their full return to gainful occupations after release
from prison.  Such disability, whether partial or complete, is a
fairly remote possibility for the viral agents we are now using
in the hepatitis studies, but it should be the concern of the
Epidemiological Board and of Congress to permit the use of funds
for disabilities resulting from studies on other diseases or
conditions which are of importance to the Armed Services and for
which the study of human beings is essential.  This is so
important for our work that I am urgently requesting you to make
every possible effort toward attaining this objective.  I shall
be only too glad to assist to whatever extent you desire in any
such efforts.

In reference to another point in our discussion in Washington,
there was also insufficient time to point out certain essential
facts relating to our studies on humans, which it was suggested
might raise a point of ethics.

I wish to be quite clear, therefore, on the following points
concerning the use of children in the hepatitis studies by
consent of parents or guardians.  No study has been initiated
except under the provision that the study in our opinion could be
of benefit to the individual himself, who is chosen for the
investigation.

For the studies of mumps in children this provision is more
obvious, since it is well recognized that children should have
mumps before puberty.  The fact that the exposure is a planned
exposure and the children are under nursing care from the start
of the incubation period provides a favorable active immunization
during the childhood years.  The importance of contracting mumps
prior to puberty is emphasized by the refusal of many schools to
utilize ultra-violet lamps in the lower grades for fear cross-
infection in mumps, as well as in vari-cella and rubella, might
be prevented.  It is also a well recognized pediatric practice to
plan exposure of children to these diseases before puberty if the
opportunity is presented to do so.

COPIED:  12/2/94
RECORD Group:  # 334
Entry: #14
File:  Commission on Liver Diseases on Human Volunteers for
Hepatitis Studies in Feb. 1945