List of Attachments For Briefing Book Volume 2 Attachment 1: Letter to Stafford Warren, From Carroll Wilson, Dated 4/30/47 Attachment 2: Memo For the Secretary of the Army, Subject: Use of Human Volunteers In Experimental Research, 2/26/53. Attachment 3: Note By the Secretaries to the Joint Chiefs of Staff On Use of Human Volunteers In Experimental Research, 2/26/53. Attachment 4: Letter From J. E. Moore, To A. N. Richards, 10/6/42 Attachment 5: Revision of Dr. Richards' Letter of 10/9/42, 10/31/42. Attachment 6: CRS Report For Congress, Protection of Human Subjects In Research, 2/28/94 Attachment 7: Human Radiation Experimentation (Bioethicsline and ETHX citations, 5/6/94) Dr. Stafford L. Warren University of California 405 Hilgard Avenue West Los Angeles, California Dear Dr. Warren: This is to inform you that the Commission is going ahead with its plans to extend the medical research contracts of the University of Washington, Columbia University, Western Reserve University, the University of Rochester, and the University of California (at Los Angeles), in the amounts recommended by the budgetary subcommittee of the Interim Medical Advisory Committee, as recorded in your letter to me dated April 7, 1947. It is the hope of the Commission that such extensions of the contracts will provide a sound basis for continuing the medical research essential to the Commission's activities, pending a full review by the Commission of the scope of the medical program. The Commission also hopes to strengthen the position of the Universities to attract personnel of high calibre to the medical research work, by authorizing them, with the approval of the Commission, to enter into contracts of employment with key personnel for periods up to three years. The Commission is entirely sympathetic with the view of your Committee that research personnel engaged in medical projects should be encouraged to exercise their own initiative and should be given an opportunity to devote part of their time to pursuing lines of research which appear fruitful to them, even though not immediately related to specific items in the approved program for the particular project. Accordingly, the Commission is authorizing its Area Managers to approve such research, up to twenty per cent of the time of the research personnel engaged on such medical projects. When such approval is given, the Director of the medical project will be required to certify to the Commission (1) that the research is useful and is not outside the general scope of the Commission's research interests, and (2) that the research will not unduly interfere with the progress of the work on the approved program at the project. The Director also will be required to indicate separately in his reports to the Commission what research has been done under this authorization. -2- It is understood that your Committee has recommended a program for obtaining medical data of interest to the Commission in the course of treatment of patients, which may involve clinical testing. The Commission wishes to make clear to your Committee its understanding of the program which is being approved program: a. treatment (which may involve clinical testing) will be administered to a patient only when there is expectation that it may have therapeutic effect; b. the decision as to the advisability of the treatment will be made by the doctor concerned. The Commission does not intend to influence in any way the exercise of judgment by the doctor as to the administration of any particular treatment authorized under the approved program. Indeed, from the discussion at the meetings of April 3-5, it seemed evident to me that doctors would not allow their judgment on this matter to be influenced by anyone. In any such clinical testing, the Commission continues to request that the same procedure be followed which was agreed upon early in March. That procedure contemplated that it should be susceptible of proof form official records that, prior to treatment, each individual patient, being in an understanding state of mind, was clearly informed of the nature of the treatment and its possible effects, and expressed his willingness to receive the treatment. In view of your recommendation, the Commission does not request that written releases be obtained in such cases, but it does request that in every case at least two doctors should certify in writing (made part of an official record) to the patient's understanding state of mind, to the explanation furnished him, and to his willingness to accept the treatment. The Commission is interested in exploring the possibility of starting various types of training programs along the lines recommended by your Committee. It is suggested that there should be submitted in writing detailed proposals for training programs, which do not go beyond the limits of what is now practicable. Sincerely yours, Carroll L. Wilson General Manager