ADVISORY COMMITTEE ON HUMAN RADIATION EXPERIMENTS
                                   - - -
                              PUBLIC MEETING
                                   - - -
                        Tuesday, November 15, 1994
                                   - - -

          The meeting was held in the Grand Ballroom North, the
Renaissance Techworld Hotel, 999 Ninth Street, N.W., Washington,
D.C., at 9:00 a.m., Ruth Faden, Chairman, presiding.
PRESENT:
          RUTH FADEN, Chairman
          KENNETH FEINBERG
          ELI GLATSTEIN
          JAY KATZ
          PATRICIA KING
          RUTH MACKLIN
          LOIS NORRIS
          NANCY OLEINICK
PRESENT (Continued):
          HENRY ROYAL
          PHILIP RUSSELL
          MARY ANN STEVENSON
          DUNCAN THOMAS
ALSO PRESENT:
          SARA CHANDROS
          PATRICK FITZGERALD
          MARK GOODMAN
          JOHN TILL
          GAIL GELLER
PUBLIC COMMENTATORS PRESENT:
          GEORGE N. AHMAOGAK
          MAGGIE AHMAOGAK
          MARCIA HAGGARD
          DENNIS NELSON
          ROSSMAN E. PEETOK
          KATHY PLATONI                              C O N T E N T S
                                                                       PAGE
Remedies, Ken Feinberg                                                    5
Public Comment:
     Mrs. Marcia Haggard                                                 69
     Dr. Kathy Platoni                                                   78
     Dr. Dennis Nelson                                                   89
     Mayor George N. Ahmaogak and 
     Rossman Peetok                                                     105
Environmental Dosimetry, John Till                                      140
International Releases, Mark Goodman and
     Patrick Fitzgerald                                                 174
Research Proposal Review Project,
     Ruth Macklin, Sara Chandros and
     Gail Geller                                                        233                           P R O C E E D I N G S

                              (9:08 a.m.)

          CHAIRMAN FADEN:  Would the Committee come to the table
please?  We're starting a few minutes late, and there's no reason
for it other than my forgetting about it.

          Okay.  Do we have a new agenda?  Excuse me.  Do we have
a new agenda?

          We have a new agenda for this afternoon, 100 percent
recycled paper.  Please note some of the things that are moved
around.  We're going to see if we can get everything in.

          If you'll note, we're going to have a report from the
Remedies Subcommittee, which is what we postponed from yesterday,
which Ken will give and then other members of the subcommittee
can help lead the discussion.

          It's scheduled for an hour.  However, if we need more
than an hour, the ten o'clock report will be moved into the
afternoon.  It will happen, but it will be moved.  So we
shouldn't feel absolutely constrained by the time frame.  If the
discussion needs to go until 10:30, it will.

          The one thing we cannot manipulate is the public
comment session which is scheduled for 10:45, as we have guests
from the public, and they've arranged their lives to come at the
appointed time.  So the only thing on the agenda that cannot be
moved around is the 10:45 public comment session.

          So with that, Ken, can you lead us please?

          And we all received a memo from the Remedies
Subcommittee which perhaps it might be helpful to pull out and
look at.

          MR. FEINBERG:  Thank you.

          This is sort of an interesting time to talk about this
topic because we have been nibbling around the edges, both the
subcommittee and the full committee, in recognizing that
inevitably we're going to have to take on this subject of
remedies.

          What I want to do this morning is to lay out some basic
axioms about remedies, lay out some concerns that have been
expressed both by the subcommittee in our deliberations, but also
to lay out some personal concerns for the sole purpose of
generating an initial discussion that will undoubtedly, as Ruth
has said, take us into the next few months of meetings to hammer
out this important section.

          So what I'm going to do in the next 20 or 30 minutes is
basically provide some premises, some of which are reflected in
the one-page memo that you have got, and then walk into the
lion's den and prepare to incur the initial inquiry, criticism,
wrath of my fellow members.  So it's a task.

          Let me start off before we talk about the substance of
the chapter and some ideas; let me start off by expressing some
concerns about remedies that have been expressed both within the
subcommittee, but also generally in the context of compensation
programs for other similar wrongs:  Agent Orange, Dalkon shield,
atomic vets, uranium miners, et cetera, during the deliberations,
the debates in Congress.

          But let me express a few concerns that must be kept at
least in the back of our mind as we go forward with remedies. 
First concerns, four concerns.

          First, that we make sure that a remedies chapter is
grounded in some sort of factual basis.  This means that we must
be aware at all times of the factual underpinnings of any
remedies guidelines that we might propose.  

          This raises problems, for example, of medical
causation.  Henry has talked about dosage levels, et cetera,
trying to reconstruct dosage levels, the problem sin
reconstructing dosage levels.

          The time that has passed that makes it very difficult
factually to learn all that there is to know.  We never know
everything we need to know about these experiments.  So any
remedies program is going to have to presume certain facts or
certain variables, and we cannot in the time that we have got
develop a remedies chapter for every single isolated case. 
That's what the guidelines are for that we propose as a
subcommittee.

          Time also plays havoc with other traditional variables
in a compensation program.  Many of the alleged victims are
deceased.  That has both procedural problems to it in terms of
getting the facts.  It also, frankly, has direct substantive
problems in determining a remedy.

          For example, does the absence of consent in 1950
justify a remedy to an estate in 1994?  I tend to doubt it, but
it's worthy of discussion.  If an alleged victim in 1950 was not
given adequate consent, that victim has been dead for 30 years. 
Does the absent of consent inure to the benefit of an estate in
1994?  I'm not sure.  I tend to doubt it.

          But, again, this is all part of the first concern I
have about accurate, factual underpinnings that justify our
remedies guidelines.

          The second concern I have is one that some of you are
aware of in other contexts, and that is the raising of false
expectations.  I think that at best we are misleading people, and
at worst we are acting in a cruel fashion if we lay out the hope
that people are going to get millions of dollars in remedies for
what we are uncovering here.

          My experience in other compensation programs is that it
is a dangerous game to raise the expectation level of people that
we have the power, even if we wanted to, to award millions of
dollars, a run on the bank in the federal Treasury, and I think
we have to be very careful about that political problem.

          Third concern, in some areas involving mass releases,
exposures, uranium miners, atomic vets, Downwinders, the Marshall
Islanders, Congress has spoken, maybe not well, but Congress has
spoken.  It has spoken both in terms of legislation that is now
on the books, and it has spoken in the form of various
congressional investigations involving libraries of documents and
reports in the House and the Senate.

          So I mean I think, again, we cannot reinvent the wheel. 
In many of these at least mass exposure areas, Congress has if
not preempted the field, Congress has certainly had something to
say, and I think that we as a Committee should keep that in mind,
that we are not reinventing the wheel here in some of these
areas.  In others I think perhaps we are.

          And the fourth and final concern, which has been
resolved by us as a Committee thanks to the work of the
Subcommittee on Scope and Priorities, keep in mind that there is
an ongoing debate about our mandate and exactly what we are
authorized to do in the way of presenting recommendations.

          So those are just some; I want to sort of set the table
by expressing my concern and, I think, the concern of the
subcommittee that as we go forward we keep in mind these concerns
as we try and fashion a remedies chapter.

          The subcommittee recommends to the full Committee that
we basically follow a methodology on remedies that's reflected in
this abbreviated, cryptic memo, namely, one, that our goal be to
draft remedies guidelines that will guide not only policy-makers,
but the public in terms of what variables we think are
appropriate for other policy-makers to consider in picking up the
mantle of the remedies chapter.

          As I understand our subcommittee work, we will not be
recommending specific remedies.  Instead we will be recommending
what remedies are available if certain variables are determined
by Congress and the executive branch to be worthy of a remedy.

          A blueprint is our goal in this chapter, a blueprint
that would lay out a series of options.  Those options would be
available as policy-makers may pick and choose if they think the
options are appropriate, and we would try and provide our policy-
makers with some of the variables in the way of culpability,
absence of medical causation, presence of medical causation,
agency, victim deceased, victim alive, wrongdoer alive, wrongdoer
deceased.  We would lay out the variables that would lead policy-
makers to agree -- in guideline form -- that would lead policy-
makers to decide on their own ab initio whether they want to
promote the remedy or not promote a remedy.

          Secondly, the subcommittee proposes that we do lay out
a series of options that are available.  I mean there are options
available ranging all the way from compensation all the way to
the other end of the spectrum, which is an apology or not even an
apology is justified in certain cases, and there's a whole range
of options in between, insurance, medical monitoring, that we
should lay out as potential options here.

          Third, the subcommittee recognizes that any remedies
chapter should distinguish between different types of
experiments.  There were experiments directed at individuals,
individuals in a small group, a cohort or a control group, small,
maybe not so small -- everything's relative -- but a group of
discrete experiments involving individuals.

          There are then, and I love that phrase of Duncan's and
others, experiments of opportunity involving mass exposures,
involving atomic vets, uranian miners, and the Marshall
Islanders, where after the fact there are experiments to
determine impact, and maybe there are grey areas in between,
Green Run, et cetera.

          I mean there are variations, but the subcommittee
acknowledges that there are experiments directed at individuals
and radiation experiments directed at A and B and C, and then
there are experiments after the fact against thousands of people
because the wind is blowing the wrong way.

          I'm not saying that any of those are more worthy or
less worthy of a remedy.  There are other factors that play when
you talk about mass exposures as opposed to individual, discrete
experiments, and I think the guidelines have to reflect that.

          The subcommittee also proposes sort of a rudimentary
grid that would be mentioned in the guidelines.  The availability
of a remedy, if any, whatever that remedy might be, if any, would
be driven by a grid which would reflect the degree of government
culpability, the degree of government culpability, sort of the
horizontal grid, with the interesting variation, degree of
government culpability, (a) government officials performing the
experiment, (b) agents of the government performing the
experiment, an intermediate step.

          And a vertical grid which would talk about the degree
of harm, either medical in terms of Experiment A causing Disease
B or Injury C; absence of harm; and the interesting question of
harm also being defined in terms of violation of individual
integrity in not knowing, not giving informed consent.  That's a
harm, I suppose.

          So that all has to be considered.  I mean the absence
of informed consent may also violate the horizontal grid
pertaining to culpability, as well as the vertical grid
pertaining to harm.

          So that was basically how the subcommittee began its
discussions in terms of trying to fashion some guidelines that
would assist both the full Committee and the public in our final
report.

          Now, that -- and Patricia has been enormously helpful
in the subcommittee in pointing out that all that the
subcommittee has done so far in presenting this cryptic memo that
talks about a methodology for developing a remedies chapter is to
beg the question of what substantive meat we give to the
variables that determine government culpability and harm.

          I mean it's all well and good to say, "Look.  We'll
have a grid, and if the government is culpable, then that
increases the likelihood of a remedy, and if the person was
injured that increases the likelihood of some remedy," whatever
that remedy might be, whatever that response might be by the
federal government.

          But it begs the question a little bit as to how one
defines government culpability, and that is where the
compensation experts have to turn to the substantive ethics
experts around the table to help us fashion what constitutes
government culpability, if any, and nature of the harm, if any.

          Now, that raises a very interesting question, and now
I'm branching off a little bit, and it's Feinberg on remedies
instead of the subcommittee on remedies because basically the
subcommittee stopped with the recognition that Pat had made to
the subcommittee, that, well, we've got to flesh this out a
little bit.

          But there are a couple of, based on past experience of
mine in these compensation plans, there are a couple of thoughts
that might guide the Committee, the full Committee, in deciding
what life we breathe into this culpability-harm grid or
guideline, so to speak, and it picks up on some of the things
Ruth has said, some of the things Pat and Duncan have said,
Henry, and others.

          First, I think that one should probably make a
distinction between proposing remedies for past conduct that was
viewed at the time as appropriate, but after the fact is now
deemed to be inappropriate.  In other words, in law at least it
is very difficult to impose culpability on people who acted at
the time in conformity with accepted standards and practices,
even if in the light of 20, 15, ten years later we know better.

          I think that it is not necessarily accurate to say that
if wrongs were committed in the light of history, but at the time
the activity was reasonable, that does not necessarily mean that
a remedy should not be available.  The question is:  what remedy
should be available?

          Everything's relative, but it seems to me that although
what I call retributive notions of justice say that perhaps some
remedy should be available, I am troubled about -- I am
personally, just to throw it open for discussion -- troubled
about holding out the possibility of a remedy, of a recommended
remedy, in cases where researchers and others related in one way
or another to government action acted reasonably at the time.

          The culpability quotient is, it seems to me, far
different than in a circumstance where the government agent acted
unreasonably even under 1952 standards, and I think that's an
important factor.

          I also think that -- and, again, you have a whole range
of remedies.  So it doesn't necessarily -- I'm not talking about
everything or nothing.  We're talking about degrees of remedy
when at the time people acted in the culpability quotient, the
horizontal grid; people acted reasonably.

          There is also the question which is obvious to
everybody, whether one's looking at experiments back in the '50s
or in 1994.  In terms or remedy, one must discuss what, if any,
harm took place.  Now, this raises some very interesting issues,
which have to be laid out.

          I think that the Committee will be on a fool's mission
if it tries to reconstruct medical causation or tries to
determine the harmful effects of radiation in specific
experiments on the victims.  I don't think we can get those
answers.  I think too much time has passed.  I think that we do
not have the resources, and I think that certain presumptions
have to be made about the causal connection between the
experiment and the impact of that experiment on individuals, and
just keep that in mind because I think that if we try and even in
our guidelines articulate what minimal medical relationship there
has to be between exposure and disease or injury, we will hold
ourselves out to a great, great deal of criticism.

          But there's another reason it becomes very important
that we distinguish what the past wrong was, if any, in light of
present knowledge, and that is that if we conclude -- let me just
give you one example that is very problematic -- if we conclude
that in 1952 there was no evidence of medical harm, either the
alleged victim was dying or incapable of being further injured,
let's say, but the wrong that was committed is determined to be
absence of consent, a violation of personal integrity in that
even if the person wasn't medically injured, the person was
injured in the sense that certain experiments were performed
without permission or without adequate permission, is that a
wrong?

          I think that is a wrong.  I think that's a serious
wrong if we determine that variable, but when you translate that
wrong from the general telling of the story, it shouldn't have
happened; when you go beyond that and try and fashion a remedy
for that person, one gets into very deep water.

          If that person is, as is I think likely, no longer
alive, I think one runs into the problem, frankly, of fashioning
a remedy other than perhaps an apology to the family from the
United States.  I think one runs into a serious question as to
whether any other remedy is appropriate.

          Violation of personal integrity of a now deceased
victim does not automatically to my way of thinking give rise to
some sort of remedy that inures to the benefit of his or her
estate.  Whereas if, on the other hand, one demonstrates in our
guidelines a variable that the person was medically injured,
either died because of the experiment, was disabled as a result
of the experiment, resulting in loss of consortium, lost wages,
disability, that all the time compensation models factor
variables like that into a remedy that injures to an estate for
ten or 20 or 30 years later.

          But I want to make the distinction.  I'm just trying to
give an example of how delicate and sensitive this gets in terms
of remedies.  Injury to an individual because that individual's
personal integrity was violated does not necessarily or even
presumptively inure to the benefit of children 35 years later,
but, again, I'm just raising some of these issues that I think we
have to flesh out.

          Now, one has to distinguish, I think -- and here is
where this Committee, I think, can perform an enormous public
service, enormous -- it's one thing to examine the whole story
and conclude that Remedy A or Remedy B is or isn't available for
retributive purposes, to rectify a wrong done in the past in
light of ten, 25 years later or whatever and propose something
ranging all the way from an apology to compensation or what have
you.

          There is a second, quite different remedy here that I
think we've got to look at, and that is a purely prospective
remedy.  I think that probably -- and this is just a personal
view -- but I think probably the best remedy that we can provide
the citizens of the United States is a prospective remedy, not
grounded in retributive notions of rectifying wrongs, but
grounded in notions of old-fashioned deterrence, which is that
from now on we propose the following guidelines, the following
processes be followed prospectively, beginning in 1994 and into
the future, to guide government researchers in how they go about
performing prospective experiments.

          That section, it's a remedy.  That section of
prospective application of guidelines hopefully to prevent the
type of wrongs that we are uncovering, I think, is a remedy for
future violations.  Those remedies may be extremely harsh.

          I mean I don't know enough about the profession, but
one can see that if everybody is put on notice in 1994 as to the
way that research activities should be conducted in the future,
from now on -- this is the recommendation of the Committee as to
how these experiments should be performed in the future -- I
mean, the remedies can, you know, range all the way from civil
compensation for violations to loss of licensing, to criminal
violations proposed or suggested for policy-makers to consider.

          So I think that the question of prospective punishment
for future violations of guidelines proposed by this Committee
for the policy-makers to consider is a very, very important
remedy that doesn't dwell on the past, but looks to the future.

          So those are just some initial thoughts.  I think that
I'm going to try and slip under the table here.  It's very
controversial, obviously, but I would hope that Patricia and
Duncan would, you know, go first.  They're on the subcommittee,
and they've worked initially with me and with the staff, with
Gary and others, in getting this far, but I think that sort of
sets the stage for discussion.

          CHAIRMAN FADEN:  Thank you very much, Ken.  We
appreciate it, and perhaps it would be helpful.  Pat or Duncan,
do you have anything to add or expand?

          DR. THOMAS:  Just a couple of points.  First of all, I
think we would be remiss in our duties as a subcommittee if we
didn't make some sort of recommendations about the distinctions
between the different types of experiments and intentional
releases in terms of how we come down on whether or not this
particular experiment, Green Run, the plutonium injections and so
on, is a candidate for special treatment under anything that we
would recommend beyond what might already be out there.

          I say experiments as a class or as a set of classes to
distinguish from any recommendations we might make about a
procedure for how we would recommend the government go about
adjudicating individual claims within the class.  That, I think,
is subsumed under what Ken has to say about the grid, and the
grid will be our recommendations for how any individual case
might be addressed.

          But to stop with just the grid I don't think provides
enough guidance to the policy-makers as to whether or not we
think that, for argument's sake, Green Run is something that has
not yet been adequately addressed and we think is an important
issue that merits, you know, special legislation or however we
want to recommend Congress address the compensation needs, or
whether we think it was so benign that we can just set it aside
and turn our attention to the other classes of experiments that
are more important.

          I think the subcommittee now turns to this difficult
problem of trying to reach some judgments as to the perspective
in which we lay each one of the individual classes of
experiments.  Now, we can't really do this until the Committee as
a whole has reached moral judgment about each of the categories,
but it's time we started thinking about doing that.

          So that was the essence of what was meant by the last
sentence in the first paragraph of this memo where it says, "Such
guidelines should be sure to focus on experiments at a class." 
That went through several iterations before it finally showed up
here, and I'm not sure that the meaning of that sentence was
necessarily clear to everyone.

          The second is I'm glad to see the final sentence of
Paragraph 2 in there as well.  Worth talking about creative
alternatives, such as apologies and medical monitoring and so on,
and then it concludes, "While recognizing the ethical
implications that such responses may themselves engender," this
is an issue which has been very briefly touched upon on several
occasions so far, but has not yet had a full discussion, and it's
time we did it.

          Yesterday the possibility of medical monitoring came up
in the context of I believe it was the prisoners' discussion and
didn't really have much of a discussion then either.  I've said
this a few times before.  I'll repeat it.  There are many
conditions for which it's possible to detect the condition early
and many such conditions for which there's really no scientific
evidence that early detection does the subject any good.  It may
do nothing to prolong life.  It may simply give the subject more
years of living with the knowledge of his disease, more time for
the insurance company to cancel insurance because of a pre-
existing condition, and for a subject to lose his job, and all
sorts of bad things can happen as a result of early detection,
and nothing good may come of it.

          So there's an extensive literature that I don't
particularly read -- I'm not an ethicist -- on this subject, and
it's something that I think we owe ourselves to get a briefing on
this subject.

          And then the final point was in response to something
that's not in this memo, but Ken mentioned that Congress has
already spoken in some cases, and we shouldn't be reinventing the
wheel.  I agree wholeheartedly with that.  I just want to
reemphasize something I said at the San Francisco meeting,
namely, that Congress spoke in the form of the Radiation Exposure
Compensation Act and included in there a requirement that the --
sorry -- not in that act; in the earlier act which established
the requirement that NIH produce the radioepidemiologic tables
for the purpose of compensation decisions and then included a
clause there saying that we ought to be reexamining this
periodically, and then when they went ahead and enacted the
Radiation Exposure Compensation Act, I don't recall any such
similar proposals in there saying that our compensation
guidelines ought to be updated from time to time to keep them
abreast with the evolving scientific knowledge.

          It seems to me sort of a foregone conclusion that there
ought to be some provision for keeping our guidelines abreast of
what's currently known.

          So that's all I wanted to say at this point.

          MS. KING:  I don't have very much to add.  I would say
-- sort of reemphasize some of the things that Ken made in his
personal comments that resonate with me.

          First of all, I think it's hard to talk about this area
without having some kind of common understanding of what the
ethical framework about redress is all about.  So I'll just put
it at that.  I don't think we've started that work.  I think that
the question of culpability from an ethical point of view is very
difficult to actually start to grapple with in the context in
which we are operating.

          I take some of Ken's remarks to focus us not so much on
what he calls retributive justice, what I call compensation
theory, as to focus on deterrence and general and specific
deterrence and what is appropriate for the future.

          I say that because what I have always been worried
about is that the assumption is that the radiation experiments --
and they do constitute some special group; that's true, but
there's been a lot of research that's been done on human subjects
in the past in this United States, not all involving radiation
where upon careful scrutiny I'm sure that we would -- I'm
confident; because I'm a cynic, I've always been confident that
we would find things that we didn't like.

          Not only am I reminded of that and have to keep these
experiments in that context; I'm also reminded of the fact that
currently research in the United States with human subject does
not carry an established compensation framework other than what
individual institutions are willing to provide out of the
goodness of their hearts.

          That suggests to me that in talking about redress and
remedies, that while it is important to focus on our task, we
ought not lose sight of the fact that it exists within a broader
framework.  So Ken's last point about the future had real appeal
to me because -- this is a personal comment of mine, not a
subcommittee comment -- because it has been very personally
distressing for me to know that for 20 years of work, after 20
years of work in human subjects research that we've never been
able to mount a serious conversation about what we do with
respect to those people who have suffered harms, as in fact some
people have, who carry the ball for the rest of us because
presumably they help provide information that's important to the
society's well-being.

          And I don't want to lose sight of them any more than I
want to lose sight of those who have already suffered.  So I'm
just saying that we have a tendency here to focus on the
radiation part, which we should, which we must, which focuses us
on the past, but there are two things to keep in mind.  The past
is larger than just radiation, and our current situation, at
least from my mind, is somewhat less than desirable.

          That is why I think that the current ethics debate, an
ethical framework debate is so critical to how this methodology
actually is fleshed out.

          CHAIRMAN FADEN:  I'm sorry.  I forgot to plug -- I was
apologizing to the microphone.

          DR. MACKLIN:  I agree with, I guess, Ken's and Pat's
comments that the notion of culpability is one -- the very
concept is one that we have to explore.  I mean there are simple
and obvious cases of what's culpability and we don't have to
worry about those.

          So, for example, one thing that I didn't hear in the
presentations was the distinction between, if this can be made,
the culpability of the government in some sense for what it
ordered, planned and devised, and the culpability of individual
investigators, researchers, the people who did the experiments. 
I mean all permutations and combinations are possible.  Both may
be culpable, whatever the criteria.  Neither may be culpable. 
The government may and the investigator not, and so on.

          So I think we have to separate that out, and this is
only a question or an observation.  There may be a different
notion of remedy or different concept of remedy for each of
those.

          Second, and I think Ken alluded to this in his
presentation, and he and I had a brief conversation before we got
started, and the question here is whether even in the absence of
culpability a remedy may be appropriate if the conduct was
wrongful.  That is to say yesterday I made the distinction --
Pat's frowning, but I'm going to explain -- I made the
distinction yesterday between wrongful conduct and wrongful moral
agency.  I mean culpability of the moral agent.

          And so it's entirely possible that we may conclude that
a person who acted carefully, a researcher who acted carefully
with regard to the risks, not negligently, used the information
then available about radiation, but simply failed to do what
today would be required by way of informed consent, that that
person could not be considered culpable, although we can
legitimately say that the conduct was wrongful and that people
were wronged because we have a notion of what it is to wrong
people, and to use them for some purpose other than themselves.

          So by the very criteria that we would judge such an
action today to be wrongful, so, too, would we judge it to have
been wrongful then, but we would make a different judgment of the
moral agent.

          So the question here is:  if we were to determine that
there is no culpability on the part of the agent, and yet the
conduct was wrongful, how does that fit with a remedies scheme?

          And I guess my final point is, and I agree with Ken
quite strongly that the difference between -- that there's a
moral difference between compensating a person who is still alive
and who was either harmed or wronged or both and the notion that
one might have to fashion a remedy, and I agree with Ken that I
don't see any ethical rationale for a remedy that would devolve
to the estate when the person is no longer alive and it could not
be demonstrated or there's not even any evidence that the
experiment hastened the person's life, made them disabled, made
them unable to work or caused some residual harm to the living
members of the estate.

          But I really am very interested in the culpability
part.

          CHAIRMAN FADEN:  Ken, would you like to reply?

          MR. FEINBERG:  I'd just like to reemphasize one point. 
When you make the distinction between culpability and wrong, and
you said Pat's frowning, Pat had her back to me, and so I know
some of Pat's frowns.  I don't know some of her other frowns. 
Body language with Pat is important in what she's thinking.

          But just remember during this entire discussion, there
are remedies and there are remedies, and if you have a scale of
remedies all the way from, you know, pot of gold to no remedy,
somewhere in between one can devise a guideline that takes into
account both of your concerns, culpability versus wrong,
government versus government agent, which I did make a brief
allusion to.

          So I think that it's all part of the discussion.

          CHAIRMAN FADEN:  I've got Henry and Phil for right now.

          Henry.

          DR. ROYAL:  I like the sound of the grid.

          MR. FEINBERG:  Uh-oh.

          DR. ROYAL:  No, no.  That's not an --

          MR. FEINBERG:  Henry's body language.

          DR. ROYAL:  No, no, no.  I like the sound of the grid. 
It sounds to me like the grid applies to all medical
experimentation, not radiation experiments.  Is that the
intention?

          MR. FEINBERG:  No, it wasn't.  That was Pat raising
that issue at least prospectively.

          DR. ROYAL:  But if you looked at the names of the axes,
culpability --

          MR. FEINBERG:  I think we may be able to.  We may be
able to --

          CHAIRMAN FADEN:  If I could just interject.

          MR. FEINBERG:  It may be generic.

          CHAIRMAN FADEN:  I mean we use the radiation context,
but the grid itself if it's useful and represents right thinking
clearly would have implications.  There's nothing sui generis or
one of the kind about radiation research.

          DR. ROYAL:  And then the second question is fairness,
singling out investigators that are doing a particular kind of
research, singling out or identifying victims from a particular
kind of research.  Where does fairness fit into this?

          MR. FEINBERG:  Well, I'm not sure Duncan and I agree on
this.  Duncan usually convinces me after two minutes, but one
concern that I have is my first point, that the factual -- the
story of what happened, the whole story, and the factual gaps in
our knowledge both in terms of what's there if we stayed here and
continued to deliberate for another five years, what else would
we find, but also the resource problem that we don't have five
years, and we're not going to get all of the information.

          I am very concerned exactly on this point, Henry.  I
personally am very concerned about distinguishing experiments,
and here's why I'm concerned.

          I'm concerned because not from the perspective of a
methodological report.  In my experience, whatever we do and
whatever we recommend runs a high risk that the public,
especially allegedly injured victims and their families, will not
take kindly to our saying that as to this experiment, this
remedy; as to that experiment, this remedy; and even within
experiments, A gets Recommendation A, B gets Recommendation B.

          The potential for divisiveness in fashioning remedies
is the great danger in all of these compensation programs.  The
half a dozen that I've developed, one has to try and fashion
remedies that walk the line between, you know, generic
usefulness, helpfulness to our policy-makers and not making
invidious distinctions among people and researchers and victims
that will, you know, fan the flames of divisiveness among people
unless it's absolutely clear and justified and can be determined,
but I have doubts about that myself.

          CHAIRMAN FADEN:  Pat and  Duncan look like they both
want to respond.

          MS. KING:  Since we were in sort of the middle of this
subcommittee, this is sort of, I guess, a subcommittee
difference.  Let me say that I think that it is inescapable that
we have to work with the radiation experiment.  That is, after
all, the charge of the panel.

          But it is my hope -- and who knows how this will
actually start to work out -- but it is my hope that -- and we
need to discuss how the experiments will be used -- but one of
the ways in which I see that they can be used, for example, is an
experiment, depending upon the factual evidence, may be used to
illustrate a particular aspect of grids or of culpability or the
fine gradations that we start to make.

          Now, I take Ken's first concern, factual underpinnings,
very seriously because when I've been listening to the case
studies carefully for factual underpinnings dealing with this
subcommittee, I don't know how Ken feels about this, but I don't
think we're producing a lot for my needs, but it seems to me that
one of the ways that we might bridge what I perceive as a gap
between the other two members of the subcommittee is to think of
ways in which to make connections because I think that the report
requires us to make connections.  

          I guess I'm also saying that I'm uncomfortable going
all the way with classes of experiments and recommending
particular forms of remedies for classes of experiments, but I
don't rule that out because I can already see that something like
medical monitoring may, in fact, be a recommendation that we
would be all comfortable with, with the certain classes of some
experiments.

          I think that some of the problems that Duncan raised
about that can actually be handled.  I don't think of them as
insurmountable, and so I'm not completely ruling it out, but I
think we have to think real carefully -- the medical monitoring
is the only one that suggested itself to me so far -- that I can
see directed to a group of people where we have identifiable
subjects.  We may decide that that's necessary in some instances.

          CHAIRMAN FADEN:  Duncan, did you want to respond to
Henry before we --

          DR. THOMAS:  Well, I gather the sense of Henry's
question is why single out radiation workers for, you know,
special culpability when they were perhaps doing nothing more
than acting according to the standards of their time, and if
they're guilty, so are many other types of investigators.  Is
that what the essence of what you were trying to get at with the
question about fairness?

          DR. ROYAL:  Yes.  I think that if the ethical analysis
that's done by this Committee is perceived to have focused in on
a portion of the medical community which is no different than the
rest of the medical community, then the fairness issue will come
up, and the hard work that we've tried to do will come under
unjust criticism or will come under criticism that it doesn't
have to come under.

          DR. THOMAS:  I would agree 100 percent with that
statement.

          It seems to me, as Pat mentioned a moment ago, we are
constrained to making recommendations really just within the
narrow focus of radiation research, but we can make those
recommendations in such a way as to say that to the extent that
we are recommending guidelines for remedies for unethical
research practices in this particular area, they ought to be
equally applicable in any other area, as well.

          It comes back though in the larger context of this
question of -- Ken put it more eloquently than I could -- if an
individual is doing no more than following the accepted practice
of his day, although we can judge his actions to be wrongful, it
is not necessarily culpable, and we may end up recommending that
-- not making any compensation recommendations in that situation.

          CHAIRMAN FADEN:  Henry?

          DR. ROYAL:  I'd like to just make one last comment, a
slightly different subject, but it won't be long.

          When we make remedies, one of the things that I would
encourage is that we give the recipient of those remedies
choices.  I think one of the bad things that we do is we think
one size fits all.  Medical monitoring, for example.  To some
people medical monitoring might be very reassuring to them.  To
other people it may be very anxiety provoking, and I would like -
- when we recommend a remedy that a number of remedies of equal
value that someone can choose from would be much better than us
imposing a single remedy on them.

          CHAIRMAN FADEN:  That's helpful.  Thank you.

          Phil has got the floor next.

          DR. RUSSELL:  I'd like to ask Ken.  Does your
recommendation regarding guidelines include recommendations for
processes through which to execute the guidelines?

          In the previous systems, the process has gotten in the
way of effectively executing the guidelines, and I think it is
important that we have a credible process in place as to have a
credible grid and guidelines for making judgments.

          MR. FEINBERG:  That's an excellent point.  The
subcommittee I don't believe has addressed that.  I know I don't
recall the subcommittee having addressed it, but the issue of how
to process the claims in light of the options, the guidelines, I
think, is something that we should deal --

          DR. RUSSELL:  How and who and guidelines for process
behavior type thing.

          MR. FEINBERG:  That also raises, by the way, an
interesting issue which I haven't thought of at all, and that is
the process that should govern for prospective application of
guidelines.  That is, if the Committee picks up on the
subcommittee's view that there is a value here in drafting
guidelines for future application of experimentation, I have no
idea where those guidelines go politically once we draft them.

          Does the National Science Foundation -- I mean I just
don't know how that works, but it clearly seems to me that we
should lay out some process for recommending at least that the
guidelines that we promulgate for future experimentation activity
be pervasive and get the type of treatment that we would hope
that they get, but I defer to the others on that.

          CHAIRMAN FADEN:  Duncan, did you want to?

          DR. THOMAS:  Yeah, I just wanted to point out that the
Remedies Subcommittee is planning a staff report at the next
meeting, which is a review of the way the process has worked for
preexisting compensation systems that are already in place, and
that could be the starting point for recommendations that we
would make about process for anything that we would come up with.

          CHAIRMAN FADEN:  Jay.

          DR. KATZ:  Well, I'll be as brief as possible.

          You know, this is -- in a page and a half issues are
being raised that are very rich, need to be considered.  I just
want to make a few observations.  Time is of the essence.

          I would suggest that the subcommittee by the next
meeting give us their marching orders in a preliminary kind of
way of what, after all, they've thought about it, and, Ken,
you've thought about it the most and probably Pat also in her
teaching.  What are your recommendations, also including any
disagreements between you, Pat, and Duncan, and what you might
propose?  Because only then I can really react and say this is
what I like; this is what I don't like; this is what we need to
debate and discuss, and we don't have much time left.

          With respect to such issues of you are awaiting the
judgment of the Committee as to what is an ethical behavior,
don't be constrained by that.  Assume what you consider unethical
behavior to be and what you would consider to be unethical for
the moment, and therefore, X, Y, and Z follows.

          So I think we need that because this is a very tricky
issue, a very tricky problem, and my hunch is on the issue of
remedies and various aspects of remedies, there will be
disagreements ultimately amongst members of the Committee, that
we will not be able to reach a consensus on that, and we have to
face up to that because things are here very problematic.

          They are very problematic with respect to the issue as
to how much attention are we going to pay to legal definitions of
culpabilities and be constrained by that or to what extent are we
also going to say something about culpabilities in relation to
remedies, and it's quite different to talk about general
culpability and culpability in relation to remedies, and saying
certain things that were done just shocks the conscience of our
society and certain remedies have to be provided.  It is a
possibility, and I don't care about the fact that in tort law
dignitary harm is not compensated unless there's actual physical
injury.

          These are -- you might want to mention it in the
footnote, but at least to my mind it shouldn't move us very far.

          Third, with respect to the issue of raising
expectations, I know what you're concerned about and what all of
us are concerned about, and we should be very careful to say that
we are just a Committee that will make recommendations to the
President, and the President may make recommendations to Congress
or who knows what he will do come January.

          And we can make recommendations and tell the survivors
and the families of the survivors, "Don't be blinded by our
recommendations," because as Adlai Stevenson said, hell will
freeze over before some of these recommendations are enacted.

          But we may want to make certain recommendations
irrespective because we think that they are right and should be
seriously considered.  I mean within reason.  I'm not talking
about pie in the sky kinds of things.  Even though we also know
that there's very little chance that they will be enacted, but a
small chance could become a slightly bigger chance, and we
shouldn't be constrained by that in talking about some things
that we are very much concerned about.

          And I've already talked longer than I wanted to.  So I
wouldn't be that much concerned about raising forth expectations
as long as we carefully define that if we have certain
expectations of the government, that the survivors involved and
their families shouldn't think that they will cash in on them.

          And there was one final thing.  Let me just say this. 
I think Pat said this or Duncan said this.  We can make it quite
clear that our recommendations, specific recommendations, have to
be constrained by our assignment in the radiation experiments,
but make it quite clear that some of these recommendations really
apply to the whole universe of human experimentation, and these
are not only problems faced in radiation research, but faced in
research in general.

          Oh, yeah, and let's be -- I come, of course.  I'm not a
lawyer, and also I've had the fortune or misfortune to be a
member of the faculty of a law school that's sort of considered a
lawless law school, and I think we can consider fashioning
certain remedies if you want to because they seem to be necessary
to fashion these remedies, even though they are not at this point
fully acceptable within the legal system.  Okay.

          CHAIRMAN FADEN:  Duncan.  Let me just let Mary Ann know
I saw her signaling.  This is responses to Jay and the
subcommittee, is fine.

          Duncan, Ruth.

          DR. THOMAS:  I just wanted to clarify --

          CHAIRMAN FADEN:  Ken and everybody wants to respond to
Jay.  So that's fine.

          DR. THOMAS:  -- what I thought Ken was referring to
about raising expectations was not our view of the political
reality of whatever Congress or the President may -- what actions
they may take in response to our recommendations, but I think we
were talking about raising expectations with regard to what we as
a Committee might end up recommending.

          I think there are plenty of people out there that are
expecting or hoping that we might recommend, you know, a broad
base of compensation for chronic fatigue syndrome in all people
around the Hanford plant and so forth and so on, and at some
point these expectations are likely to be dashed, and that's what
I think we were talking about.

          CHAIRMAN FADEN:  Pat and Ken.

          MS. KING:  There's something constraining about being a
member of the subcommittee.  So I'm not speaking as a member of
the subcommittee.  I'm speaking as a member of the Committee,
commenting on the subcommittee on which I serve.

          First of all, I think that Jay's point is quite
accurate in the sense that, one, we're way behind the eight ball
in terms of time.  Two, the Committee needs to think more
broadly.

          I happen to think -- and this has got nothing to do
with political concerns at all -- that conceptually this is a
tough problem, that we ought not -- and we tend to do it;
everybody is doing it when they're talking -- we move immediately
to the practical, and we really have very much a legal model in
our heads no matter what we say, and I think this is wrong.

          I really think that what we're talking about is a
different kind of area.  You may get to your legal model, but
you're talking about a different kind of area.  You are talking
about people who were involved physically in research who face
risks.  Sometimes those risks come about in the past and in the
future, and we should think expansively.  So to my mind, the
subcommittee needs to be reconstituted a little differently. 
Despite being called an ethicist in the world, I don't ever hold
myself out as one, and I don't think I'm really qualified,
although I do it all the time, as Ken knows, that I'm really
qualified to do a kind of conceptual framework on what redress
consists of and to think about it, but I think it's necessary in
this area because I quite agree with Jay.

          So my plea is the committee can stay the way it is. 
That's all right, but we certainly need some staff ethical help
that has expertise in ethics or a consultant.   Ken will probably
kill me.  My body language, Ken?

          We can check out Ken's body language right now.

          (Laughter.)

          MS. KING:  And I think that while I like Phil's point
about process and I quite agree with his point about process. 
Process to me is the game putting the cart before the horse.  My
view of process is to a large degree affected by what I think I
should be accomplishing and then what process gets me there, and
what's really troubling me is I want to talk in redress terms in
a broader fashion than my own legal training tends to focus me
into, and I don't know how to say that any better because I'm as
guilty as anybody.  I find myself falling back into my legal
framework.

          But I do revisit it because I think it is inappropriate
for here.  So that's my contribution as a Committee member to the
subcommittee, that we need a different kind of input in the
subcommittee, and I think we need it before next month.

          DR. KATZ:  I have one question to ask you.

          CHAIRMAN FADEN:  Okay.

          DR. KATZ:  Of course, you also read The New York Times,
and there are, I'm sure -- the Washington Post, too -- and from
time to time Gina Kolata and others discuss ethical issues, and
then they have five distinguished ethicists commenting on that,
and each of these five ethicists consider certain conduct ethical
or unethical.

          Now, in the light of that, is there some limited value,
important value, but in a sense limited value also, to these
ethicists' contribution?  And you are not an ethicist -- to be an
ethicist on the subcommittee.

          MS. KING:  I accept all of the flattery, but my bottom
line conclusion is the same:  that the conceptual framework for
this chapter, which should -- the rest of the work should not
await the development of the conceptual framework.  I'm not
suggesting that, but I'm suggesting that we need to give real
attention to the conceptual framework and not sort of make it as
an aside because I, too, sort of feel the time constraints.

          CHAIRMAN FADEN:  Ken wants to respond.

          Let me just interject one thing as the chair.  This
afternoon I want to make a proposal about reconstituting
subcommittees that might address Pat's concerns.  So we'll see
how that goes.

          But Ken.

          MR. FEINBERG:  Three quick responses to your comments. 
First, we are behind the eight ball.  Frankly, the timing,
although a problem, we can meet the schedule.  One of the things
the subcommittee as a group wanted today was to test the
political waters of the Committee, but I think that we can move
expeditiously.

          Secondly, I disagree with you when you at least suggest
there's a presumption in your mind that the Committee will likely
be divided on the subject of remedies.  I hope very much that
will not be the case.

          If, in fact, there is experimentation in the past that
shocks the conscience, I would hope that the guidelines as
drafted will provide unanimity.  I believe that unanimity on the
Committee is very, very important in this area.

          Third, when you talk about false expectations, I think
Duncan is right in his response, but I also want to expand my
concern about false expectations, and that is, as I think I
mentioned, I'm concerned about the consumers, the groups out
there, that have been following not only our deliberations, but
have been tracking the problem for the last 20 years in Congress.

          And I want to just reemphasize my concern that we not
act in a way that will raise false hopes among the groups out
there as to what is justifiable among themselves inter se I think
is a very important point.

          The only other point I'd say, Jay, is you say you're
not a lawyer, but you teach at Yale Law School.  Either you are a
national resource or an unguided missile.  I'm not sure.

          (Laughter.)

          MR. FEINBERG:  Thank you.

          CHAIRMAN FADEN:  We have Ruth and Mary Ann, and if
there's a moment, I would like to raise a question or a comment
or whatever.

          Ruth and then Mary Ann.

          DR. MACKLIN:  This is a little more about culpability,
but one element that seemed to me somewhat missing from
everything that's been discussed so far, but it's been certainly
discussed yesterday and in many ways by the Committee, is the for
want of a better term, shorthand, Cold War purpose of the
government in this research, and partly because that affects or
promotes the need for secrecy, thereby limiting by its very
nature what a researcher might otherwise have been able to
disclose to people has to be viewed in some way as an element
either of culpability or of constraint in some way.

          Now, I mean as I thought of that and heard Henry's
remark, the question is:  how -- I mean the fairness issue.  Is
this unfairly singling out radiation research?  Well, I mean if
wrongs were done by any researchers for any subjects, for medical
experiments or any other, I would certainly concur that the
framework or the grid ought to address all of them.

          But the fact is that it was people in the field of
radiation who were doing this kind of research sponsored by the
DOD and the DOE for a purpose other than, at least in some
instances, other than contributions to medical science for the
benefit of patients, and somehow that has to be in this grid, not
as a general grid for deterrence in future things, although maybe
also there, but because that was such a perhaps unique or not
wholly unique, but such a central feature of this whole set of
activities that we're talking about here.

          So I wonder if the Committee addressed or subcommittee
addressed or has any comments on the particular aspect of
government culpability when a researcher never would have done
these kinds of things, some of these kinds of things, to patients
were it not for the interests of the AEC or the DOD or whoever it
was that was promoting this kind of research.

          MR. FEINBERG:  Two answers.  One, I don't think the
Committee has addressed that, to my memory, and secondly, I'm not
sure it's at all relevant.

          You raise the issue.  Hegel would not be happy with you
on that, but I mean are you suggesting that government
culpability is somewhat perhaps diluted because activity aimed at
a target or a victim, that there's a greater good or for the
greater good of society?  I mean I'm just not clear on how that
variable somehow, if I'm correct, immunizes the government from -
- the researcher from responsibility.

          DR. MACKLIN:  It shows how unclear I was.  I actually
meant to suggest that perhaps culpability was enhanced.

          MR. FEINBERG:  Enhanced?

          DR. MACKLIN:  That is, things that otherwise would not
have been done to people --

          MR. FEINBERG:  Oh, I see.

          DR. MACKLIN:  -- and secrecy that otherwise would not
have had to be --

          MR. FEINBERG:  Was hidden behind this justification.

          DR. MACKLIN:  That's right.  Hidden behind the
justification --

          MR. FEINBERG:  I've got it.

          DR. MACKLIN:  -- and also promoted a line of research
or a type of research that, to use the example we looked at
yesterday, the Cincinnati experiments, never would have been
conducted as a piggyback.

          So I really meant to suggest whether there was some
enhanced --

          MR. FEINBERG:  Maybe it --

          CHAIRMAN FADEN:  Let me just introduce one thing, and
that is I think your point is well taken.  We have to consider
this, but we're dealing with a whole range of human radiation
research conducted in this big period of time, some substantial
portion of which will not have that connection.  So we need to
remember that, that some of this work clearly is related to Cold
War kinds of concerns, but by no means all of the work that we
are looking at has that connection.

          All right.  Let me just get the process thing right,
but it's a very important issue to raise.  Mary Ann is next.  I
see Henry with -- right on that point.  Okay.

          And then, Phil, did you have a comment on this point? 
So Mary Ann, can you -- all right.

          DR. ROYAL:  Ruth, it's not clear to me that the
distinction that you're making between an experiment that was
sponsored by the DOD is an outlier in terms of what happens with
medical, you know, and the term biological experimentation.

          For example, the plutonium injections.  The concern
there was, in my mind, for patients.  The patients happened to be
the people who were working at plutonium enrichment plants who
were being exposed to plutonium, and doctors who were concerned
about the health of the workers thought that this information was
valuable to them in order to be able to protect their health.

          So the distinction that you're making is a very clear
one isn't as clear to me.

          CHAIRMAN FADEN:  Phil.

          DR. RUSSELL:  The same lines.  I think if you look at
it wouldn't have happened if an agency hadn't promoted it
probably pertains to all medical research done in the United
States under government, whether it's NIH or anybody else.

          So the issue of the relationship between which federal
agency funded it and ethics, I think, is a specious connection. 
I think the ethics have to stand on their own with regard to the
fundamentals of the ethics of experimentation, informed consent,
and so forth.  I think the issue of which agency funded it and
any presumption that it's ethical or nonethical is wrong.

          MS. KING:  Well, I certainly didn't mean to suggest it
was which agency funded it, but I'm talking about the nature of
the research, which if it is secret, the purpose cannot be
disclosed because to disclose the purpose was to disclose the
fact that it was research designed to look at the effects of
radiation on the body, but not it could be therapeutic for the
individual patient.

          I mean again, it's not who funded it, but rather the
kind of purpose that lay behind it that was not directed at the
individual patient.

          DR. RUSSELL:  I think there's a very large body of
research that has nothing to do with patients at all.  It has to
do with human physiology, and it can be perfectly ethical.  So I
think you're drawing some conclusions here regarding the purpose
of the research which are not directly related to the ethics.

          CHAIRMAN FADEN:  Maybe there's a refinement here which
is what we're trying to get at in the questions for the TBI case,
and that is if it's determined that there were morally
inappropriate dimensions to a line of research and that, to
satisfy your concerns, Phil, occurs first, and then it's
determined that in part or in whole those morally unacceptable
dimensions of the research were because there was a government
interest in advancing a line of work that -- I don't know how to
express it -- related to a set of concerns that seemed to be in
opposition to the welfare of the people who were being studied,
then that adds a dimension that needs to be folded in, in some
models adding to culpability, in other models perhaps not,
depending on how one sets it up.

          But I think that the issue is not merely stipulative
just because there was an interest in looking at the impact of
plutonium on people or on whole body radiation, that it's
necessarily wrong because it was related to a war effort or a
plutonium production effort, but rather, if that were to add
morally unacceptable dimensions to it, which is the first
determination, and then if in part or in whole those morally
unacceptable dimensions were related to another level of policy
making --

          MS. KING:  Can I suggest --

          CHAIRMAN FADEN:  -- then it starts to --

          MS. KING:  Three levels, Ruth, and I don't want to lose
the thought.  This is an issue that cuts across several chapters
of the report.  We ought to assume that there will be research in
the future where, again, there will be reasons that will say the
purpose cannot be disclosed.  What we have to do, I think, is to
recommend ways of taking account of some of the problems
realistically in the future.

          Some of this is very analogous to deception research
where -- I say "analogous."  I mean we know we've got issues.

          CHAIRMAN FADEN:  Right.

          MS. KING:  So actually this issue is not just a
remedies issue.

          CHAIRMAN FADEN:  Yes, definitely.

          MS. KING:  It is a remedies issue.  It is also an issue
in two other parts of the report.

          CHAIRMAN FADEN:  And I think there we're going to have
a lot of Committee interest in that area.

          Let me do this.  We are almost ready for our public
comment period.  Could we have Mary Ann and Nancy make their
comments and unless there are specific questions to the
subcommittee, not have subcommittee responses?

          (Laughter and simultaneous conversation.)

          CHAIRMAN FADEN:  So that the public comment period can
start more or less on time and we can get a quick break in in
between so that we can give our public speakers full attention.

          Mary Ann.

          DR. STEVENSON:  All right.  I'll be quick.  While this
was going on I've had more questions come up.

          CHAIRMAN FADEN:  No, that's all right.  You've been
waiting patiently.  So go ahead.

          DR. STEVENSON:  This is sort of in relation to things
that Ruth just raised and the other comments.  You know, this
question of whether it is or is not which agency funded, I think
there's a very important question as to the process whereby the
funding was granted, and it was very clear that a lot of the
experiments that went on that we're considering didn't really go
through any kind of peer review scrutiny, and so of the example
at the end of it is that once the Cincinnati experiments actually
went out of the DOD funding into NIH peer review, they were
stopped.

          I mean so that review process, I think, is very
critical, although it certainly has its problems in keeping some
level of ethical standards intact, or at least we hope it does,
and so I think that's something that we can consider as a
Committee in terms of promoting some sort of forward perspective
guidelines to this topic in the future that Pat's raised.  This
may well come up again.  So how do we safeguard against this kind
of experimentation going on?  And maybe a recommendation or
requirement for some kind of peer review process by people
outside of the field obviously, outside of the agency.

          But the question I was actually holding for this long
was a comment on the grid, which I also find very appealing, and
I think as much as we have a lot of work to do in establishing
the framework for the government culpability axis, the harm-
injury axis is also in dire straits particularly because -- and I
fully agree with Ken -- we can't presume to make those
determinations on dose.  We don't have time resources, and even
if we did, we'll never get the facts.

          So I guess I do have a question to address to the
subcommittee as to how, and we'd better get going soon, we're
going to establish that harm axis.  I mean the model, the model
that's standing is sort of the VA type model where one makes a
list of presumptions.  The person was there and they've acquired
or developed this disease.  Then they fall into that category.

          But we all know that there's been a lot of problems
with that VA scheme and a lot of dissatisfaction that we've heard
in our public comment sessions on the processing of those claims,
and so I think we really need to give some strong thought to that
and soon to establish that axis, that vertical axis of harm.

          CHAIRMAN FADEN:  I know that there are people dying to
respond, but in December we'll have a complete and total response
to Mary Ann's question.

          Nancy, you'll have the last word and then we'll have
our break.

          DR. OLEINICK:  All right.  Mary Ann asked one of the
questions that I wanted to.

          I just want to make one other response to the comment
that Ruth made concerning the special case of radiation, and I
think this is not anything new.  We've said it before, but at the
same time period there were other experiments going on on
chemical warfare, on biological agents that probably would
undergo the same kind of scrutiny, and if the Committee were
charged to do that -- and I think we're going to make a mistake
by singling out radiation and saying that those who worked on
radiation were especially culpable because of the radiation in
any way.

          CHAIRMAN FADEN:  I think there's agreement on that.

          With that, thank you very much.  I had a feeling we'd
take until 10:30, and we did.  We're going to break now and
resume promptly at 10:45 for our public comment period.

          (Whereupon, a short recess was taken.)

          CHAIRMAN FADEN:  Committee members, I know you're out
there somewhere.  We can have public testimony, but there's no
one here to hear it.  Okay.  We're getting there.  We're getting
there.

          All right.  We need to begin the public comment session
of our meeting which is in many respects the highlight and the
most important part of our meetings.  We can't conduct this part
on our own.

          Let me just remind our public speakers before we begin
about our format.  We would appreciate it if you can keep your
comments to five minutes, and that will leave us five minutes for
Committee questions, and that will give you an opportunity to
expand on your comments.  We find that format is very helpful
both to us and to the presenters, that we can get a chance to
discuss together the issues that have been presented.

          We have a mechanical device here that's supposed to
assist us with our process, and it basically will begin blinking
when there is one minute left of your time for you to sum up.  So
it's set for that kind of an arrangement, and we hope that it's
not too annoying and that it works to our advantage and not as a
source of irritation.

          We have six speakers before us this morning, and I know
that we're all eager to hear from all of you, and that's part of
the reason why we would appreciate your all keeping within the
time frame.

          Let me also remind all of our public speakers that our
staff, as well as ourselves, are available to you at the lunch
break and at any time that you want to provide us with additional
documentation or more information. We're very eager to receive
it, and most of the staff members are sitting on the side as
opposed to in the audience.  So anybody over on the side is
someone who is connected with the Committee and would be more
than happy to take additional information you or to arrange
whatever would be convenient for you to provide additional
information either in terms of discussion or if you have any
documents or testimony in writing that you would like to provide
to us.

          So please don't feel that the ten minutes you receive
in public comment is all the attention you will be receiving from
the Committee.

          With that by way of background, Duncan would like to
introduce our first public speaker.

          DR. THOMAS:  Mrs. Marcia Haggard wrote to me some time
during the summer, and I called her a little bit later, and we
had a rather long conversation about her experiences as one of
the radium treatment patients.  I think she has an interesting
story to tell us, although not experimental in the sense that we
have talked about.  This was mentioned on several previous
occasions, that there are some interesting parallels that we can
learn about sort of what was in its day a standard but ill-
advised medical treatment, and I'm looking forward to at last
having the opportunity to meet Mrs. Haggard face to face and hear
what she has to say.

          CHAIRMAN FADEN:  Thank you for coming, Mrs. Haggard. 
We appreciate your time.

          MS. HAGGARD:  Thank you very much.

          CHAIRMAN FADEN:  Is your red light on, just so we -- on
the mike.  If you push the button, you'll get a red light.  Now
you're on.  Okay.

          MS. HAGGARD:  Distinguished Committee members, my name
is Marcia Haggard, and I am a radiation survivor.  I am very
grateful to the Committee for the opportunity to speak here
today, to share some of my radiation history and to comment on
the need specifically of the radium exposed as I perceive them.

          Due to time constraints, I will only summarize my more
complete statement that I have asked the staff to enter into
today's record.

          Marie Curie died in 1934.  That same year my parents
were married, and four years later, in 1938, I was born two
months premature with a small, benign birthmark on my lower lip. 
My concerned parents were referred to a physician specializing in
the treatment of disfiguring birthmarks in infants.  My own
cavernous hemangioma was growing rapidly, and the doctor
recommended immediate treatment with radium, a widely practiced
therapy in that era.

          In October 1938, at the age of 11 weeks, when I weighed
only seven pounds, I received a two-hour treatment from a crude
applicator taped across my mouth and chin.  The treatment was
repeated seven weeks later.  We don't know the dose I was given
in the four-hour exposure.  My doctors have estimated anywhere
from 1,000 to 3,000 rads.

          The treatment was completely successful, and my parents
often told me about the miracle of radium as I was growing up.

          At age 17 I suddenly developed large exostoses on my
shoulder blades which were surgically removed.  We now know that
these bony growths are a common consequence in patients who
ingest or are injected with radium as juveniles.  We now suspect
that I ingested some of the bone seeking radium in my infancy by
sucking on the applicator.

          Major health problems did not appear until nearly 50
years after my exposure when I began to have healing
complications following oral surgery.  Eventually my doctors
realized that I was suffering from radiation necrosis of my jaws. 
This condition, seen often in the radium dial painters, was
called radium jaw in the 1920s, radium poisoning in the 1940s,
and osteoradionecrosis of the jaw in the 1980s.

          Its hallmarks are poorly vascularized, demineralized
necrotic bone with multiple sequestra; poor healing following
surgical trauma; and constant, severe pain from radiation induced
neuromas on the nerves themselves.

          We learned in 1988 from the research of Dr. Robert Marx
that the risk of osteoradionecrosis increases linearly with time
after exposure and can occur many years after radiation.

          I have had hyperbaric oxygen treatment, a recognized
therapeutic modality in clinically confirmed cases of
osteoradionecrosis; brain surgery to partially sever the main
sensory nerve to my jaw and face to try and relieve my constant
pain; and excision of most of my necrotic mandibular bone with
cadaver bone grafting.

          There is no known cure for radiation necrosis.  Medical
treatment is aimed at preserving viable bone and coping with
constant pain.  I have never had cancer.  Dr. Roger Macklis at
Harvard is doing interesting research work on the puzzle of
delayed onset of expected cancers in patients with internal
radium burns.  He suggests that the alpha emissions from the
decay of radium in the bone into radon may stimulate production
of a sort of super healthy bone marrow which may deter the onset
of cancer.

          My radiation experience may be unique in that it spans
a half century of time.  It began in an area that Mr. Gil
Whittemore described for us at the July meeting when radium was
ingested, inhaled, injected, sold over the counter as a health
tonic, cosmetically applied in the beauty parlor for excessive
facial hair.

          When physicians and others who handled radioactive
materials in their work were given some suggested dose exposure
limits, but patients in the clinical setting, even infants, had
no protection whatever.  Remarkably we radium treated from those
dark ages have not all died.  I am only 56 years old and expect
to suffer the pain of radium necrosis perhaps 30 more years.

          I'll abbreviate the rest of my statement.  I contacted
Dr. Eliezer Huberman at Argonne, who I learned was doing radium
research.  He was very interested in my case, but was not able to
accept me into his treatment study protocol because of no
funding, because he had a moratorium on human experimentation, et
cetera.

          I also tried NIH and was told that the equipment there
to measure internal radioactive body burdens can only be used for
people who are injured in the laboratories or in their work at
NIH.

          I urge the Committee to sponsor a follow-up of everyone
who has been treated with radium and to allow for radiation
necrosis to be an acceptable deleterious health effect.

          I am going to be having my second brain surgery at
Johns Hopkins in a few weeks in an attempt to implant a thalamic
stimulator which has in some cases relieved constant severe pain. 
I'm very grateful to this Committee.  Dr. Thomas said many in the
radium community have vilified the medical community, and I have
no anger toward the doctor who treated me.  I think he probably
died a very painful death himself from handling radium daily in
his work, and my present team of doctors has been as supportive
and concerned as they can be.

          But we have no guidelines.  We don't know what
treatment to try.

          Thank you very much.

          CHAIRMAN FADEN:  Thank you very much, Mrs. Haggard, and
thank you very kindly for staying within the time limit.  We
appreciate it.

          If we could take questions or comments from the
Committee members now.  Duncan.

          DR. THOMAS:  One of the things which you enclosed in
the materials that have now been circulated to the Committee was
a brief report of a Swedish cohort that's been established of
patients who received similar treatments.

          In this country we've certainly learned a great deal
from the misfortunes of the radium dial painters and other
cohorts of radium injected patients in Germany, and so on.  I'm
not aware of any similar efforts for what I gather from what you
said is really quite a substantial number of radium treatment
patients in this country.

          Are you aware of any efforts to try to assemble such a
cohort?  Do you know of any investigators that are attempting to
do something along those lines?

          MS. HAGGARD:  I don't know of anyone presently.  I know
in some of my research at National Library of Medicine that there
were journal reports in the 1950s, which included dial painters,
but also had perhaps 30 people who had been medically treated
with radium and were studied at that time, and indeed, it is
their treatment that we base some of our work in my case now, but
nothing recent.

          The Swedish hemangioma treatment at Radiumhemmet
involved 20,012 infants between 1909 and 1959, all of whom were
treated for hemangioma.  They also did not have adequate funding
and followed up only 129 females who were treated for hemangioma
of the chest and simply measured breast size in adulthood, and
although dependent upon dose, nearly no adult female who had been
treated with radium for hemangioma of the chest grew a normal
sized breast on the irradiated side.

          CHAIRMAN FADEN:  Yes, Nancy.

          DR. OLEINICK:  One of the concerns that's been raised
by a number of individuals who have testified to us is the
difficulty in obtaining their own medical records, and I wondered
if it -- it looks like you certainly have some here, although I
haven't had a chance to look through these yet.  Did you at any
time have trouble getting this information, your own records, at
any point, contacting physicians?

          MS. HAGGARD:  In terms of the original treatment in
1938, the doctor has long died, long ago died.  My family
physician from childhood is going to be 100 next year and has
recently stopped practicing because he said he couldn't see quite
as well.

          (Laughter.)

          MS. HAGGARD:  I called and asked him if he, indeed, had
been sent any of the records because I had seen him in my
childhood, and he said, "You know, we didn't keep records then. 
We would have said Marcia Haggard or Marcia Schaefer, radium
treatment."  He said the applicators were huge, and there was no
dosage, and I have included in the material I've submitted to the
Committee pictures of the needles and the applicators and the
estimated dosages, but it was a very crude arrangement.

          They weren't concerned with the dosage.  They were just
concerned with whether you had enough of an erythema dose to
indicate that you had had success.

          In 1985, when I began having very serious health
problems with necrosis, my very young and very wise dentist said,
"Begin saving copies of all of your records because someday
someone will be interested in this problem.  We don't understand
it," and since then I have maintained copies of every record in
my own home.

          CHAIRMAN FADEN:  We're glad you did.

          MS. HAGGARD:  Thank you.

          CHAIRMAN FADEN:  Are there other questions for Mrs.
Haggard?

          (No response.)

          CHAIRMAN FADEN:  Thank you very much, and thank you for
all of the documentation you've provided the Committee.

          MS. HAGGARD:  Thank you.

          DR. THOMAS:  Thank you.

          CHAIRMAN FADEN:  Our next speaker is Dr. Kathy Platoni.

          Thank you for joining us.  Can you just make sure?  Is
your red button still punched?  Don't unpunch it.  Is it still
on?

          DR. PLATONI:  Yes.

          CHAIRMAN FADEN:  Okay.  Great.

          DR. PLATONI:  Thank you.

          Distinguished Committee members, I'm very grateful for
the opportunity to speak today.  My name is Dr. Kathy Platoni.  I
am a licensed clinical psychologist and a major in the United
States Army Reserve.  I am speaking today on behalf of both my
mother, Sydell Platoni, myself, and as the voice of my beloved
father.

          I wish to express sincere thanks and gratitude to Mr.
Bill Griffin, Iowa Coordinator for the National Association of
Atomic Veterans; Ms. Jean Ralph and the National Association of
Radiation Survivors for the long awaited opportunity to bring to
light the truth about our relentless 12-year battle to uncover
the facts regarding the death of my father, Eugene J. Platoni.

          My father's life was stolen away in his prime.  Eugene
J. Platoni died on February 28th, 1983, and after five months and
$500,000 worth of the finest medical treatment available.  The
magnitude of the loss we have experienced has not diminished with
time, nor can it be adequately explained or understood by four
file cabinets filled with medical literature and the unclassified
documents pertaining to his naval service during World War II.

          The cause of his death, angio-immunoblastic lymphoma, a
condition so horrific and rare that it cannot be found in the
medical literature to date, remains an enigma and a question mark
that will not allow us to see closure in our lives.  His autopsy
listed 18 separate diagnoses as the cause of death:  autoimmune
hemolytic anemia, angio-immunoblastic lymphoma, serratia sepsis,
transfusion hepatitis, upper gastrointestinal bleed, pneumonia,
subphrenic abscess, fluid overload, disseminated intravascular
coagulopathy, tachycardia, septic shock, anasarca, pleural
effusion, ascites drainage of the pleural space secondary to
trauma at thoracentesis site, anemia, Jacksonian seizures,
clinical depression, and acute renal failure.  The immediate
cause of death was reported as cardiopulmonary arrest secondary
to immunoblastic lymphoma.

          What is most bizarre about my father's disease process
is that he maintained a state of perfect health until the onset
of diffuse adenopathy, Coomb's positive hemolytic anemia, and
cold agglutinins with drop in hematocrit.  He was walking or
running five to seven miles a day and living an extraordinarily
zestful life style for a man of his age.

          During the course of his multiple illnesses, his blood
type changed three times, from O to B and back to O.  He
underwent over 65 blood transfusions, daily plasmapheresis,
hemodialysis, bone marrow biopsies, six full blood exchanges, a
splenectomy, a cervical node biopsy, tracheostomy, endotracheal
intubation and ventilation, thoracentesis and IV chemotherapy.

          He suffered brain death two weeks prior to death, which
was indicated by Jacksonian seizures, which are violent
convulsions that traveled down the left side of his body and up
through the right side repetitively.

          By the time my father became comatose, he has suffered
massive internal bleeding, development of a large cell lymphoma,
and his immune system was ravaged by an immune deficiency process
not unlike that of AIDS.

          The only early precursor of what was to devastate us
for the rest of our lives was my father's diagnosis of
chorioretinitis in 1965, a probably early symptom of radiation
related systemic disease which involved partial and temporary
blindness and that remitted spontaneously.

          Without reservation, I believe that my father's
exposure to radiation during World War II is responsible for his
untimely death as formidable disease, such as angio-immunoblastic
lymphoma do not occur in a vacuum and without the strong
likelihood of exposure to known or unknown carcinogens, such as
atomic radiation.  Were this not the case, lymphomas would not
have been approved for inclusion for compensated radiation
related illnesses under Public Law 100-32, which was passed in
May of 1988.

          It is also highly unlikely that I would have been born
with a thyroid gland trailing a tail behind it had my father not
been exposed to radiation.  I have undergone 22 surgical
procedures within the last 11 years, beginning with the loss of
32 teeth simultaneously at the age of 23.

          I have had my skull reconstructed from anterior and
posterior pelvic bone four times due to bone deterioration
disease, in addition to implantation of a surgical steel Ramus
frame in my mandible and transplantation of full thickness
abdominal tissue grafts to rebuild the roof of my mouth.

          I have had my skull and throat muscles realigned and
wired together from the orbits of my eyes out to my ears and down
to my throat so tightly that a straw wouldn't fit in my mouth.

          I was diagnosed with polycystic ovarian disease in 1983
and after removal of a third ovary and a dermoid cyst, the latter
of which consisted of hair, tooth and bone, I was diagnoses with
trophoprivic hypothyroidism in 1984 after over 100 blood tests
performed at Walter Reed Army Medical Center.

          I suffer from advanced osteoporosis so that my bones
have deteriorated and disintegrated to the degree that they are
indistinguishable from that of an 85 year old woman.

          I suffer from osteoarthritis in every joint in my body. 
There is no family history whatsoever on either maternal or
paternal side of any of these diseases or conditions from which I
suffer.

          This should not be a surprise as the contamination of
one's genetic composition can readily result in such congenital
defects and malformations if toxic exposure has occurred in one
or both parents.  There is more than sufficient evidence in the
medical literature to support this statement, particularly among
the offspring of radiation victims.

          We cannot remain in blissful ignorance any longer about
the consequences of radiation exposure.  Even fallout emitted
during our government's atmospheric nuclear testing has exposed
individuals to deadly radiation that remains actively harmful 50
years after the fact.  There is no shortage of cancers among
these individuals, their children and grandchildren, but they
have gone unrecognized, and our government has remained free from
responsibility for inflicting harm against millions of innocent
individuals.

          Still the burden of proof remains a legacy that
radiation victims and their survivors must bear, often an
infinitely impossible task.  To continue to accommodate this
state of affairs is unconscionable.

          I will take my battle to discover the truth to my
grave, but my own longevity remains a questionable entity.  More
than one atomic survivor has died under unexplained circumstances
during the process of discovery.  On several occasions during the
last ten years, I have discovered listening devices on my
personal telephone.

          Within the contents of my four file cabinets are
documents and correspondence from the Defense Nuclear Agency, the
Department of Veterans Affairs, and I'm afraid I'm going to have
to stop.  I've gone over my time.

          I've given my testimony so it's a matter of --

          CHAIRMAN FADEN:  Your statement is here.  Perhaps we
can cover some of it in questions.

          DR. PLATONI:  That would be good.

          CHAIRMAN FADEN:  Thank you.

          Are there questions for Dr. Platoni.

          DR. THOMAS:  Maybe it was in the piece which you didn't
get a chance to get to.  What I didn't hear is could you tell us
a little bit about the nature of your father's exposures to
radiation?

          DR. PLATONI:  That's what still remains a great
mystery.  All of his service records were altered, and under
Freedom of Information Act I've only been able to obtain copies
of what was easily accessible to anyone, and I do believe that
many of his records are in some archives somewhere that are not
accessible to me.

          His records were altered, crossed out in India ink, and
as contradictory listings of his locations on ships he was on
throughout his service records, and I believe you also have them. 
They've been entered into the record.

          DR. THOMAS:  But your understanding is the exposure
would have -- was he involved in Japan with the atomic bomb in
Japan or where?

          DR. PLATONI:  We do believe that he was off the coast
of Nagasaki and/or Hiroshima because he told that story many
times, but there's no documentation of that in his service
records.  At some point during his service he was exposed to
radiation or used in radiation experiments.  We cannot find
anything.

          DR. THOMAS:  I saw a letter here indicating that he had
been at Eniwetok; is that right?

          DR. PLATONI:  Yes, he was at Eniwetok, yes.

          DR. THOMAS:  But that would have been after you were
born, was it?

          DR. PLATONI:  That was before I was born.  I was born
in 1952.

          DR. THOMAS:  Thank you.

          CHAIRMAN FADEN:  Are there other questions for Dr.
Platoni?  Ruth.

          DR. MACKLIN:  Well, during the course of these
illnesses that led to your father's death, was he aware of or did
he have any information or suspicion about the suspected causes,
that is, that it did have to do with exposure to radiation and
that it might have had something to do with what happened during
the war, and if so, did he discuss that with you and your mother?

          DR. PLATONI:  During the course of his illness, he was
in intensive care, and he was strongly sedated.  So whether or
not he did suspect I have no way of knowing.  He probably didn't
have the cognitive abilities with all of the medications he was
on.

          The head of his medical team did, however, feel that
radiation was strongly suspect in his case, but there was no
documentation in the medical literature.  All we have is my
father's word that, yes, he was near the location where the
atomic bombings had occurred at Nagasaki and Hiroshima.

          CHAIRMAN FADEN:  Are there other questions for Dr.
Platoni?

          (No response.)

          CHAIRMAN FADEN:  Thank you very much, and thank you for
providing us all of this information.  We appreciate it.

          And we understand how difficult it is for people to
keep their comments to five minutes, but we would appreciate it
so that we do have more time for discussion and to get everyone
in.

          I am not sure if Ms. Salisbury is here.  She didn't
check in.  So we don't know if she came or not.  Is Ms. Salisbury
in the audience?

          (No response.)

          CHAIRMAN FADEN:  Then I'll assume that she did not
come.

          Our next public presenter is Dr. Dennis Nelson.  Is Dr.
Nelson in the audience?  Thank you for joining us, Dr. Nelson.

          Please begin.  I think the other way.  Just put the red
light on.  Push it and if you see a red light, your mike's on.

          DR. NELSON:  I would like to thank the members of the
Advisory Committee for this opportunity to speak to you today. 
My name is Dr. Dennis Nelson.  I am a research scientist and a
retired naval officer.  I have a Ph.D. degree in biophysical
chemistry.  I'm also a Downwinder of the Nevada test site.

          St. George, Utah was a town of 5,000 people in the
1950s, approximately 100 air miles from the Nevada test site. 
From the beginning the authorities assured the residents of St.
George that radioactive fallout from the bomb tests represented
no danger to the community, and for the most part they were
believed.

          The residents did not know at the time that the site
managers had already adopted a policy of directing the fallout
clouds over St. George and away from the more populated areas in
Las Vegas and California.

          In 1953, my youngest sister Margaret turned one.  At
the same time the pressure to develop the H bomb had greatly
intensified the tempo of the test program and the decreased
safety and violations of safety standards to accommodate these
expanded test schedules.  The inevitable happened in May 1953
when Shot Harry, a 32 kiloton thermonuclear device spread intense
fallout over St. George.  Spot readings of six and eight
Roentgens per hour were recorded by the on site monitors.

          For comparison, after the Chernobyl accident, the City
of Prybiat was evacuated when the radiation level reached five
Roentgens per hour.

          Later an AEC scientist, Dr. Harold Knapp, testified
that if it had rained in St. George on that day half of the
population would have died of acute radiation exposure.

          In St. George, the residents were told by radio to
remain inside for two hours while the fallout cloud passed by. 
Unfortunately the cloud had already deposited its radioactive
load two hours earlier.  No instructions were given to the
citizens on how to minimize exposure.  The on site monitors were
told to take frequent showers, to discard their clothing, and to
eat only canned or imported food.

          By contrast, the residents were not even told to wash
their vegetables and fruits from their backyard gardens.  They
were not told to take showers, nor to avoid drying their clothing
on an outdoor line.  They were not told to turn off their
evaporative coolers, which sucked the outside air into their
houses.  Instead they were assured that there was no danger.

          In secret, however, the government agents fretted quite
considerably over this incident.

          When I was nine years old the AEC ordered all cars
arriving from Las Vegas to be stopped and washed in St. George
before proceeding north.  I remember the wash water running into
the city gutter system which supplied the irrigation water to our
backyard gardens.  I wondered if whatever was on the cars might
end up in our food.  I also wondered what the point was in
staying indoors if the coolers brought all of the outside inside
anyway.

          As children we often spent a great deal of time
outdoors.  In the summertime my brother and I slept under a
mulberry tree in our backyard.  My family believed the
assurances, and after our initial curiosity over the tests was
satisfied, we basically ignored the tests.

          I did, however, wonder what happened to my baby teeth,
which I contributed to a can on the window sill of my fifth grade
class.

          In September 1953, Howard Andrews, a biophysicist with
the National Institutes of Health, wrote a supplement to the site
reevaluation report entitled "Residual Radioactivity Associated
with Testing of Nuclear Devices."  In this report he warned,
quote, "It seems necessary to adopt a rather conservative
attitude towards the involuntary exposure of the general
populations.  An error on the radical side will not be
immediately apparent, but the chickens will inevitably come home
to roost at some later date."

          For my family at least, the first chicken came home to
roost in 1966 and they have continued to return on a regular
basis ever since.  My mother was the first to be diagnosed with
malignant brain tumor, and after surgery died at the age of 47. 
In 1969, my brother, age 19, was diagnosed with lymphoma, treated
with a combination of surgery and chemotherapy, and survived.  In
1977, at age 34, I was diagnosed with skin cancer which recurred
in '82 and was successfully treated.  In 1980, my father, a
nonsmoker, was diagnosed with disseminated bronchiogenic
adenocarcinoma of the lung and died after receiving chemotherapy
and radiation, and in 1990, my youngest sister, Margaret, was
diagnosed with cancer of the colon.

          CHAIRMAN FADEN:  Take your time.  We appreciate how
difficult this is Dr. Nelson.

          DR. NELSON:  And after her heroic battle including
almost a year in the hospital and multiple surgeries,
chemotherapy and radiation treatments, died in 1992 at age 40. 
At the time she was Assistant U.S. Attorney in Salt Lake City and
in the prime of her life.

          The average age of death in my immediate family member
is 49.  Out-of-pocket expenses for medical care exceed $500,000. 
In 1990, Congress passed a compensation bill for the downwind
victims.  Only one of my family members is eligible for this
compensation payment of $50,000 under the law.

          Livestock, as well as people, were affected by this
radiation.  The animals were the first indicators that something
was seriously wrong.  In the spring of 1953 a herd of sheet
returning to Cedar City from their winter range near the Nevada
test site began to die.  Thousands of sheep died and many more
lambs were dead or deformed.  They were so deformed that they
were destroyed.

          Initially government veterinarians from the Public
Health Service, the Naval Radiological Defense Laboratory, and
Los Alamos voiced a common opinion that radiation was at least a
contributing factor in these deaths.

          Three years later when a sheep case came to trial,
these same men would no longer testify to this effect.  In the
interim, the government attorneys and the AEC experts had
launched a campaign to convince these men that their initial
judgment was in error.

          By the trial date in 1956, the Los Alamos vet had
changed his mind, and the NRDL and PHS vets had been persuaded
not to testify.  The government attorneys brought in two AEC
experts who had conducted radiation experiments at Los Alamos and
Hanford, and it was on the basis of their testimony that Judge
Christensen ruled against the plaintiffs.

          The two AEC scientists clearly had a monopoly on the
data.  These two men have been named in other testimony before
this Committee.  They are Dr. Leo Bustad from Hanford that Ann
Hopkins mentioned in her testimony in Cincinnati and Dr. Clarence
Lushbaugh from Los Alamos.

          Twenty-five years later, as new information was
discovered in conjunction with a different lawsuit filed by the
downwind cancer victims, Judge Christensen determined that the
government experts and lawyers had perpetrated a fraud upon his
court and reversed his previous decision.  Three Justice
Department attorneys responsible for the fraud were John J. Finn,
torts attorney; his boss, Bonnell Phillips, Chief of the Torts
Section; and Warren Burger, head of the Civil Division and Deputy
Attorney General of the United States.

          In 1983, the Tenth Circuit Court of Appeals in Denver
overturned Judge Christensen's new finding and in 1986 the
Supreme Court voted five to three not to hear the appeal, but by
then Chief Justice Burger disqualified himself for unspecified
reasons.  The sheep owners remain to be compensated.

          Human losses followed.  Karlene Hafen was the first
childhood leukemia victim.  She died in '56.  The AEC and the PHS
became increasingly concerned about the health aspects of the
test program.  In 1961, Ed Weiss, a biostatistician from the
Division of Radiological Health, appeared in southern Utah where
he began a retrospective study of leukemia and thyroid cancer
deaths between 1950 and 1966.  The attempt was to show that there
was no effect of radiation on the downwind population.

          Weiss instead found that 28 leukemia deaths were
present where 19 were expected on the basis of national average,
and this was a further problem because of the fact that Utah had
one of the lowest cancer rates in the country.

          The two Weiss reports were then forwarded to the AEC in
1965 for review and approval, along with a draft press release
announcing a new clinical study of 2,000 school children for
thyroid abnormalities, tooth, bone, and soft tissue
abnormalities, segmental heterochromia of the iris, and ability
to taste and smell a number of chemicals.

          Dr. Dunning of the AEC objected to the publication of
the leukemia study on the grounds that it might, quote, generate
serious issues from a legal viewpoint.  Even the Science Advisor
in Johnson's White House got involved with concerns that the
federal government's liability for any clinical effects possibly
due to radiation which might be discovered.

          After a high level meeting in the White House between
HEW, AEC, and many lawyers and administrators, Dwight Ink,
General Manager of the Atomic Energy Commission, reported back to
the Commissioners that the problem with both Weiss reports were,
quote, adverse public reaction, lawsuits, and jeopardizing the
programs of the Nevada test site, unquote.

          The Commissioners directed that Surgeon General Terry
receive a letter expressing their concerns, and the Weiss report
disappeared from sight for 14 years.  Only after Lynn Lyon at the
University of U. published a similar study in 1979 did this
report reappear.

          In the press reports about the clinical examinations of
school children in St. George, a number of studies are mentioned,
to include thyroid bone cancer and congenital abnormalities.  I
have been unable to locate any of the reports on bone cancer or
congenital abnormalities or, in fact, any of the reports other
than the thyroid and the leukemia studies.

          I'm still interested in what happened to my teeth.  In
Cincinnati, we learned that the AEC had a body snatching
division, and now I believe that they also employed the Tooth
Fairy.

          (Laughter.)

          DR. NELSON:  In last Sunday's Post, Jessica Matthews
wrote an article entitled "Expensive Secrets."  It deals with the
serious problems of our outmoded and expensive Cold War era
document classification procedures.  She maintains that, quote,
overly indulgent secrecy protects the stupid, the incompetent,
and the evil, as well as the merely wasteful.  The absence of
scrutiny by colleagues or independent experts lets bad decisions
pass unchallenged and negligent management persist for decades. 
With some accountability, the several hundred billion dollar
nuclear and chemical clean-up bill run up by the nuclear and
defense establishments would never have grown so large.  Secrecy
breeds arrogance, and in the cost case contempt for the public. 
In the mid-1950s, the AEC, which knew different, promised those
living downwind of its above ground nuclear test site that the
fallout, quote, does not constitute a serious hazard to any
living thing, unquote.

          I believe that those responsible for the human rights
violations and environmental catastrophes of the Cold War era
operated under a protective umbrella of secrecy and national
security privilege.  They must now be held accountable for their
actions.

          Monetary compensation by itself is merely an insult and
does little to heal the real wounds.  The men who perpetrated
this crime upon my family have been identified and must be
punished or justice will not prevail, and I am not alone in this
view.

          I would like to just read a brief position of the Task
Force for Radiation and Human Rights, of which I'm a member.

          CHAIRMAN FADEN:  Dr. Nelson, let me just point out if
you do that there really won't be any time for questions.  So
that's your choice.

          DR. NELSON:  Okay.

          CHAIRMAN FADEN:  It's entirely up to you.

          DR. NELSON:  Okay.  That's fine.  I think this is self-
explanatory.  This happened over 40 years in multiple iterations. 
So --

          CHAIRMAN FADEN:  Whichever you would prefer is fine
with us.

          DR. NELSON:  Okay.  When we begin to talk about
remedies, the task force is concerned that there has been no
discussion of restoring the victims' rights.  When many of these
experiments took place, the victims had legal rights that over
the course of the Cold War were methodically stripped from them. 
I'm talking about the court's gross expansion of the sovereign
immunity defenses over the years which have robbed more than one
radiation victim of their day in court.

          The Task Force on Radiation and Human Rights views the
situation as follows.  The challenge to this Committee is to make
recommendations for nonexclusive remedies which protect the
rights of the victims to their day in court.  This right can only
be restored to the victims by waiving the sovereign immunity
defense of the federal government.

          Thank you.

          CHAIRMAN FADEN:  Thank you very much, Dr. Nelson, and
thank you for telling us what we appreciate is a very personally
difficult story.  Thank you.

          Our next two speakers have traveled a very long way to
be with us.  They are both from North Slope Borough, Alaska, and
we appreciate very much their coming.  We welcome the Mayor
Ahmaogak, and please my apologies if the pronunciation isn't
correct, and Mr. Peetok, if they would care to join us, and we
understand that Maggie Ahmaogak will be joining us as well.

          Welcome.  Is Mayor Ahmaogak the first speaker?  Thank
you.  Thank you so much for coming.

          MAYOR AHMAOGAK:  Good morning, Madame Chairman, members
of the Committee.  My name is George Ahmaogak.

          CHAIRMAN FADEN:  Is your light checked?  Please just
press your mike and see if the red light is on.  Okay.  Thank
you.

          MAYOR AHMAOGAK: My name is George Ahmaogak.  I'm Mayor
of the North Slope Borough.  

          I'd like to first change our testimony.  I'd like to
present my testimony after the gentleman next to me presents his. 
Mr. Rossman Peetok comes from our municipal government from
within our North Slope Borough.  He's coming from one of
villages, Wainwright, which is 90 miles west of Barrow.  Mr.
Rossman is one of the recipients of Iodine 131 and 125.  He will
give his testimony in Eskimo and my wife Maggie will be
interpreting this testimony.  

          He will also not only talk about his experiences with
125 and 131 Iodine.  He will tell about the other recipients
within his village that have gone through difficult process when
they were administered this 125 and 131.

          After he gets done with his testimony, then I'll
present mine also.  Thank you very much.

          CHAIRMAN FADEN:  Thank you.

          We welcome you, Mr. Peetok.

          MR. PEETOK:  Good morning.

          (Speaking through interpreter)  He wants to first say
to you something that is very heavy for him to give to you. 
First of all he'd like to wish that he's sorry that for who came
to Wainwright, that he didn't have a chance to see them.  He'd
like to talk about the five people that after taking that
radioisotope that these people that were given the radioisotope
had gotten sick.

          He'd like to talk about his grandmother, an elder in
Wainwright.  After 20 years of being given through this
experiment, she no longer could talk because her thyroid was numb
and kind of dead to her feelings, and as time went by she died
from her heart attack.

          He's also mentioning his mother's father that had gone
through the same symptoms and also died of heart attack.  Another
person that had been under these experiments also ended up with a
hole in his thyroid and the windpipe was placed in the throat. 
Another one of the people that are under this -- undergone
through this experiment also started having eye problems,
couldn't see well anymore.

          For what he's gone through, that all of this past he
has been one of them also and he has seen all of them gone
through what he's just letting you hear.

          He also wants to mention some of the people that are
from Point Hope, have the same concerns.  From the list or the
report that came out, there is missing names, only mention of
five or six people that were undergone this experiment from Point
Hope.  

          They have not been isolated by name.  At the time they
went through these experiments, they were not told what they were
being given, and they did not get their consent or let them
understand that it was radiation that they were being given.  All
of the people that went through this experiment were never asked
that they were being given what they took.

          He doesn't like the way it happened and the way they
were treated.  All of the people that are still alive from this
experiment, those that are still alive from this experiment are
still encountering problems.  He would like for you to know and
he's telling you now that he'd like for you to know that.

          And he thanks you for giving him this time and for
listening.

          CHAIRMAN FADEN:  Thank you very much, Mr. Peetok, and
thank you also for your translation.  We appreciate it.

          Now we understand we'll hear from the mayor as well,
and perhaps we could hold our questions until the mayor's
presentation.

          Please remain at the table if you would.  Thank you.

          MAYOR AHMAOGAK:  Good morning, Madame Chairman.

          I come before your Committee today to hear a deplorable
story about human radiation experiments performed on dozens of
Alaska natives from our villages in our North Slope Borough
during the period of 1950s and 1960s, as well as radioisotope
tests that occurred in the area dependent on for subsistence
purposes by Eskimos of the Arctic for generations.

          As I will explain, the tests on Alaska native human
subjects here were without consent or, as it turned out, merit. 
After providing limited information and doing little to overcome
known language barriers, military researchers exposed our Inupiat
people from the Arctic regions to radioactive isotopes in
experiments designed to measure the ability of the United States
soldiers from the Lower 48 States to survive in the Arctic
climate.

          I also will discuss an intentional release of radiation
in our region occurred during the early 1960s with the United
States Atomic Energy Commission, performed experiments on the
distribution of radioisotopes in Arctic soil and water, using
contaminated radioactive soil from Nevada.

          These experiments occurred at Cape Thompson, at the
Project Chariot site, in an area that has been used by
generations of the Alaska natives for subsistence hunting and
fishing.

          All of the experiences I am here to talk about today
took place near my home, the North Slope Borough.  The North
Slope Borough is a political subdivision of the State of Alaska
and encompasses approximately 89,000 square miles of the northern
most region of our state.  The vast majority of our borough's
population are Inupiat Eskimos, whose ancestors have lived in the
area for generations, surviving the harsh climate primarily
through subsistence hunting.

          Until the 1970s when oil was first developed at Prudhoe
Bay, our North Slope Borough was largely isolated.  Many of the
local inhabitants spoke only Inupiat, our dialect, our language. 
Most borough villages still at that time remained quite remote,
and some of the inhabitants of these villages, particularly the
elders and the Eskimo older elders, did not even speak English
even today.

          In the summer of 1956 and continuing into 1957, the
United States Army Aero-medical laboratory conducted a series of
medical experiments on approximately 102 Eskimos and Indians from
the State of Alaska and outlying areas, the iodine experiments. 
These experiments were designed to study whether Alaskan natives
had physiological differences that enabled them to withstand the
cold temperatures better than other people.

          The native trust was gained by impressing the elders
with technology never before seen by remotely situated Alaskans. 
An X-ray picture of an Inupiat leader's head so impressed local
leaders and other elders that the Army scientists were allowed to
live among the Eskimos and observe their lives.  Scientists were
then able to perform cold weather experiments on our people.

          One experiment involved administering the radioactive
Isotope 131 in pill form to test thyroid uptake.  Many of the
native participants have since reported that they were never
fully advised as to what drugs were being used in experiments or
what tests they were given and never informed as to the potential
negative effects of exposure to radiation.

          This story was so shocking that CNN was prompted to
produce a telecast exposing these experiments.  Appropriate
title:  "Eskimo Guinea Pigs."

          In addition to thyroid experiments involving the use of
Iodine 131, evidence has recently come to light that similar
experiments were performed on Inupiat subjects by the United
States Navy in 1967 and 1968 using another radioisotope, Iodine
125.  Although records reveal that the village elders have been
provided some information about these later tests, it is unlikely
that any of the actual participants were informed about the
procedures and the risks of the experiments.

          Not only did the federal government experiment with
radiation on our Eskimo people.  The United States Atomic Energy
Commission also performed research and investigation involving
radioisotope distribution uptake on the land and on which the
local natives depend for subsistence purposes.  Radiation was
left on the Arctic lands for close to 30 years.  Many of our
local residents have contacted me to express their concerns that
the radioactive isotopes left beneath the tundra may have made
their way into the flesh of the caribou that graze in this area
and upon which the local Alaska natives depend on for
subsistence.  My people are concerned about the potential health
effects on their families in the result of the consumption of
this caribou.

          When this situation was brought to the attention of the
federal officials, a remediation effort was undertaken that was
recently concluded with the publication of the Project Chariot
site assessment and remedial action final report.  Our people
were deeply disappointed, however, in this report.  After seeming
to go great lengths to solicit public comment and
recommendations, it is our belief that the Department of Energy
failed to take these public comments seriously, and this has been
sorely frustrating on our part.

          Therefore, in no way can our people believe that the
final report is final.  It fails to address most recommendations
made by the borough, North Slope Borough Science Advisory
Committee and submitted to the Department of Energy.  A later
released response document, which no one had an opportunity to
review prior to Department of Energy officials  presentation of
the final report in a meeting last month in our native village of
Point Hope did not satisfactorily address public comment.  Such
disregard for effective input from local experts undermines any
determinations and conclusions the final report or this later
document might reach.

          My people also have lingering questions as to whether
all relevant information has been made available to us regarding
Project Chariot.  There exists a 1962 letter to Phil Holdsworth
from the United States Atomic Energy Commission revealing an
experiment design and location different from that described in
the Department of Energy's final report.

          I want to thank Mr. Tom Gerusky of the Department of
Energy for his prompt response to this letter, indicating his
preliminary investigation led him to determine that those
alternative experiments were never carried out.  Neither I nor
the North Slope Borough community, however, can rest assured that
all possible instances of contamination have come to light until
the department declassifies all documents relevant to Project
Chariot.

          The continued classification by the Department of
Energy seems to be in direct contradiction to the recent
commitment of that department, as well as your Advisory
Committee, to come clean about secret government experiments
which may impact public health and engender mistrust of
government.

          In your June 13th to 14th meeting, your Advisory
Committee agreed to begin reviewing experiments involving human
exposure to radiation that have been well publicized in order to
meet with the public expectations.  The North Slope Borough is
confident that the Iodine 131 test and 125 will be a part of this
review as they have been brought to the attention of the public
by newspapers and television stories and are subject of the
National Academy of Sciences' Polar Research Board follow-up
health study prompted by congressional inquiry.

          We ask that your Committee give careful attention to
the Iodine 131 and 125 tests independent of the Polar Research
Board study, which will be released this coming fall.  The
borough will not be given an opportunity to review or comment on
a draft of the Polar Research Board report and believes that the
Advisory Committee examination will be broader in scope,
encompassing ethical concerns and minority population issues.

          We also ask that this Committee give close attention to
the Iodine 125 experiments.  In addition, Project Chariot
experiments are well known and were even the subject of a new
book by the researcher Dan O'Neill entitled The Firecracker Boys,
just published by St. Martin Press.

          With respect to the scope of the Committee's charter,
it has been suggested that tests involving incidental exposures
suffering in the course of routine medical procedures should not
be included in the Committee's scope.  While the use of Iodine
131 and other radioisotopes to examine the thyroid was and still
is routine, the experiments conducted on the Inupiats in the
1950s and the '60s cannot be classified as common and routine
medical practices.

          The Inupiat people used in the studies were not
patients whose doctors were concerned about the functions of
their thyroid glands.  The Inupiats chosen for these experiments
were healthy individuals who otherwise would not have been
exposed to this type of radiation.  Indeed, they clearly were not
designed to offer medical assistance to the Inupiat subjects. 
The only purpose of the experiment was to gain knowledge to
assist non-Alaskan natives in surviving Arctic climates.

          To that end, the proper dissemination of information to
Inupiat participants was sacrificed, preventing any sort of
informed consent on the part of these natives.  To this end, the
North Slope Borough all these years, ever since this experiment
had started, has been put up with the problem of providing
medical assistance to these people, travel, medical travel,
funeral arrangements, and these are all coming from local
sources.

          In its recently issued interim report of the Advisory
Committee on Human Radiation Experiments, your Advisory Committee
indicated that it would focus on the issues of whether in
radiation experiments participants were properly informed of
risks, give proper informed consent, or were deceived by those
performing the tests rather than simply attempting to quantify
physical harms incurred by radiation experiment victims.

          In addition, your Committee has chosen to examine
whether particular populations were targeted as research subjects
because of their lack of political or economic power.  It is
clear that this empowerment is a precise description of the
Inupiat subjects in the Arctic region involved in the experiments
I am discussing here today.

          I support your Committee's determination that these
focuses are necessary due to the complexities of radiation
dosages and the difficulties of establishing a link between
present day negative health effects and an exposure to radiation
decades before.

          On behalf of the North Slope Borough and the natives
victimized by iodine experiments, I applaud this Committee's
focus on ethical issues which transcend concrete physical harms
and feel that such a focus is a key to granting the iodine
experiments and Project Chariot the attention they deserve as
instances of the abuse of trust between the United States
government and the North Slope Borough residents.

          Perhaps the most important data we ask the Committee to
consider in its review of iodine experiments, as well as Project
Chariot, is the personal anxiety those tests have created for the
vulnerable study participants.  In a letter to me about the
iodine experiments, a native named Winfred James, Sr., relates,
and I quote.

          "There were five of us from the village of Gambell that
spent the whole week at Ladd Field, only knowing that they were
going through cold weather tests.  If any other things were done,
they never told us.  I remember everything they did to us.  We
were given Iodine 131 and put in a small room lined with lead
foil, naked and wired to all of our openings:  ear, mouth,
rectal, underarms, and so forth, until we shivered from
temperatures dropping," and unquote.

          Similarly, in the interviews with CNN which aired in
May of 1993, residents of another village within our North Slope
Borough involved in iodine experiments told reporters that they
were neither informed of the nature of the testing nor warned
about the potential side effects of cancer causing drugs that
were administered.

          In that documentary, borough residents, one of the
eldest, Justus Mediana, said and I quote, "The scientists
conducting the study never explained to me about what kind of
testing I underwent.  I didn't understand him anyway at that
time.  I couldn't speak English.  I could only say, 'Yeah, yeah,
yeah.'  That's how I spoke English at that time," end of quote.

          Bob Ahgook, another resident of Anaktuvuk Pass, was
asked by CNN if he understood the nature of the experiment.  He
said that he did not even realize the tests were to study the
effects of cold weather and the thyroids of natives.  He thought
his diet was being observed.  He told the CNN reporter, and I
quote, "No, I don't remember the scientists telling me about
anything.  Maybe if I had known I could have received to take
it," end of quote.

          These iodine tests on the Inupiat fit squarely with the
intended purview of your Committee's jurisdiction.  Limited
information was provided to Inupiat participants.  There were
known language barriers, and there was an apparent presumption
that the consent of village elders would suffice for that
individual's participation.  The borough, North Slope Borough,
cannot countenance even the suggestion that a limited
presentation about these experiments to village elders without
further attempts to inform individuals participating in the
experiments would qualify under any standard of informed consent.

          Even beyond the issues of informed consent, serious
ethical questions exist concerning the targeting of this dis-
empowered minority population for use as test subjects.  Likewise
the selection of the Cape Thompson area for Project Chariot
experiments reflected a wholesale dismissal of the Eskimos of the
Arctic who depended on the uncontaminated ecosystem for their
subsistence survival.

          On behalf of the radiation experiment survivors and all
the residents of the North Slope Borough, I appreciate the
opportunity to share our stories with this Committee.  I would be
happy to answer any questions or provide any additional
information that could assist the Human Radiation Advisory
Committee in their review of this highly irresponsible and almost
unforgivable government action.

          So we're ready to take any questions you have.  Thank
you very much.

          CHAIRMAN FADEN:  Thank you, Mayor Ahmaogak.  I'm sure
that we have many questions.  I'm not sure we can answer them all
now.  I know you're leaving us some documentation, and we will
certainly pursue this further.

          Are there questions?

          MAYOR AHMAOGAK:  I do have one statement.  We have
other people if the Committee has got time.  There is one
individual from one of our villages, Point Hope, that I would
like to also testify on Project Chariot or Iodine 131.

          CHAIRMAN FADEN:  Unfortunately, perhaps what we could
do is take his testimony or her testimony, but not -- can we do
it some other way?  We'll figure out some way to do it.  Let us
take our questions at the moment.

          Ruth, did you have a question?

          DR. MACKLIN:  Yes.  Mayor, you mentioned in your
written testimony and then spoke of the gaining of the native
trust by impressing elders with technology and speaking to the
leaders and the elders.  To your knowledge, what did the Army
scientists or the Navy personnel later -- what did they tell the
elders or the leaders in your community of what they were doing?

          MAYOR AHMAOGAK:  Well, at that time, like I stated,
there was known language barriers, and none of them hardly spoke
any English at all, and they didn't even try to explain to them
through interpretation or anything what these experiments were
involving.  No one even asked them for their consent.  They
didn't even -- the natives that I travel all across the villages
have told me the same story over and over.  Nobody knew what they
were being administered.

          DR. MACKLIN:  What did the natives think?  Was there
any discussion among the natives and the people who lived there
at the time or the leaders, any discussion about what they
thought the purpose was of the Army or the Navy being there and
living among them?

          MAYOR AHMAOGAK:  I don't think that the purpose or
anything was made understood by the United States Army.  None
whatsoever, as I understand it.

          DR. KATZ:  But this is a slightly different question. 
If I understand Ruth correctly, suddenly these doctors appear,
and they were there with you.  What did you think they were doing
there?  Why this sudden interest?

          MAYOR AHMAOGAK:  Well, the sudden interest is that they
were starting to experience a lot of health problems with these
individuals that are there.

          CHAIRMAN FADEN:  No, I think the question goes to --

          MAYOR AHMAOGAK:  Maybe I'm not getting his question.

          CHAIRMAN FADEN:  The question was at the time when the
scientists first appeared --

          MAYOR AHMAOGAK:  At the time?

          CHAIRMAN FADEN:  -- what did the people in the villages
think about what was going on?  We're trying to get to what
misunderstandings or what misperceptions were intentionally or
unintentionally created.

          MAYOR AHMAOGAK:  The elder said at that time what
you're referring to, they were never talked to, the villagers,
none whatsoever.

          CHAIRMAN FADEN:  No, we understand that.

          MAYOR AHMAOGAK:  No discussion of --

          CHAIRMAN FADEN:  So your presumption was that this is
the government, and if the government wants to do something, they
want to do something.  Was that -- was there no questioning?

          MR. PEETOK (speaking through an interpreter):  They
were told that they were just going through examinations.

          CHAIRMAN FADEN:  That's important.  That's very
important.

          Let me take a list because I see many hands.  Phil, did
you have --

          MRS. AHMAOGAK:  And also related to that one, there
were also people from Point (inaudible) that were also involved.

          CHAIRMAN FADEN:  Thank you.  That's very helpful.

          Phil and Ken and Duncan and Nancy.

          DR. RUSSELL:  Were there any inducements to participate
or payments involved in these studies?

          MAYOR AHMAOGAK:  There was not to our knowledge.

          CHAIRMAN FADEN:  Nothing, nothing.

          Ken.

          MR. FEINBERG:  Mr. Mayor, what is the status of this
inquiry of Congress?  Is Senator Stevens or Senator Murkowski
aware of this?  Have they expressed any interest in this?  What
is the status of your efforts with the Congress of the United
States?

          MAYOR AHMAOGAK:  Our status so far insofar as we're
concerned with Congress, we hear very little of the activity. 
One thing that we heard about is possible compensation, but never
to this moment have we got any commitments of any sort, nor any
type of assistance or provide any medical attention or
assistance, for that matter, but we never had any kind of clear
signal coming from -- but the only thing that I did hear was that
there was some declassification of materials that was going to
take place as a result of this.

          MR. FEINBERG:  Have you raised this problem and this
story and this experience with Senator Stevens or Senator
Murkowski?  Are they aware of this?

          MAYOR AHMAOGAK:  They are aware of it.

          MR. FEINBERG:  And no action has been taken?

          MAYOR AHMAOGAK:  No action has been done thus far as I
understand, but there's a lot of communications back and forth
and a lot of attempt is being gathered to try to declassify a lot
of information also, like what the gentleman said here also. 
There was five people that we're still trying to isolate from
Point Hope that are recipients of this, and we have been going
through this bungling experience of trying to get into the files
since they're declassified at this time.

          But, yes, there has been, to answer your question, not
to my knowledge any type of action has been given by our
congressional delegation, but they are fully aware of it and
they're doing everything they can to assist us to deal with this
problem.

          CHAIRMAN FADEN:  Duncan.

          DR. THOMAS:  I was struck by your comments about the
apparent belief that the consent of the village elders would
suffice for that of the individual participants, and I'm trying
to understand where such a presumption might have come from
because it's not a presumption that we would make normally about
people in the Lower 48.

          Is there anything you can tell me, anything in the
Inupiat culture, any sort of a tradition by which village elders
would have this sort of right to make decisions affecting
individuals on behalf of the community?

          MAYOR AHMAOGAK:  There is -- there was earlier days,
elders' council and so forth, tribal councils that were there,
but at this stage in the early part of the game when these tests
were being administered, there was a communications gap to start
off with, to begin with anyway, and most of the subjects didn't
understand what they were being administered because they
couldn't communicate, much less give their consent or whatever. 
I mean there was no English speaking Eskimos at that time.  Only
during the time that I went to school after that time I learned
how to speak English.  I mean most of the people are all up
there.  So there was a communications factor -- problem there.

          DR. THOMAS:  So your presumption is it's because of the
difficulty of the investigators communicating with the
individuals that such a presumption might have arisen rather than
that there is sort of any tradition of communal decision-making
or anything like that?

          MAYOR AHMAOGAK:  Well, as I understand it, going
through from village to village and talking to all of the people,
from what information that we had gathered even after Polar
Research Board had been there, we went through from the North
Slope; we were traveling and talking to these individuals, and
their story remains the same.  No consent; they didn't know
anything, what they were getting involved with.  Nobody made it -
- explained it to them what they were going through.

          CHAIRMAN FADEN:  I'm sorry.  Mary Ann, you want to
follow on this point, and then Nancy is waiting.

          DR. STEVENSON:  Do you have a sense that the village
elders who may or may not have given permission understood what
the point of the experiments were, even if they weren't subjects
of the experiments?  Did anybody in the community truly
understand or have an explanation of why these experiments were
being done?

          MAYOR AHMAOGAK:  Nobody in the community as far as
they're concerned understood what this whole problem and this
test was involved with.  Nobody.

          DR. STEVENSON:  And not the elders who --

          MAYOR AHMAOGAK:  Not even the elders.

          DR. STEVENSON:  Okay.

          MAYOR AHMAOGAK:  As I said, there was a communications
problem, and they didn't know how to speak English one bit.

          MRS. PEETOK:  Rossman just mentioned that he's one of
the survivors of these experiments, and there was no permission
ever asked of the elders.

          MAYOR AHMAOGAK:  Anymore questions?

          CHAIRMAN FADEN:  Yes.  Nancy.  Sorry.  Just one more.

          DR. OLEINICK:  Just one more.  In spite of the language
barrier, was there any way that any of the participants tried to
express their desire to stop the experiment in the middle?  Was
there any way that it could have been stopped?

          It can be done sometimes by nonverbal cues, by just
walk out of the room or something to that effect.  I'm just
concerned.  I'm just wondering whether there was any way that the
participants expressed the desire -- they didn't understand what
was going on, but that they didn't want to continue or that they
didn't want the next person to have to undergo what they were
doing.  Was there any way that that happened?

          MAYOR AHMAOGAK:  I don't think there was a ways and
means to express that because at that time the United States Army
doing cold weather testing at that time is pretty powerful.

          DR. OLEINICK:  Yeah.

          MAYOR AHMAOGAK:  With these people coming into the
community and doing tests.  I mean it's the United States Army. 
What do you expect?

          DR. OLEINICK:  Yeah.

          CHAIRMAN FADEN:  Does Mr. Peetok have an answer?

          MRS. PEETOK:  Yes.

          MR. PEETOK (speaking through an interpreter):  At one
point in time they had a mayor of the city council that had
stepped in and asked why they were being -- why some of these
people that were undergoing the experiments, why the clothes were
being taken off, yes.

          He had told them to stop what they were doing to the
people because of -- to stop taking their clothes off.  That was
the only instance he knows that the mayor had stopped the process
that they were going through.

          CHAIRMAN FADEN:  And did they stop at that point?

          MR. PEETOK:  The mayor asked them to stop, and they
stopped.

          CHAIRMAN FADEN:  At that point.  Could I ask you:  were
they uniformed personnel?  Were they Army personnel in uniforms
or were they scientists in white laboratory costumes or both?

          MR. PEETOK:  They were in uniforms, military.

          CHAIRMAN FADEN:  Military uniforms.

          Okay.  Are there -- I'm sorry.  Lois.

          MS. NORRIS:  Do I understand that radioactive soil from
Nevada was distributed throughout the tundra or on the tundra? 
Is that what I understood you to say?

          MAYOR AHMAOGAK:  That's correct.

          MS. NORRIS:  Was anyone informed that that was being
done at the time?

          MAYOR AHMAOGAK:  There was a person here from Point
Hope that would like to testify if you have a few minutes.  He'd
like to tell historically that.

          CHAIRMAN FADEN:  The awkwardness is that we -- what I
want to identify is that Dan Guttman, the Executive Director of
our staff --

          MAYOR AHMAOGAK:  Yes.

          CHAIRMAN FADEN:  -- will be --

          MAYOR AHMAOGAK:  To answer your question, there was
radioactive soil that was deposited from Nevada, which is several
miles away from the village of Point Hope called Project Chariot,
and the Point Hope people can tell the experience, what they went
through.  They're better off to answer that question.

          MS. NORRIS:  You might be able to answer just one
follow-up question.

          MAYOR AHMAOGAK:  Yes, sure.

          MS. NORRIS:  Do you know if there has been any testing
on the plant and animal life to determine whether there was any
uptake of that radioactive waste?

          MAYOR AHMAOGAK:  There was at the last Department of
Energy meeting that we had in Point Hope -- stated that they did
take samples of ground squirrels, lichen, water samples, and
radiological aerial surveys, and the bottom line report, what the
DOE is convinced is that they didn't measure any contamination at
all, but still I think the problems were that there was some
health -- there was a lot of concerns like that 1962 letter that
I spoke of earlier, saying that there was multiple plots.  

          When Project Chariot remedial action took place, this
cleaned up only one plot.  To answer the basic question, the
intended experiments was to do multiple plots, and the person
that responded to us, Mr. Gerusky, only said that it was only
done only once, but to date we're not satisfied from the
government documents because they're classified.  We can't get to
see how many plots that they did actually clean up.

          CHAIRMAN FADEN:  Mary Ann, can we make this the last
question?  We really want to hear --

          DR. STEVENSON:  Do you feel like you've received to
your satisfaction information about the identification -- or you
may do that yourself -- of the people involved in the exposures
and the doses they received?  Have you gotten that information to
your satisfaction?

          MAYOR AHMAOGAK:  Yes, we've gotten that information,
and there again, going through bureaucracy and going through red
tape and trying to get this information of how many people were
involved, and we went through a tough process, but we did isolate
the ones for Iodine 131.

          What we don't have is the five recipients that we have
from Point Hope that we can't justify their names, but the next
step that we took further for the Committee's information, for
the people that are deceased, we're starting to dig into their
files and their medical records and finding out what they died
from.  A lot of them are cancer.

          The ones that are living right now, we're doing further
information with epidemiologists from Johns Hopkins University,
trying to understanding to see where these sicknesses are coming
from, but as the gentleman said, holes in their thyroid, all of
that is very true.  We have a complete disinformation gathering
that we're doing.  We're looking at Iodine 131, Iodine 125,
Project Chariot, but there is a hellaceous cancer problem that we
have on our hands, and we're trying to deal with this problem on
our own with local sources and with no help from nobody.

          But we will find out.

          CHAIRMAN FADEN:  Well, we thank you all --

          MAYOR AHMAOGAK:  Thank you very much.

          CHAIRMAN FADEN:  -- very much, but did you want to make
one more comment?

          MR. PEETOK:  He'd like to talk about another thing that
he forgot to mention.

          CHAIRMAN FADEN:  Please.

          MR. PEETOK:  After he took the Iodine 131, a woman, her
thyroid gland swelled up pretty bad and couldn't eat anymore, and
she started showing signs of getting skinny.  She traveled from
her home town.  

          He's mentioning that this lady traveled from a camp,
had to get away from the camp to the home in order to try and
heal that swelling in the thyroid glands.  She is still alive
today.

          CHAIRMAN FADEN:  Thank you.

          MRS. AHMAOGAK:  That's what he wanted to add.

          CHAIRMAN FADEN:  Thank you very much, all three of you,
for traveling this great distance and for providing us with this
information.

          Let me just point out -- Dan, you will be available?

          MR. GUTTMAN:  Also, Faith Bulger and Barbara Berney is
out there somewhere.  Barbara, are you out there?  Why don't you
go over in the corner so that these folks --

          CHAIRMAN FADEN:  And, Faith, could you stand?

          MR. GUTTMAN:  -- because you have been --

          CHAIRMAN FADEN:  If you would continue to meet with our
staff members, we could get more information from you.  We would
appreciate that, and that's Faith and Barbara and Dan will be
joining them as well if he can.

          MR. GUTTMAN:  Yes.

          CHAIRMAN FADEN:  That would be great.

          Thank you very much.  We appreciate it.

          For Committee members, let me just tell you what the
schedule is.  We're going to go have lunch.  We're going to have
an hour lunch, assuming they can bring us lunch fast enough and
begin at 1:15 rather than 1:30 and do the report on research
proposal review projects first, I think.  We'll try to figure
that one out, but we need to come back at 1:15, not at 1:30, to
try to make up for some of the time that we've lost.  So please
go eat.

          (Whereupon, at 12:12 p.m., the meeting was recessed for
lunch, to reconvene at 1:15 p.m., the same day.)                             AFTERNOON SESSION

                              (1:21 p.m.)

          CHAIRMAN FADEN:  All right.  If the Committee would
please come to the table, we're going to being with Dr. Till's
presentation.  We're trying to pick up 15 minutes which we're
rapidly losing.

          Now, our goal is to start now, pick up some time.  Oh,
good.  I think as soon as we get one more Committee member we
will begin and here comes our one more Committee member, two more
Committee members.  We're on.

          All right.  Just as a comment, we're trying to pick up
15 minutes.  Depending on how the timing goes, the current plan
is we'll have Dr. Till's presentation.  We will then discuss the
intentional release case.  We will then have Dan's briefing with
respect to declassification which relates, in part but not in
whole, to the Green Run issue.

          We will then hopefully have our break a little bit
earlier and then begin the session after the break with a
presentation from the Protocol Review Subcommittee, which should
take up to a half hour, and then we will get to the Committee's
strategy discussion.  What are we going to do for the next month?

          Okay.  We're back to our old temperature control
problem.  We seemed to be plagued with this every hotel that we
go.  People complained that it was cold in the morning.  So they
turned the air off.

          Do we turn the air back on?  Okay.  Would someone
please request that the air be turned back on, and maybe at the
break we'll turn it back off again or something, but it seems to
be that in Washington they are incapable of creating a climate
control that works.

          Let me begin.  It's my pleasure to introduce John Till
who is our guest at the end of the table, who is a graduate of
the Naval Academy and served in the U.S. Navy nuclear submarine
program and is currently a rear admiral in the U.S. Naval
Reserve.

          I will, in the interest of saving time for his
presentation, skip all of his eminent accomplishments and
qualifications and go to the bottom line.  He is the past
Chairman of the Technical Steering Panel that is directing the
Hanford environmental dose reconstruction project, and in that
capacity he led an effort to actively involve the public in
scientific research to determine the effects of early Hanford
operations.

          Dr. Till is going to try in 15 or so minutes, and then
we'll have time for discussion, to bring those of us who are
technically and scientifically naive a little bit of
understanding about environmental dose issues and environmental
risk issues.

          We thank you very much, Dr. Till, for taking the time
to try and educate those of us who need educating, which is some
chunk of the Committee.

          DR. TILL:  It's a pleasure to be here, and it's an
almost impossible task to really give you a thorough
understanding of environmental dosimetry, but I'm going to try in
the few minutes that I have to describe to you through dose
reconstruction work that I've been involved with for the past
eight to ten years, how we reconstruct historical doses.

          But what I want to leave with you, I think, most
important about that is how good or perhaps not so good, as you
may perceive it, that we are in reconstructing historical doses.

          I want to stress that the work that I do as a scientist
involves reconstruction of doses from environmental releases of
radionuclides, and that's a very important distinction, as
opposed to medical purposes or occupational exposures, but I've
been involved in this work for about 25 years.

          I also would like through this presentation to share
with you some of the lessons learned through the Hanford dose
reconstruction project because I encountered in that project many
of the problems that you're dealing with here, the same kinds of
problems regarding access to information, interpretation of
historical data, declassification of information.

          Let's see.  If we could just click on the first slide,
this is a rather simple slide, but I want to describe to you what
dose reconstruction is all about.

          CHAIRMAN FADEN:  Dr. Till, let me see if I can get
something done about the lights.  Is there anybody who can?  Are
there any light switches?

          DR. TILL:  I'm going to keep talking so we don't lose
time.

          CHAIRMAN FADEN:  Keep talking.

          DR. TILL:  But this is really just a very simple
diagram, and it's to try to illustrate to people how we perceive
dose reconstruction, and it's like a puzzle with many pieces,
many more than is shown here, but thousands of pieces.  The
difficulty is that you really don't have a picture of this puzzle
before you begin to put it together.

          There are many pieces that include bits of data, and I
won't go over all of those in the puzzle, but information on the
sources term, and that's what we call the quantification and
characterization of the information of the material release to
the environment, information on environmental monitoring data
that may have been collected at the time, information on
meteorological data.  All of these are pieces to that puzzle.

          And that's what dose reconstruction is all about.  The
key to this -- and if you would go on to the next slide -- is
really what's in these boxes, and if you've never been in the
repository -- and I don't know if the Committee has ever made a
visit to a repository -- I would urge you to do it because you
will see the absolute and I have to call it chaos because that's
what it is in most cases of how all of these historical records
are stored, for those that you can find, and this is just an
example of records stored at the Savannah River site.

          But, indeed, these records hold the key to dose
reconstruction.  We believe that if we can get to this
information and get to the right pieces of paper, we think we can
do a pretty good job of reconstructing the past.  If we know, for
example, what the meteorology was for a particular day or for a
particular period of time, we can tell you pretty well today if
that material went up a stack where it went, what direction, and
how far.

          Okay.  The next slide, and this is horrible.  I know
that.  I made this in my office, but this is what we're looking
for.  These are original notes, and this piece of paper happens
to come out of the Fernald site, and it deals with some log --
it's a log book, which is sort of the key source of data that we
look for, but it's a log book that describes releases of uranium
to surface water at the Fernald site.  

          I just threw this up as an example for the kinds of
records we're looking for, and what often you find in the
historical records are summaries of data, summaries of releases
that previous researchers have made, and that's not the kind of
information we use.  We believe in going to the most original
source for the data.  If we can find hourly logs, daily logs,
monthly logs, then we come up with our own summation of
characterization of the source term, for example.

          Okay.  The next slide just describes to you two types
of searches that we use in our work, and one's called a directed
search, and really that's what I believe this Committee is doing
in your work.  You're sort of going to different locations
looking for specific kinds of information.

          That's what was done at Hanford.  We were dealing with
about 48,000 boxes of records at Hanford.  When the project
started, we realized that we could not look through all of the
boxes to find records, and therefore, we started to go to
particular boxes where we thought the information was stored.

          There's a great weakness in a directed search of the
records, and the great weakness, of course, is that you may not
find everything.

          In some new work that we have been doing for the past
two years, and this is a project that's been sponsored by the
Centers for Disease Control, they've taken a new approach to
looking through the records for a dose reconstruction project,
and this approach is that we spend the first two years of work
doing nothing but a systematic search of these records, that is,
going through every box to see what's there to decide whether or
not there are sufficient data to carry out a dose reconstruction
in the first place, just making sure that you have everything;
cataloging the records; and we have, and we've about finished
this work, been through 38,000 boxes of historical records at the
Savannah River site.  It's extremely tedious.  It's expensive.

          On the other hand, we have now for the first time ever
in the history of that site catalogued all of the information in
the historical records.  Most of it, of course, is not useful to
us, but other researchers now, for example, people who might be
interested in medical exposures on site or occupational exposures
on site, will know where to go to get that information.  It's all
in a massive database that we've assembled and is being turned
over to the Centers for Disease Control.

          The next slide is just to make a point with you that we
look through the boxes ourselves.  I mean as researchers, I have
a small research team.  There are 17 of us.  That is the point,
that you can't send someone in who doesn't know what you're
looking for to search for the information that you need in dose
reconstruction.  I would advise you in your work to be very
careful.  When you're sending out a message to do a search at a
particular location, how you go about doing that.  

          It's not a matter of trust, and that's my point.  It's
a matter of thoroughness, and it's also a matter of people out
there not knowing exactly what it is that you need for your work. 
I've done this.  We did it at Hanford where we sent people out to
find particular records, and we didn't get back exactly what we
needed.  We had to go back and find it ourselves again later on.

          So the picture that I'm trying to give you right now is
that in the first place we do have the capability of going back
into these historical records, not always, but often finding bits
and pieces of information that allow us to put together this
puzzle of dose reconstruction as we call it.

          The next slide, of course, is the Hanford site.  I'm
going to shift a little bit to tell you that I got involved in a
study to reconstruct the doses at Hanford back in 1988.  It was
an extremely enlightening study for me.  I recognized immediately
that this was a study brought about by public concern, and that
as a scientist, we had to go about doing our work in a completely
different way.

          We declared this study to be an open study; that
anything we did, that anything we had could be viewed by members
of the public at any time.  But we had to deal with some very
important issues at Hanford that I was extremely unaware of in
going into the work.

          The next slide just lists a few of the things, which
I'm not going to have time to go through all of, but in terms of
the organization of the study, it was, of course, being paid for
by the Department of Energy.  We were working for Battelle
Northwest, the very laboratory we were to be directing, and it
took us about two years to get all of this sorted out and get the
study transferred out of DOE and into the Centers for Disease
Control.  A great lesson in terms of how public studies should
not be set up.

          Openness was a big issue at Hanford, and I'll talk just
a little bit about that because I know you're dealing with some
of these same problems.  Access to and declassification of the
historical records, and public involvement.  I'm going to come
back to openness and declassification very briefly.

          First of all, with openness on the next slide, I just
list a few points that I think you need to remember.  I know that
this Committee itself has taken a very proactive stand toward
being open and it's a necessity in the type of work that you're
doing.  We have to understand that in carrying out public studies
and scientific public studies that they'll cost more if they're
considered open, but I still stress that even in public studies,
scientists have to have the right to have some degree of privacy
in your work and to make your conclusions before you make them
public.

          With regard to access and declassification, which is a
major issue at Hanford, the next slide sort of lists our initial
approach here, and that was that we had members on this panel who
had appropriate clearances to look at classified information. 
The problem that we were confronted with was that of credibility.

          And so we took a very positive stand that any
information we used in the study had to be declassified.  Now, if
you'll put yourselves in our place back in 1988 when we started
this work, the first information we needed to create the sources
terms at Hanford was information on plutonium production, and if
you know that back in that time, of course, this was all
classified.

          So we were immediately told that we could not have
plutonium production information, and our position was that we
had to have it, and therefore, through a discussion with the then
Secretary of Energy, Admiral Watkins, we were able to get
plutonium production declassified through 1961 and ultimately
through 1972, which is what we needed.

          But my point to you about declassification, and we can
talk about this a bit later, in the work that you do and the work
that I do, everything as a scientist has to be peer reviewed.  If
it's classified, it cannot be peer reviewed, and therefore, as a
scientist I cannot work with classified information, nor will I.

          I suspect that much of what you discover in your look
through the historical records you're going to be confronted with
the same problem.  I want to make the point, and it's very
important, that in dose reconstruction I've never come across a
situation where information that we needed could not be
declassified.  It's hard for me to envision how anything that
this Committee is doing cannot be declassified.  Just what you
need.

          Now, recognize that means you may have to get documents
and documents with deletions, but there are ways to verify what
the deletions were, and that's, of course, the approach that I
would certainly recommend that you take.

          The next slide, and now what I'm going to do in the
final few minutes that I have is just try to give you some
appreciation for how we go about this science or some people like
to call it an art.  Maybe it is in terms of estimating doses to
individuals from radioactive materials in the environment, and
this slide just illustrates one study, and Duncan Thomas has
already talked to you about this, I imagine, because Duncan was
involved in this, as well.

          Two studies carried out, supported by the National
Cancer Institute, carried out by the University of Utah, one a
leukemia case control study; the other a thyroid cohort study. 
My point is that if you get the right information, one can do a
rather decent job of estimating doses to large numbers of people.

          In the leukemia case control study, we had about 7,000
controls and about 1,100 cases.  We had individual dose
assignments for each control and each case, "individual" meaning
that we knew the residence history of that person, and if you
knew residence history, which we had special access to this
information through the LDS Church, that was the key factor in
assigning a dose to each person.

          So once we knew where they lived, we had an algorithm
that we could use to assign the doses, and in the thyroid cohort
study, a similar situation of 3,500 children that we'd been
tracking for a number of years, where we assigned doses to each
one of those individuals based on their diet, life style, and
residence history during the period of atmospheric weapons
testing.

          How good are we at doing this?  We assign to each dose
estimate, and these are best estimates of dose; they are not
upper bound estimates.  They're best estimates of dose, an
uncertainty with each assignment.  These uncertainties typically
in the work we did at Utah range on the order of factors of two
to four or five.

          Now, you may think, and someone mentioned the word --
used the word "accurate" here this morning for dose assignments. 
I would certainly never do that, but for the purposes of
epidemiological studies, if you can estimate doses to a large
number of people, you're estimating a best estimate of dose for
every person individually and assigning an uncertainty.  You can
do a lot with that epidemiologically.

          How good that might be for the purposes of this
Committee and special doses to special people, I'm not sure.

          The next study that I'll just mention briefly is work
we're doing at the Fernald facility.  Go ahead, Jeff, and this is
just a photo of that site.

          This is just northwest of Cincinnati, Ohio, where
enormous amounts of uranium are released to the environment
particularly through the early 1950s and mid-1960s.

          The only thing I want to mention here is the process
that we use in recreating the source term, as we call it.  That's
the amount of material that's actually released, and the approach
that we take in every study is to try to come at the source term
from as many independent angles as possible.

          Now, for example, around the Fernald facility there
were measurements of uranium in soil taken over the years.  They
weren't all taken the same way.  They weren't all taken in the
same place.  However, we can use that data, and we did use it to
help us bound this source term between 160,000 kilograms to
900,000 kilograms.

          Now, you think that's horrendous, but that was our
first cut at the source term.  That's called our outside-in
approach.  What we did as well is to look at those historical
records as I showed you earlier, all that we could find, and
through almost 100 different release points estimated for each
point for each period of time on a monthly basis how much uranium
was released, and that number is on the order of about 350,000
kilograms with a fairly small uncertainty.

          So that's how we go about reconstructing the source
terms for these facilities.

          Finally, what do we do with this information?  We try
to put these pieces together so that they give us some confidence
that these aren't just wild guesses.  The next slide just shows
you some of the data -- I'm sorry.  We need to move on one more
-- some of the data, and this is our observed to predicted.  This
is a logarithmic scale.  However, you'll see in the green what
our predicted concentrations were, and this is at a location in
the northwest direction from the Fernald facility, and you'll see
the red line indicating what some measurements were that we found
in these historical records.

          My point is here that we look at this and we say, "Hey,
this is pretty good.  We're at least in the ball park."  It gives
us confidence that our prediction of the source terms and our
prediction of the calculated concentration of uranium around the
Fernald site are pretty good.

          Okay.  That's, I think, all for the slides, and I'm
going to stop because I've gone very fast and just conclude by
saying, first of all, this field of environmental dosimetry, of
dose reconstruction is relatively new business, particularly the
mathematical models that we use for predicting doses.  These were
not around in the older days.  Even our appreciation for and
understanding for pathway analysis, which of course in the case
of iodine at Hanford was enormously important since the milk
pathway was the key pathway we were concerned with; that
information of that kind has evolved more in recent years rather
than in early years.

          It doesn't mean that it wasn't known, but our ability
to quantify material going through various pathways, to quantify
the material ultimately getting back to human beings, and then
converting that into dose is fairly new, within the last --
certainly within the last two decades.

          I've gone very fast.  I apologize for that, but I hope
I leave you with the impression that we do know something about
this science and that we have some confidence in our ability to
recreate historical doses.

          Thank you very much.

          CHAIRMAN FADEN:  Thank you, Dr. Till, and the reason
you're going quickly is our fault, not yours.  It's the amount of
time that we have to spend on so many different issues.

          Henry.  We're obviously open.  I saw Henry's hand.

          DR. ROYAL:  John, one of the things that we heard about
when we were in San Francisco was school children who were having
what sounded possibly like thyroid uptake measurements made in
school.  Do you know anything about those?

          CHAIRMAN FADEN:  Around the Hanford site.

          DR. ROYAL:  Around the Hanford site.  Sorry.

          DR. TILL:  As far as the school children were
concerned, I don't.  Now, at the Hanford site there is a
radioepidemiological study being carried out by the Fred
Hutchinson Cancer Center.  Is that what we're talking about?

          DR. ROYAL:  No, I was talking about at the time that
the releases were occurring, that someone testified before the
committee saying that she had been brought out of her classroom
and had been counted in some machine.  So it sounded like there
was actual organ uptake measurements that were being done in the
general public at that time.

          DR. TILL:  And I don't recall exactly when this was.  I
don't believe that this individual was talking about measurements
that were made during the period when the highest releases
occurred.

          DR. ROYAL:  You're right.  This was '52.

          DR. TILL:  Right.  It was after, and I think this is
when, of course, more was recognized about the importance of
doing some kind of surveying on the public.  Unfortunately if we
had had the foresight back in those days to make those kinds of
measurements, it would give us the kind of validation that we
need today.

          There were many measurements made of the thyroid burden
of workers at Hanford, and that data are being used to help us
with the validation, but it's extremely complicated, and it's not
as useful as I would like.

          CHAIRMAN FADEN:  Mary Ann.

          DR. STEVENSON:  I don't know if you know this, but how
well did the predicted dose estimates at the time that these
releases were made, and we'll use Hanford as an example,
correspond to the present day dose reconstruction?  I'm just
trying to get a sense of how well they guessed how much they were
going to be putting out and how much they guessed they would
expose people to really turned out to be accurate.

          DR. TILL:  Are you talking about predicted dose
estimates from the '40s?  To my knowledge, there were none, and
I've seen no estimates of dose that were made that are in the
historical records.

          In fact, the first estimates of dose that I saw from
Hanford, the first calculations of dose really were done in the
middle 1980s.

          DR. STEVENSON:  But when we read at least about the
proving ground in Nevada, I mean, there were some sort of
presumptions made as to given a certain size of a bomb how much
release there would be and how much exposure there might be to
Downwinders.  There were some attempts, it seems like.  Whether
or not they were accurate I'm not sure.  That's what I'm trying
to get a sense of.

          DR. TILL:  Actually I have not seen any calculations
like the Downwinders.  If that were in the historical records, I
would like to see it, but I'm not sure that back in those days
they were capable of making those kinds of calculations.

          CHAIRMAN FADEN:  Nancy.

          DR. OLEINICK:  I just wanted to follow up on what Henry
was asking in terms of the questions about the measurements on
the children.  What you said was that in the very early releases,
there were no measurements made, but that later on there was a
realization that they needed to follow the population.  Are you
aware of data then on measurements on these children or even on
adults later on in the '50s?

          DR. TILL:  I really am not sure about that, Nancy.  We
had someone to testify about this.  The point is that these
measurements were suddenly being made, but they were really after
a time period when we were most interested, and even suspected
that you might be able to measure specific body burdens.  So I
really don't know the answer to that question.

          DR. OLEINICK:  Okay.  So you're not aware of it because
I mean that would be of interest to us --

          DR. TILL:  Right.

          DR. OLEINICK:  -- if the data were available.

          DR. TILL:  Right, and in fact, if I were aware of it
and had been sure that they existed, we would probably use it in
the validation exercise.

          DR. ROYAL:  John, just for clarification, could you
tell us when the large releases of radioactive iodine occurred? 
It was from '44 to '48, '49?

          DR. TILL:  Actually the largest releases occurred --
the releases began in December of 1944, and the largest releases
occurred during 1947 and -- I'm sorry -- in 1945 the largest
releases occurred, and by 1947 essentially they'd recognized that
the problem existed with radioiodine releases.  Filters were
added.  Cooling times were increased to reduce the releases very,
very significantly by the end of 1947.

          The Green Run occurred in 1949.  So the time period
that we were most interested in in the study was '44 through '47. 
A total of about 780,000 curies were released during that time
period.

          DR. ROYAL:  And the Green Run, just to put that into
perspective?

          DR. TILL:  About 8,000 curies.

          CHAIRMAN FADEN:  Other questions for Dr. Till?

          (No response.)

          CHAIRMAN FADEN:  Well, we thank you very much.

          DR. TILL:  My pleasure.

          CHAIRMAN FADEN:  We appreciate your expertise and are
humbled by your efforts relative to our time frames I think is
what it comes down to.

          All right.  I think that just following our agenda,
we're going to proceed through and that's a good segue into our
case study on intentional releases, which does focus on the Green
Run at Hanford, and we've got Mark and Pat.  Dan, do you want to
come up to the table so that we can?

          DR. GOODMAN:  Hi.  Our presentation will address the --

          CHAIRMAN FADEN:  Oh, excuse me.  Just let me interrupt. 
I'm sorry, everybody.  It's Tab H.  It's Tab H so we can find it. 
I'm sorry, Mark.  Go ahead.

          DR. GOODMAN:  Our presentation will address the facts
of the Green Run as we know them and present some discussion
points for an ethics analysis.

          One key question is whether the Green Run or something
like it could occur today, and we, therefore, review current
environmental regulations and their potential relevance to the
Green Run case.

          I'll begin with a discussion of the facts and unknowns
and including a review of the environmental regulations, and
Patrick will follow with a discussion of the main points for the
ethics analysis.

          First, the facts.  The Green Run occurred in December
of 1949.  It was an intentional release of radioactive materials
from the Hanford plutonium production facility.  The purposes are
at least partly known, partly unknown.  What is known is that it
was designed to test the ability to detect nuclear production,
nuclear materials production in other countries and perhaps also
nuclear weapons testing.

          It was to provide some historical -- well, there's also
a suggestion of other purposes, but we don't have any documents
that verify that there were any other purposes to the Green Run. 
They may be secret or they may just not exist.

          For some historical background, in the mid to late
'40s, the Air Force began a program of atomic intelligence which
included a variety of techniques for detecting nuclear weapons
explosions and production at long ranges.  In the previous year
before the Green Run, there was a program of air sampling at
Hanford and at Oak Ridge to test, again, radiation detection
equipment.

          And then the Soviet Union exploded its first nuclear
weapon in September of 1949.  Within three months, the Green Run
had occurred.

          Now, the source of information that we have are almost
entirely -- well, the original documents are from the Health
Instruments Division at Hanford.  There are also some subsequent
reports, but they rely on the same information.  There are also
some of the participants who are still alive, and we intend to
interview some of them, but we have not yet done that.

          And the question of classification arises on these
sources.  We know that some sections of the reports from the
Health Instruments Division are deleted in the declassified
versions that we have.  They may bear on some of the questions of
interest, for example, who is responsible, what other purposes
there might have been, what considerations were given to safety,
but neither the Air Force nor the Department of Energy reports
finding any planning documents or reports that address our
questions in any more detail than what we already have.

          Now, the release itself -- let me step back and talk a
little bit about how plutonium is produced.  You put uranium fuel
into a reactor.  Uranium 238 is transformed by neutron activation
into Plutonium 239, and then you take the fuel out, Step 2, allow
it to cool for some period of time so that it becomes safe to
handle, and then Step 3, you dissolve it and chemically separate
the plutonium.

          In the process of dissolving it, you release
radioactive gases, and among them particularly at the early times
are Xenon 133 and Iodine 131, iodine being particularly
biologically active.  It has a half-life of about eight days.

          In 1945, the typical cooling period was 30 days.  By
1949, it had been extended to 100 days typically, 90 to 100 days. 
The Green Run fuel was only allowed to cool for 16 days.  Now,
that's something like -- the difference between 16 and 100 days
is something like ten half-lives or a factor of 1,000 in the
activity of iodine.

          And as John Till had said, there were roughly 8,000
curies of iodine released at the time.  There were extensive
efforts at monitoring the environmental conditions, including
meteorological conditions, the wind speed, temperature profiles,
and they imposed -- they had imposed beforehand some
meteorological constraints for, I believe, some combination of
safety and the success of the experiment, these conditions that
would make it possible to measure radiation.

          But as it turned out, the actual conditions were not
favorable; at least were reported to be, quote, worst possible. 
The air was stagnant.  The material was not dispersed at long
distances, and then the cold front came through and essentially
it all rained out very shortly there afterwards.

          There's extensive monitoring of air, water, induced
radiation levels.  What I found most interesting was the
monitoring of radioactivity on vegetation, which over large areas
exceeded by factors of 100 or more the current standards for
intervention.  That is, once the radioactivity reaches .013
microcuries per kilogram on vegetation, the state health
department intervenes to protect the food supply.  So we had
levels that were over 100 times that.

          Now, because there was such extensive monitoring, as
John Till has reported, we have a fairly good idea of how to
reconstruct the doses, and it turns out because it occurred in
December, many of the pathways for human uptake were greatly
reduced.  That is the food pathways, milk and also meat and eggs. 
So the primary pathway was through direct inhalation, and this
accounts for the fact in spite of this extensive ground
contamination, the individual doses were estimated to be
relatively low.

          Now, we haven't reviewed this dose reconstruction, but
Battelle has apparently done such reconstruction and estimates
the maximum dose at about six millirem to the thyroid.  That's
something like 200 millirad to the thyroid.

          There's been no reconstruction of the total population
dose, that is, added up over all the people, and for comparison,
the Green Run was about one percent of all the radioactivity
released during the period of 1944 to 1970, and in that period,
the maximum individual doses have been estimated as high as 1,000
rad or so, which is roughly 30 rem to the thyroid.  So a factor
of something like 5,000 distinguishes those two.

          Let me move now to the environmental regulations as
they exist now.  I'm going to concentrate on the most clearly
applicable provisions.  We haven't done a thorough job of
researching every environmental law.

          There are two basic types:  the procedural constraints
and the substantive ones.  We're going, by the way, in a
different order from what's in the briefing book.  This would be,
I think, 1(b).

          CHAIRMAN FADEN:  Tab H.  They're separated by yellow
sheets.  We don't have little sub-tabs.

          DR. GOODMAN:  Anyway, there are two types of
constraints in current law, the procedural and the substantive
constraints.  The procedural constraints tell you how the
government should do things, and the substantive ones -- well,
the government and private parties -- the substantive ones put
limits on what the government or private parties can do.

          As far as procedural constraints, there are those that
come under the National Environmental Policy Act and related
legislation.  These require government agencies to prepare
environmental impact statements for, quote, major federal actions
with significant impact on the human environment.  These
environmental impact statements should analyze alternatives for
meeting objectives of the proposed program.

          The purpose of this is to require the agencies to
inform themselves and also the public of the likely impact of
their programs.  

          Also under these and related regulations, EPA,
Environmental Protection Agency, exercises oversight, that is,
has an obligation to review and comment on proposed federal
actions, including environmental impact statements, and if it
finds actions unsatisfactory from the point of view of human and
environmental protection, human health and environmental
protection, it can refer them to the Council on Environmental
Quality, which is in the Executive Office of the President.  So
they can buck it upstairs to the President roughly.

          And there are also provisions related to public comment
and public notice for environmental impact statements.  That is,
the environmental impact statements, draft ones, should be made
available to the public for comment, and those comments taken
into account.

          But these procedural requirements do not enforce any
particular outcome.  The agency is still free to decide the most
environmentally damaging approach if that is the best way to
achieve its goals.

          There are substantive constraints primarily under the
Atomic Energy Act and the Clean Air Act.  At least these are the
ones that would apply in the case of the Green Run.

          The Atomic Energy Act gives general authority to the
federal government to regulate human exposures to radiation
hazards.  EPA and the Nuclear Regulatory Commission have general
guidelines, but for the most part, the agencies are free to
regulate their own conduct.  That is, they develop, implement,
and enforce their own guidelines, regulations under the Atomic
Energy Act.

          The Clean Air Act, the authority under the Clean Air
Act is with the Environmental Protection Agency, and there are
quantitative limits on exposures to radionuclides released into
the atmosphere.  The quantitative limit is 10 millirem per year
to the maximally exposed individual, which if this were repeated
over a lifetime would correspond to some multiple, small multiple
of one in 10,000 risk of induced fatal cancer.

          The goal was to reduce the risk to one in 10,000, but
they didn't -- the actual numeric limit doesn't quite implement
that.

          There are a number of other statutes that I won't go
into, and then another question -- a basic question though is
this is what happens under normal circumstances.  Are there
loopholes for exceptions for abnormal circumstances?  And I've
identified three types of loopholes:  one, secrecy; two, national
interest or national security; and, three, which I've touched on
already, self-regulations.

          For secrecy, there are exceptions in the implementing
regulations for the National Environmental Policy Act, NEPA,
which say that environmental impact statement can be classified
in whole or in part, and court decisions based on this have
severely limited the ability of the public to find out what's
been done in secret.

          So this is a real barrier to the public notice/public
comment part.

          As far as national interest exceptions, the Clean Air
Act has an exception that allows the President to exempt any
proposed federal action from the requirements of the Clean Air
Act.  It requires the President to report by the end of the year
to Congress on all such exemptions, but there's no prior notice
required.

          Finally, the agencies are given authority to regulate
themselves under the Atomic Energy Act, and one might think that
there's an inherent conflict of interest in there, that agencies
might not be as strict on themselves as if they were overseen by
another agency.

          Some safeguards would remain.  EPA oversight is there
in any case:  the authority to refer proposals to the Council on
Environmental Quality and some reporting requirements, even if
only to Congress.

          Now, this sort of leads to the question:  could the
Green Run have happened under today's regulatory environment?  I
don't think that's quite the right question because the
circumstances of the Green Run would not be repeated.

          But the question really ought to be whether events that
raise similar ethical concerns could happen today, and that's
something that Patrick will talk about.

          DR. FITZGERALD:  Thanks, Mark.

          What I'm going to do in my presentation is try to give
the facts of Green Run and the environmental regulations an
analytical framework.  The object here is to highlight the areas
where we might judge Green Run to question the adequacy of
current regulations and to ask whether something analogous to
Green Run can happen today.

          In the briefing book there are three memos which I'm
going to be trying to summarize, and I'll summarize them at the
same time.  So you won't be able to follow the memos.  The
presentation won't specifically follow the memos.

          So what I'll try to do is to proceed by addressing five
questions.  First, did the Green Run create a favorable balance
of harms and benefits and how well do current environmental
regulations insure that future actions will have such a favorable
balance?

          There are two primary concerns here.  The first is that
we adequately consider the harm to the total population. 
Intentional releases normally spread the likelihood of harm over
a large population.  For example, specific individuals might
contract cancer from intentional releases even though that
release may pose a small chance of harm to the individual in the
exposed population.

          The Clean Air Act and the Atomic Energy Act, however,
are designed to limit the likelihood that the maximally exposed
individual will experience harm rather than likelihood of the
harm to the total population.  So these regulations don't address
all of our concerns.

          Guidance within DOE, however, does regulate the
collective dose and thus the harm to the total population.  Any
collective dose over 100 person-rem triggers a special reporting
requirement that forces the facility to report to DOE
headquarters with an explanation.

          This limit is close to the collective dose that Green
Run would have produced from this perspective.  The harm caused
by Green Run would be significant, but not uncharacteristically
high when compared with other releases.

          The second problem that we encounter in relation to the
harms and benefits -- can people hear me over this?

          CHAIRMAN FADEN:  I'm also waiting for these glass,
crystal things to fall down at any moment.  It's blowing so hard
that they're clanging in case you're wondering about the chimes. 
So, Patrick, I wouldn't take it personally, but we may have to
evacuate.  I admit you're in a very vulnerable position.

          We're going to try to get -- if anybody's back there,
could somebody get the blower turned down?  Somebody should be
checking into building safety regulations, in addition to
environment.

          Try and proceed, Patrick, and we'll see if we can't do
something about it.

          DR. FITZGERALD:  Well, the first kind of problem under
the harms and benefits was considering the harm to the total
population.

          The second problem that we encountered is to try and
balance harms and benefits from intentional releases and
specifically from Green Run because they are so disparate.  There
are disparate social values.

          In addition to affecting public health, intentional
releases can harm the environment and benefit both national
security and the advancement of science.  Regulations do consider
some of these problems.  NEPA, for example, directs agencies to
independently consider environmental effects by requiring an
environmental impact statement that conducts not only a cost-
benefit analysis of economic values, but also a cost-benefit
analysis of environmental values.

          Environmental regulations also address the conflict
between national security and other social values.  Each of the
environmental regulations may be circumvented on grounds of
paramount national interest.  Threats to national security,
therefore, can trump environmental regulations and the
environmental values that they're designed to protect.

          Internal DOE guidance also attempts to weigh these
disparate values.  ALARA or "as low as reasonably achievable"
standard is designed to consider unquantifiable values.  More
specifically, radiation doses should be as low as social,
technical, economic, practical, and public policy considerations
reasonably permit.

          If the emission is necessary for national security, a
low collective dose might not be unreasonable because it's
weighed against this other social value.

          At least one of the purposes of the Green Run was the
development of a long-range monitoring system for plutonium
production.  Consequently, the Green Run is going to force us to
weigh the value of national security against the value of public
health.

          Adjudicating this conflict may be more difficult
because of the sense of urgency and fear that Americans probably
would have felt at the time during which the Green Run was
conducted.  The Green Run followed shortly after the first Soviet
atomic weapons test.  So developing a system to monitor Soviet
plutonium production and thus to determine the extent of Soviet
threat must have been considered paramount to national security
at the time.

          The second question, did Green Run unjustly burden any
individuals or groups in society, and do current regulations
protect against unjust burdens?  We might think that an
intentional release distributed harms unjustly either because it
distributed them disproportionately or because it distributed
them in an egalitarian manner.

          Disproportionality in distribution results when
individuals or groups that bear the harms are not the group that
stands to benefit or when the entire society stands to benefit
but only a subset of that society bears the harm.

          The harms may be distributed in an egalitarian manner
if the individuals or groups who bear the harms are among the
least advantaged members of society.

          Executive Order 12898, federal actions to address
environmental justice in minority populations and low income
populations, is designed to address some of these concerns.  The
executive order directs agencies to make achieving environmental
justice part of their mission.

          Whether this executive order will be effective is yet
to be seen because the proposed strategies for each agency will
not be made public until February of 1995.

          Since the Green Run burdened a single community, we
might consider it to be disproportionate, and since Hanford
community is highly polluted, we might also say that the Green
Run further burdened an already heavily burdened community.

          But the Green Run could have only occurred at the
Hanford plant.  In 1949, this was the only U.S. facility capable
of reprocessing sufficient quantities of irradiated uranium for a
full-scale test of long range detection of gases released in the
plutonium production.  So if a full-scale test was necessary, and
this, of course, is an open question, no other site could have
been chosen.

          The third question, did the government adequately
consider the will of the affected populations during the Green
Run and do current regulations insure that they will adequately
consider them today?

          If the government acquired individual consent from
everyone that was possibly affected by an intentional release, no
intentional release would be possible.  Invariable someone would
refuse to consent.  Thus, if intentional releases are ever
permissible, we must rely on a less stringent standard for
authorization than individual consent.

          The most likely standard will be some kind of consent
of the governed obtained through democratic and fair procedures. 
Procedures for implementing policies, however, can be more or
less democratic.

          When the burdens fall heavily on specific individuals
or groups, some might argue that procedural requirements for
democracy should be stricter than normal.  For example, public
officials could be required to consult with the affected public
in an open setting.

          This raises several questions for intentional release
in general.  Does both the affected and the general public know
about the release and its potential hazard so they can hold its
representatives accountable?  Is the group that is most affected
by the release adequately represented?  Is there a reliable means
for considering public input?  Is the public input considered
seriously?  Does the public have an effective method of
challenging government decisions?

          None of the environmental regulations require
individual consent.  We might interpret some of the provisions,
however, as requiring a kind of democratic consent.  NEPA
requires federal agencies to seek and respond to public comments
on environmental effects, including the people living in the
environment, and of all of their major actions.  The government
need not do this in any other public policy.  In any other
policy, it doesn't have to do it, for example, on economics, on
questions of welfare policy, on foreign policy.

          The fact that the government does consult the public on
questions of environmental impact makes environmental policy
uniquely democratic.  Despite this fact, we might question
whether environmental policy is democratic enough.

          While NEPA requires agencies to consult with the
public, it does not require that they follow or even be shaped by
the public's wishes.  There is no requirement that the public at
large or the members of the public most affected by a federal
action approve of that federal action.

          In addition, NEPA does not require public consultation
when the federal action concerns classified material.  One of the
most difficult questions about weighing social values, how
environmental values should be weighed against the value of
national security, is done behind closed doors.

          In the case of the Green Run, we have no indication
that anyone outside of the government was informed about the
Green Run, much less that they consented to it.  The public
neither had an effective method of challenging the government
decision, nor did they have a way to hold officials responsible
for their actions.

          We can question, therefore, whether the government took
adequate steps to obtain the consent of the governed.

          The fourth question now.  How much of the Green Run was
secret and do current regulations allow for similar occurrences
today?  Questions about secrecy are multifarious.  Was the
information kept secret?  Were affected persons in the general
public informed about the release?  If they were, then what
information were they given and was it effective?  Were they
informed about possible harms that might result from release? 
Were the members of the public consulted before the proposed
release was finalized?  What actions, if any, were recommended to
the public to minimize potential harm?

          The Green Run was not made public until 1986, and some
parts of it remain classified.  As far as we know, the government
did not provide any information to the exposed populations about
the tests or about its risks.

          More importantly perhaps, we have no indication that
the government warned the public of the release.  This absence of
warning prevented individuals from taking precautionary actions,
such as leaving the area or simply staying indoors.

          If the current environmental laws were in place in
1949, it is unclear that they would have prevented Green Run.  It
would fall under NEPA, and thus, the Air Force would have to
analyze alternatives.  This analysis, however, would not have
been made public since the Green Run was classified.

          Furthermore, no reviewing agency would likely have been
in the position to refute or even authoritatively question any
claims of national security made by the military or the AEC.

          Substantive regulations might not have been of much
impact either.  The Clean Air Act and the Atomic Energy Act
regulations can be superseded in cases of paramount national
interest.  Given the perceived Soviet threat, this exemption
might easily have been invoked.

          And now the fifth and final question.  Was the Green
Run reviewed prior to its execution and could similar projects
avoid review under current regulations?

          Intentional releases raise several different questions
about an adequate review, that an adequate review might have to
answer.  Can intentional releases achieve its proposed goal?  Are
there any alternatives that could limit unwarranted side effects? 
Do the side effects constitute an unacceptable cost?  If there
are attached studies, are they conducted in an ethical manner?

          Because these questions require several different kinds
of expertise to adequately answer, they may require several
different kinds of review.

          Do the current regulations require a proposed
intentional release to be reviewed by disinterested third
parties?  NEPA requires that the EPA review major federal actions
for their environmental impact, and NEPA also requires that any
agencies with special expertise review proposed actions.

          In most cases, this would seem to guarantee a
disinterested third party.  It might be possible, however, to
have the EPA or another agency that has a special expertise to
have promotional interest in obtaining the data which the agency
is trying to gather.

          In addition, even the reviewing agency does not have a
promotional interest in the proposal, other government agencies
may be more accommodating that individuals or groups outside the
government.  We have no indication that anyone in the government
who did not promote Green Run reviewed its plans.  It would be
hard, therefore, to call those who did review the plans
disinterested.

          We also have no indication that radiological safety
considerations were taken into account, and plainly in the Green
Run such documents may yet appear.

          An environmental impact statement under NEPA and EPA
approval under the Clean Air Act would have been required for
Hanford operations, which probably would have placed limited
limits on the operational missions.  A report to EPA would have
been required on the atmospheric emissions and would likely have
to have raised concerns since the six millirem for one day comes
close to the ten millirem annual limit.

          But as stated earlier, the public would not have been
given the opportunity to review the Green Run, and no agency that
could have reviewed it would have been in the position to refute
or authoritatively question the military or the AEC claims of
national security.  No current regulations would have required an
executive branch to notify Congress before the Green Run, but if
the President did invoke the paramount national interest
exclusion to the Clean Air Act, he would have had to report to
Congress at the end of the year.

          All in all, it seems that an effective third party
review would have been unlikely.

          So in the Green Run it seems that we have the value of
national security seems to have trumped our other ethical
concerns.  In addition, if today's environmental regulations were
in place in 1949, they would have been circumvented by the
executive branch.

          We can ask whether the Green Run should have happened,
but perhaps more importantly, we should ask whether current
regulations provide sufficient protection against analogous cases
today and in the future.  Should any public notice be required of
classified projects?  Should, for example, the public be notified
of possible health risks that the classified project may pose
even if they cannot be told about the details or about its
nature?  What kind of oversight should apply to classified
projects?  For example, should Congress review any executive
action which invokes the paramount national interest exemption?

          If the Green Run did nothing else, it raises many
interesting questions, and I hope you enjoy grappling with them.

          Thanks.

          CHAIRMAN FADEN:  Thank you, Patrick.  It was well done. 
Thank you both.

          We had a lot to read about the Green Run, and for some
of us this is relatively new territory and very interesting
reading.

          Let me ask one totally irrelevant question.  It turns
out that this is the low blower.  Okay?  So it either has to go
off or we have to deal with the noise.  Off?  The noise is too
loud?  You'd rather keep it on?  I shouldn't have asked.

          (Laughter.)

          CHAIRMAN FADEN:  Do you want to move?

          PARTICIPANT:  This is going to be one of the more
difficult decisions.

          CHAIRMAN FADEN:  Reed is not returning.  Reed is not
returning.  So why don't you go ahead and move, and, Eli, are you
very uncomfortable?

          DR. GLATSTEIN:  No.

          CHAIRMAN FADEN:  Okay.  Then let's leave it on for the
time being and see if it does inhibit discussion.  You're still
free to move because Reed is not returning.  So it's okay, and if
it gets so that we can't stand it, we'll turn it off, but I
thought this was the high blower.  It wasn't.

          Well, Patrick has left us with a series of very
challenging questions, and the floor is now open, and we can
either follow the discussion as Mark and Patrick have set it out
or ask specific questions of the memos as well.  There's a lot of
fine material that we were provided.

          I see Henry and Lois and Ruth and Phil.  Let's start
there.  Henry.

          DR. ROYAL:  I find this to be a huge, complicated area,
but there are a few points that I'd like to bring to the
Committee's attention.

          The first is that environmental regulation is
increasingly complex and controversial.  I would recommend to
Committee members a short book written by Clinton's recent
appointee to the Supreme Court, Judge Breyer, entitled, I
believe, Breaking the Vicious Cycle, and what Judge Breyer talks
about is that if our goal as a society is to protect the public's
health, that we need to take into account all of the benefits and
all of the risks of various activities, and it's best that I just
recommend the book to you.

          The reason that I brought that specific comment up was
because of the discussion about whether or not it was appropriate
that you expose 100,000 people to nine millirems.  So the
collective dose issue.

          In terms of the collective dose issue, again, what I
would reiterate is that if we have limited resources to protect
the public's health, that we have to take into account all of the
risk and make sure that we are maximally protecting the public's
health by spending what resources we have available to have the
maximum health impact.

          That's the only point I want to make at this moment.

          CHAIRMAN FADEN:  Thank you, Henry.

          Lois.

          MS. NORRIS:  This should be fairly easy to answer and
just for my information only.  Does anyone actually know whether
the Green Run achieved the hoped for results?  I mean I'm just
curious about that.

          CHAIRMAN FADEN:  The question is whether it
accomplished its mission?

          MS. NORRIS:  Yeah.

          DR. GOODMAN:  Unfortunately the reports we have talk
about the monitoring activities of the Health Instruments
Division, and they aren't from the Air Force talking about the
success or failure of the program.

          Let me just read a bit from one of the reports here. 
"Under the worst possible meteorological conditions for such a
test, the airborne instruments detected the radioactive gases at
a distance of better than 100 miles from the stack.  Under
favorable conditions, it was estimated that with the same
concentrations this distance could have been increased by up to a
factor of ten."

          Now, I have no idea what objective criteria, if any,
were placed on this test for success or failure, but that's
relevant, I think, to the question.  It's the most relevant
information I've been able to find.

          MS. NORRIS:  Thank you, and I had one more quick one.

          You mentioned that the Green Run exceeded by a factor
of 100 or something the current standards for environmental
releases.  Today's standards?

          DR. GOODMAN:  Right.

          MS. NORRIS:  Were there standards in place at that time
which have been changed since?

          DR. GOODMAN:  Yes.  One of the documents refers to a
standard which is actually lower than the current interdiction
standard for protection of vegetation, and it says the maximum I
think they call it persistent concentration or permanent
concentration on vegetation based on a rough estimate of the
thyroid dose, I think, in animals, not in people.  I'm not sure
about that latter part though.

          The report cites it, however, with a great deal of
skepticism, saying we believe the real limit is at least 12 and a
half and possibly 50 times higher than that.

          CHAIRMAN FADEN:  Right.

          DR. MACKLIN:  I want to begin by commending Patrick and
Mark for undertaking this valiant task, particularly the ethical
analysis, and let me just say I would have probably done the same
kind of thing looking at harms and benefits and trying to balance
them and making this kind of analysis.

          But I'm coming to the view that it doesn't work.  Now,
I know that part of the motivation is to compare it with or use
the methodology that is well entrenched and widely used and
accepted in biomedical experiments, and I can only say there that
I think in that well accepted realm the balancing of harms and
benefits is often a kind of a fiction for all the reasons that
you cite here, even when there is some -- I mean when you talk
about the proportionality and the disproportionality and the
balancing.  Even when there is some way in advance, some
reasonable way of quantifying or predicting what the harms are in
biomedical research and there is some certainly imperfect, but
some ability to predict what the likely or hoped for benefits
are, even then, I submit that when IRBs are asked to do this kind
of balancing it's largely a fiction, and the fictional part is in
implying that the weighing is something like balancing an
equation or using a pan balance scale where you can just look and
see and then, you know, calibrate it.

          As difficult as it is there, but we sort of have to
accept it, I think it's almost impossible either for intentional
releases in general or as you've described this, what was known
or could have been known about the harms or potential harms, on
the one hand, and then as you quite rightly point out, the
incommensurability of the benefits, harms to public health,
benefits, presumed or hoped for benefits to national security.

          I mean at least in the biomedical realm when we're
balancing harms and benefits, we're looking at physical harms or
physical, psychological, or social harms to individuals, and then
medical or physical benefits or at least even in normal healthy
volunteers, contributions to knowledge about physiology.

          So the incommensurability is so great, that's one of
the things that leads to my skepticism about the harm-benefit
balancing.

          I have one comment which I think I conveyed earlier,
and I'll share it with the whole Committee.  The proportionality
question as it's described on page 2 of Tab H, Part 1(a), this is
the distribution question, and as stated here, it says,
"Disproportionality in distribution results when the individual
or groups that bear the harms or risks of harm are not the group
that stands to benefit or when the entire society stands to
benefit, but only a subset bears the risk of harm."

          Now, any research that involves normal healthy
volunteers, that is, other than patients, has this feature of
disproportionality.  That is to say the people who stand to
benefit are never the subjects in the normal healthy volunteers,
and it is someone, and it's not even clear who, but someone
eventually who may stand to benefit.  So it's not as if -- and
unlike clinical research where the patients are the ones who
undergo the risks, but also may stand to undergo the benefits.

          So I think we should be careful.  I'm just saying this. 
I'm not being critical of it, but only pointing out that if the
same feature would be a feature of biomedical experiments in
which normal healthy volunteers rather than patients are used,
then that I think needs to be pointed out, the similarities and
differences.

          So I guess in conclusion this is really an observation,
not a question.  I apologize for going on so long.

          I think what we may have to do is undertake an analysis
of the appropriateness of the model.  That is, as I said, this is
a valiant attempt, and I would have tried to do it myself if I'd
been asked to do it or forced to do it, whichever, but in
concluding that it doesn't work --

          CHAIRMAN FADEN:  We spared you one thing.

          DR. MACKLIN:  -- I wouldn't want to conclude that
beforehand, a priori, but I think in spite of, you know, the
meaningfulness of the words as they're put down here on the piece
of paper, I don't know how anyone could reasonably go about that
balancing, and especially if we're talking about public health
versus national security with all of the unknowns that are in
there, I think the answer to that balancing will come down to an
individual's or group's predilection for placing public health as
a very high value or placing national security as a higher value
without any way of reasoned debate being able to resolve the
disagreement.

          CHAIRMAN FADEN:  Patrick, go ahead.

          DR. FITZGERALD:  Yeah, let me talk about first the
feature -- you claim that disproportionality is a feature which
is common in biomedical experiments, too.  I fully agree with
you.  I think the reason it takes on a unique aspect in
intentional releases is that there is no individual consent
involved.

          The problem of disproportionality, when you harm me to
benefit somebody else, it's not so problematic if I agree to it. 
If I say, "Yes, I will give my kidney up," it's not a problem,
but if you take my kidney without asking me, it becomes
problematic.

          So that feature, the reason it's kind of unique here, I
think, is because of the lack of individual consent.

          On the first question you were talking about whether
this model of balancing could actually work.  I'm not sure
either.  I think you're correct to say it does come down to
predilection in the end, but I should point out that this is how
agencies do it now.

          For example, the Clean Air Act.  There's a general
standard where you cannot expose an individual above a certain
level, but if it's below that level, then the DOE guidance is as
low as reasonably achievable, where "reasonably" is cashed out in
terms of trying to weigh all of these disparate and seemingly
incommensurable values.

          So if you think there should be another standard, I
think that's the significant conclusion because you would be
suggesting a new standard for the way DOE proceeds.

          DR. GOODMAN:  I just wanted to add one point on that,
and that is the question of the paramount national interest
exception to the substantive environmental regulations.  That
would seem to allow one interest to completely trump another
rather than being weighed in the balance in some way.  So I think
the question of balancing harms versus benefits is an important
issue in determining whether these exceptions are adequate to
protect -- maintain adequate safeguards for the environment and
for public health.

          CHAIRMAN FADEN:  I saw Dan wanted to say something,
and, Pat, did you want to get on this point, too?  All right.  So
we'll have Dan and Pat.

          DR. RUSSELL:  It's very interesting because while I
haven't read Judge Breyer's book, but particularly in the law,
and Ken's not here, but Pat can correct me, when people don't
have models, the balancing test is what comes in as sort of a
catch-all, and you never know.  Then the judge will say, "Well, I
applied the balancing test," and that's the application, and then
you argue to the next case.  In the absence of a model, it's the
so-called balancing test where everything gets put into the
hopper.

          DR. MACKLIN:  I think it's just as much of a fiction
there.

          DR. RUSSELL:  Legal fictions are a basic element of the
law.

          (Laughter.)

          CHAIRMAN FADEN:  Pat, you were on this point?

          Is your button on, Pat?

          MS. KING:  I understand some of Ruth's qualms about the
balancing test for some of the reasons she stated, but I would
also say that -- I won't speak for ethics -- but public policy-
makers and lawyers deal with this kind certainly all the time.  I
think that the real question here is for lack of a better model,
and it just stretches my mind beyond belief to think that we'll
come up with a better one.  That's what I'm worried about because
that's what you called for.

          It seems to me that the real issue then becomes what
your last point was, and that is:  who does the balancing and
what do they take into account and what accountability can we
expect from them?

          And we might want to focus on that.  I was sitting here
trying to think of some of the balances that have been struck
that are pretty famous.  I guess the one that's the most famous
is the Delaney clause which talks about cancer, carcinogens, and
the environment where Congress basically doesn't allow any, if I
remember the Delaney clause well.

          But the balance was struck by Congress, and so it seems
to me that one of the things that we're back to are the
traditional accountability questions in a democracy, and that is
nobody is going to be a perfect decider and nobody is going to
weigh these things perfectly well.  What we have to look at is to
see what process determines who gets to make the decision and
whether they're accountable in some more open way or at some time
to a broader group.

          I don't see any other way out, and I think that may be
critical here where you're talking about national security, where
you have to be cleverer than usual in trying to think about ways
of accountability.  There are ways that we have.  One of them,
for example, is the -- I don't know how well they work --
briefings to designated outside officials.  That is where some
Congressmen come in -- Phil is shaking his head.  I didn't say
they work.  I said Congress is where we're supposed to go for our
democracy, Phil -- but it's that sort of out has been the way we
have typically answered some of these risk balancing and benefit
balancing issues.

          CHAIRMAN FADEN:  As it happens, Phil is the next up so
he gets to talk about democracy.

          DR. RUSSELL:  The decision-making here was where the
invoked the issue of paramount national interest.  It's
fundamentally a military type decision.  It's a Commander-in-
Chief's decision.

          The military is continuously faced with incredibly
difficult decisions that trade off harm to a small minority
against the national interest, and it's usually in the matter of
the decisions come up as how many casualties do you expect to
obtain this objective.  How many body bags are balanced against
the military objective?

          And I think the classical decision in history was
Winston Churchill's facing the issue of the destruction of
Coventry in order to protect the secret of the British capability
with radar, and he sacrificed fundamentally, made the decision
personally to sacrifice thousands of civilian casualties against
what he perceived as the necessity to preserve that capability to
win the war.

          I'm sure it was very difficult, and it was probably a
decision that could only have been made by the Prime Minister
personally.  It was only appropriate that he make it.

          And so I think one of the things we have to concern
ourselves with is how high up the scale is it necessary to go to
affix the responsibility to make these kinds of decisions because
these kinds of decisions can't be put off to a second or an
independent party.  This is a fundamental -- in this case they
were trading off a measurable harm, a predictable harm to the
civilian population for a military capability to understand the
military capabilities of potential adversaries, the Soviet Union
and China.  We were very, very concerned about how much could
they make and what kind of stuff they were making and what their
potential was going to be.

          So I think we have to really understand that these
issues are incredibly difficult.  They are balanced.  You balance
a potential of national interest, even national survival, versus
some harm, and then the question is who is qualified and under
what circumstances to make such a decision and, of course, to be
accountable for it afterward in some open fashion.

          One other comment I'd like to make is that the public
comment process in the course of preparing an environmental
impact statement has an immense impact on the agencies.  Even
though the ultimate decision is the agency's alone, they don't
have to acquiesce to all of the public statements.  It does,
having been involved in more than one of these, I can assure you
that it has an immense impact, and it changes both the content,
the thinking and the outcome.

          So if it's possible to get public comment and so forth,
that's very, very highly desirable, but some of these it
apparently is going to be impossible.  Then we have to really
understand how to affix the responsibility, and I think one of
the problems with Green Run is who made the decision and in what
way was he or she accountable afterwards.

          CHAIRMAN FADEN:  Thank you, Phil.

          Eli.

          DR. GLATSTEIN:  Did I understand you right that you
don't have the full story of Green Run, that some of it is still
classified by the Air Force?

          DR. GOODMAN:  Some portions of I think two of the
relevant documents from that period remain classified.

          DR. GLATSTEIN:  Why?

          DR. GOODMAN:  We don't know what is in there.  Dan can
comment a little bit on that, but we don't have any indication
that there's a complete set of information in documents that we
haven't seen.  There's just some excerpts from these documents,
and people have said that if you saw what was in there, you'd
understand why it needs to remain secret for national security
reasons and maybe it's not particularly relevant to your work.

          I can't comment on that because I haven't seen it.

          CHAIRMAN FADEN:  Dan, just as a point of order, shall
we save the discussion until you do the whole thing on
declassification or do you want? --

          MR. GUTTMAN:  I can just put out the facts.  The facts
may be relevant.

          CHAIRMAN FADEN:  Sure.  Jay, would you mind waiting
until Dan responds on this question of classification?

          MR. GUTTMAN:  There are two things at issue.  One is
the documents and the other is the information, and we've been
told -- General Russell knows -- you can have documents that are
secret or classified, and then you can have information that
exists independently of it.

          So as Mark have said, the Department of Energy has said
that all the Green Run information that they have has been
declassified.  The information that remains classified is within
Department of Defense's purview.  It appears to be a finite --
you know, everybody know what we're talking about.  It's in this,
you know, wherever it is, and --

          (Laughter.)

          MR. GUTTMAN:  -- the question, there are two questions. 
One is can that be made public, and we've been told at least
tentatively not likely, but we're going to have to follow that
through, and the second --

          MR. GLATSTEIN:  Even though it's 45 years old?

          MR. GUTTMAN:  Well, Senator Glenn has just sent a
letter to Secretary of Defense expressing that opinion, that he
can't see anything in the 45 year old Green Run documents that
should remain secret, but let me just make the parallel point.  

          Mark was also suggesting that it's possible that we
could all, I suppose, conceive of information that's 45 years old
that maybe, you know, should be kept secret.  I can't -- I'm not
the physicist, but Mark conceives it.  It may be that those
documents have information not of interest to us, but information
that might be weapons design secret, in which case it still might
be that the information we're interested in -- General Russell's
and Phil's question of who is responsible -- might be known today
and can be obtained by interviews because some of the people who
were involved with Green Run are still around.

          So there are two separate trails.  One is the documents
and whether they are accessible, and two, whether there's
pertinent information and whether that is accessible even if not
in the documents from people who are alive.

          CHAIRMAN FADEN:  Yeah, I think the point Dan is making
is a critical one.  It was hard for me initially to understand
the distinction between the two, but now I'm finally getting it.

          The document issue, just to underscore what Dan said,
as best as we can figure it out here, we're not talking about
tons of classified documents that somebody is sitting on and
refusing to declassify.  We're talking about blacked out sections
in documents that we already have access to, and the blacked out
sections are not a lot of text.

          Okay?  But they are nevertheless blacked out.  We don't
know what's in them obviously because they're blacked out, but we
don't want to give the impression that it's, you know, 20 pages
of blacked out stuff.  It's not like that, and so far as we can
figure out, there aren't any other documents around that are
wholly classified that we have not been 

provided, which leaves us with this big, open question: are there
answers to the questions that we have in somebody's head if not
on some piece of paper and can we try to ascertain that
information through talking to people, even if we can't get that
information from a documentary record because there doesn't seem
to be one?

          Now, that still leaves open the question of what to do
with these blacked out sentences, is really what it comes down
to, in the document.

          Pat, is this on the declassification issue for the
Green Run?

          MS. KING:  I wanted to ask whether we have raised, and
if so, what objection there is either in having somebody who has
a clearance here or somebody who has a sufficiently high
clearance outside of DOD who can review the material, somebody
that DOD might trust and that we might trust --

          CHAIRMAN FADEN:  No, we -- let me just interrupt you. 
We can go look at it at any time, but we have been invited. 
Those of us who already have plans --

          MS. KING:  Then why have we not gone and looked at it?

          CHAIRMAN FADEN:  That's the issue that we have been
struggling with in line of the presentation that John Till made. 
The view was if we could get it declassified so everybody could
look at it at one time, that would be best.  It now looks like --
by the way was just turned off.

          MS. KING:  Thank God because I was just about to leave.

          CHAIRMAN FADEN:  We're trying to strike a balance. 
First it was hot.  Then Nancy protested, and we offered her
Reed's seat.  As I saw that more people were getting cold, there
were not enough seats to shift over.  We turned it off, and we'll
probably turn it on again because we'll get miserable in another
half hour.  So this is the subtext for all of our meetings. 
We'll do a guide to conference facilities.

          DR. RUSSELL:  It's called the balancing test.

          CHAIRMAN FADEN:  The balancing test, exactly right.

          MS. KING:  But now is the time.  Can we send somebody
over?  It may not be necessary to be declassified.

          CHAIRMAN FADEN:  And we have been assured by people who
have looked at it -- we don't have to take their assurances --
that were we to see the material, we would not find the answers
that we're seeking in that classified material.  We would learn
something that maybe some of us don't want to know about that,
but not the answers to the questions we're seeking.  That's what
we have been told by people who have looked at it.

          DR. GLATSTEIN:  Yeah, but the point is this whole
declassification/classification process is a means of anonymity
that essentially blocks knowledge, blocks spread of knowledge,
blocks a lot of things, protects people who make decisions, and
then they're not subject to review.

          I mean this is -- if there really is a national
security problem, it's understandable.  On the other hand, it's
very hard to conceive of this study, which is 45 years old, as
representing a national security interest today.

          CHAIRMAN FADEN:  Well, again, remember, just in
fairness to the arguments we've gotten from the Defense
Department, it's these several lines.  It's not like it's the
whole history of the Green Run that they've refused to
declassify.

          I know nothing about this world, Eli.  So I haven't a
clue about what could be 45 years old and still worthy of
classification.  People who are experts --

          DR. GLATSTEIN:  It sounds like a bureaucrat's delight.

          DR. GOODMAN:  Just to get a slightly more accurate
description, it's something like a few pages in aggregate out of
a 150-page report roughly, including over half of the first page. 
So maybe something about the purpose or some other background
material is in there that is still classified and I don't know
why.

          CHAIRMAN FADEN:  I think the issue Pat's raising is
we've been playing around with this issue now for months.  Okay. 
We had been hoping that whoever it is who makes these
determinations would reach the decision that these three pages
could be declassified.

          There is now this letter from Senator Glenn that's been
sent.  If that works and the response to Senator Glenn's letter
is, "We can now declassify these three pages," fine.

          If the answer is, "I'm sorry, Senator Glenn.  As we
told the Committee, we still believe that these three pages must
remain classified for national security purposes," is it the will
of this Committee that some subset go look at the three pages and
come back and give some sort of report about what's in them?

          DR. GLATSTEIN:  Yeah.

          CHAIRMAN FADEN:  Yes.  Fine.

          MS. KING:  You may not be able to report, but I --

          CHAIRMAN FADEN:  Only report that --

          MS. KING: -- but I do think that you need some
independent determination that it is not of value to us that
comes from this Committee.

          CHAIRMAN FADEN:  It would seem to me that it would be
with the understanding that some subset of Committee and staff
went to look at this that we would be free to report on that
point.  It is or it is no relevant.

          If we report that it's relevant, okay, it puts those of
us who go to see this in a terrible disadvantage, which was the
dilemma that was raised earlier in the course of our
deliberations.  It would also, however, give more political
leverage to the argument that it ought to be declassified, but
that doesn't necessarily follow that we'd be successful with it,
any more successful with a declassification request than
previously, but we just have to all know the dilemma on which we
are embarking if we go to look at those three pages.

          Henry.

          DR. ROYAL:  I don't see what we have to gain by waiting
to go see the document, wait another month or two to see what
happens in response to Senator Glenn's letter.  If Senator
Glenn's letter is successful in declassifying the document, then
fine.  If it's not successful, then we're going to have to send
someone two months from now, and I don't see any advantage of
waiting two months as opposed to doing it now.

          CHAIRMAN FADEN:  Phil, did you want to weigh in?

          DR. RUSSELL:  Knowing that the original intent of the
test was to develop intelligence capability, one can only assume
that the remaining classified material relates to intelligence
capability.  I could also make the assumption that given the
political liability that the Air Force is taking on by keeping
that classified, they must have a pretty darn good reason to do
so.

          CHAIRMAN FADEN:  Yeah, I'm kind of persuaded by that at
this point, too, the pressure.

          DR. RUSSELL:  So I'm quite comfortable with the idea
that we're not going to get any more information about those
issues that this Committee cares about, and it may cause some
difficult with communications if, for example, Ruth --

          DR. GLATSTEIN:  It's hard to imagine --

          DR. RUSSELL:  -- she has to state in public that she
can't talk about it because it's --

          DR. GLATSTEIN:  Well, I appreciate that, but it's hard
to believe that the technology over 45 years in that area has not
changed so dramatically that what was learned and even the
reasons it was ascertained in the first place are not irrelevant
in 1994.

          DR. RUSSELL:  Maybe.

          CHAIRMAN FADEN:  One of the problems is I feel like
such a rank amateur here.  What do I know?  I mean it's a very
awkward situation to be in, and Phil is right.  We're all in that
awkward situation, where none of us -- you know, well positioned,
but we're citizens.  We've got to make a judgment here about how
to proceed.  It affects the dynamics of the Committee, and --
maybe it should be staff?

          DR. KATZ:  The chair of the Committee or another member
of the Committee who has clearance because you're in much too
pivotal of a position.

          CHAIRMAN FADEN:  I actually am glad somebody else
raised that.  I have a similar concern about my being the person
to go see it. I  think that it puts me in more of an awkward -- I
appreciate your saying that.  I hesitated to do that because I
didn't want to suggest that somebody else be the person.

          DR. KATZ:  Who has clearance on the Committee?

          CHAIRMAN FADEN:  Does any other Committee member, Dan,
have clearance yet?

          MR. GUTTMAN:  Unless Phil has clearance, I don't know. 
You're the only one I know of.

          CHAIRMAN FADEN:  We are trying to get people, and this
has been whatever problem.  There are several staff members who
now have clearance.  Mark has clearance.  Patrick, do you have
clearance.  Mark has clearance.

          MR. GUTTMAN:  Eight or nine staff members.

          CHAIRMAN FADEN:  Eight or nine staff people, including
Mark, who has obviously been following the stuff, has clearance,
but we could either have this be a staff issue or we could push
for someone else on the Committee.

          MR. GUTTMAN:  Well, let me ask.  Is what Phil was
saying that we shouldn't?  You weren't suggesting, Phil, that we
shouldn't look at the document or were you?

          DR. RUSSELL:  I would think it would be not advisable
for Ruth to look at the documents.  If the staff plus one other
Committee member --

          DR. GLATSTEIN:  That would be fine.

          DR. RUSSELL:  -- that would suffice.

          CHAIRMAN FADEN:  Well, we can push on that matter.  I
think it's probably a good idea that Phil not be the one
Committee member who looks at the material.

          DR. MACKLIN:  I have a question, too, about this which
is not to argue that we shouldn't look at it, but I think we have
to at least be clear about what information or what kind of
information, not obviously information, what kind of information
we might find out that would bear on our work, number one.

          I mean, for example, is it going to enable us to do the
balancing a little better because now we just have -- Phil's
saying no, and I agree -- but I'm saying now we just have some
general statement like national security versus general against
public health, and I've been a little bit skeptical about this
kind of weighing.

          Is it some information about, as Eli is suggesting, the
people who made the decision, that is, where the responsibility
lies?  And if so, how is that relevant to what we're doing?

          In other words, I'm only asking if we can identify what
we don't know that we would need to know to help our work, it
would seem to me that would make it much clearer whether we ought
to go do this or not.

          CHAIRMAN FADEN:  We've got Nancy and Dan wanted to
respond.

          DR. OLEINICK:  Well, one of the concerns certainly is
was there a discussion as to the impact on the population that
was going to be potentially affected and should they be notified,
and if the discussion led to a decision not to notify the public
and to just let it happen, I think that might be rather -- you
know, that would certainly go to the issue of would it impact our
benefits and --

          DR. MACKLIN:  Well, we know that the public was not
notified.

          DR. OLEINICK:  We know that they were not notified.  We
don't know whether it was ever discussed.

          DR. MACKLIN:  Yeah, wait a minute.  We know that they
weren't notified.  So you've got two possibility.  Either nobody
even thought about discussing it, you know, which is pretty bad,
or they discussed it and decided to hell with the public.

          I mean I don't see how in either case --

          (Laughter.)

          DR. MACKLIN:  -- it's going to -- you're right if we're
fact gathering, but the question is:  how does it bear on
conclusions that we want to reach?

          Now, one of the central questions that -- I mean and
the one that Patrick identified and the one that we're certainly
concerned about -- is could this happen again.  Now, if there's
anything that we might find out by looking at these documents
that would shed any light on that question, I think it would be
significant and absolutely necessary to do it.

          But whether they discussed it or not or failed to
discuss it, either way, I mean, there was a little bit of an
omission there.

          CHAIRMAN FADEN:  Dan, did you want to?

          MR. GUTTMAN:  Well, just to comment on what Ruth -- to
a lawyer, it's sort of the relationship between the formula,
Ruth's question of, well, if we got more facts what would we
know, which is the standard law school "what would you like to
know" and you still can't figure out the answer, right?  And the
process, which is the notion of the deterrence factor in saying -
- this is the part with Phil and what Pat was saying -- that
decision-makers know that they will be obligated to tell people
these things.

          Now, your point is, well, we can draw an adverse
inference if they want to keep it secret.  We'll assume the
worst.  That's sort of the balancing there.

          CHAIRMAN FADEN:  Eli.

          DR. GLATSTEIN:  It just seems to me, however, that when
you talk about national -- I mean Mark used a great term.  He
used the term "trump," that national security trumped all other
interests, and obviously there are times when that's perhaps
true, but I hate the idea that anyone can just say "national
security over any damned issue" and trump any other cause, any
other basis for decision-making.

          DR. RUSSELL:  You're speaking to the issue of the
capacity of administration, the Commander-in-Chief, to govern and
protect the national security.  He has to have that leeway.

          CHAIRMAN FADEN:  I think the issue is not that the
Commander-in-Chief shouldn't have it.  The issue is what are the
procedural safeguards.  Was this really a decision by the
Commander-in-Chief?  We don't know that.

          DR. RUSSELL:  Well, I don't know, but I mean certain
people putting words in the Commander-in-Chief's mouth.

          (Simultaneous conversation.)

          CHAIRMAN FADEN:  I think where we're going as we go
towards this is the Committee first has to conclude can we
acknowledge or do we want to acknowledge that there might be
instances in which intentional releases that have adverse effects
or potentially adverse effects on civilian populations might be
justified on national security grounds.  If we want to
acknowledge that there might be such a case, then we would move
to the issue of what are the appropriate safeguards for assuring
that it only occurs truly in an emergency or whatever the right
national security language issue is, with the right safeguards
for the national interest, and we can have Pat and Phil and
whomever debate about whether Congress should have a role or not
have a role.

          DR. GLATSTEIN:  Yeah, I don't have any problem with the
President saying this is national security.  I have a problem
with the general saying it.

          CHAIRMAN FADEN:  So that's kind of what that issue is. 
We don't know authorized the Green Run.  Okay?  We don't have a
clear fix on that, and that is a key issue.  At least I don't
think -- is that right, Patrick and Mark?  We don't know who
authorized the Green Run.

          DR. GOODMAN:  I think that's correct.  I think it's
plausible -- we obviously don't know -- that that kind of
information might be in there, and it might even lead to us
asking the Air Force to look in a particular place, although
that's speculation.

          CHAIRMAN FADEN:  That's where I think it bears to your
question, Ruth.

          Now, whether there's the answer to that question in
this blacked out stuff, you know, we don't know, and if it turned
out that the answer was there and we still couldn't get it
declassified, we are in a funny situation at best, which is sort
of my concern.  So now we'll know there's the answer to that in
there and the people who know can't talk about it.  I mean we're
sort of stuck.

          But my guess is that there's still going to be lots of
stuff that we're not going to know even if we look at this
material, and then we should still be pursuing the avenue you
mentioned, Dan, which is trying to find out if it's possible to
get any information from people's recollections of what happened
and hopefully get that declassified, get people free to talk to
us on the record about their recollections or their knowledge of
what happened in Green Run, which is an avenue we have yet to
actively pursue.

          Duncan.

          DR. THOMAS:  Mark mentioned earlier on in his
presentation the suggestion by someone or someones that there was
some other purpose for the Green Run as well.  I'd like to know
if this is anything more than just a rumor.  Is it based on
anything?  Are you free to tell us who makes these suggestions?

          DR. GOODMAN:  Let's see.  I talked with Bob Alvarez,
who is now with the Department of Energy, and he hadn't looked at
it for some time.  He thought there might be something to do with
radiological warfare.  The General Accounting Office said they
found no evidence of that.

          I was reading a book on environmental releases at
Hanford suggesting that they were testing the option of
shortening the cooling time as a routine matter so that they
could increase plutonium production, but again, that's
speculation.  This is not a classified source.

          It's like quoting someone else and reading between the
lines.

          DR. THOMAS:  I guess my reason for raising this is I
feel pretty strongly that we don't know the purpose, and whatever
we've been told so far about it has something or other to do with
intelligence gathering, long-range detection of Soviet
activities, somehow doesn't seem to wash for me.  It just doesn't
make -- it doesn't make sense.  It's hard for me to imagine what
measurements we would have made around Hanford that would be of
any real use in detecting that at very long range distances,
anything really useful about what the Soviets were up to in terms
of measurements made outside of Soviet air space that we couldn't
have found out by some other means.

          So I feel pretty strongly that there's got to be a
hidden purpose in here someplace or other.  It may have to do
with long-range detection, indeed, but if that's the case, we
ought to be able to document that.  I don't see any way we can
find this out without actually looking at these documents.

          CHAIRMAN FADEN:  Jay, did you want to say something?

          DR. KATZ:  Yes.  As Pat mentioned and Dan mentioned,
balancing is the way of law, and balancing is problematic.  It's
problematic.  The area in which I know the most about balancing
is in family law and the best interest of the child, the doctrine
which allows the judges to balance, but it doesn't only allow
them to balance, but it gives them a tremendous amount of
discretion and a tremendous amount of authority, and one can make
and, you know, surely in the classroom one can begin to make some
inroads in the analysis of the doctrine on what aspects of the
balancing should be removed from judicial discretion, and
judicial discretion ought to be curtailed.

          So I don't think we'll be able to get away from
balancing in our work, but we don't really have necessarily to
engage in reworking the Green Run and impose our own balancing on
what transpired then, but what we might be able to do is two
things.

          One is to discuss to some extent the problematics of
balancing and the kind of balancing that generally has occurred,
and also some of the things that Ruth Macklin referred to
yesterday about what is being balanced, the kind of different
things that are being thrown into the hopper, and we might be
able to alert the reader that to the extent to which we have to
live with the dangers of balancing, that balancing can be
accomplished and done in a much more careful manner.

          But a related issue here is -- and I think we ought to
do some more thinking and work on it -- is the whole problem of
secrecy and national security because that's going to be the
recurrent issue in the years to come.

          Can we begin to, again, let policy-makers and the
public know about the problematics of invoking national security
and investing it with secrecy?  To what extent can it be limited,
particularly in non-Cold War kind of situation?  What kind of
constraints and responsibilities can we impose on our Commander-
in-Chief?

          There are some in the Environmental Protection Act, I
mean, that he has to inform Congress about exceptions.  Now, I do
not know what that means and whether that's sort of a pro forma
kind of statement, but can one think about these matters more
carefully?

          After all, in the last 15, 20 years, we've tried to get
away from the issue of secrecy.  The Freedom of Information Act,
including Secretary O'Leary's call to arms and the President's
endorsement of it.

          So I think we should say something about it, not
necessarily providing any solutions, but alerting people to the
dangers and whatever bits and pieces of recommendations that we
can make, so much the better.

          CHAIRMAN FADEN:  Yeah, I think that unfortunately we've
got a time problem.  I think that where Jay ended is about where
we need to end.  Let me say a couple of things.

          There is a proposal I'm going to bring up when we go to
do our strategy thing that would include -- and it follows a plan
we had anyway -- a major discussion of secrecy and national
security issues in December, in any event.  So we will be
revisiting the general themes about how this relates both to
intentional releases and to biomedical experiments, actually
visiting for the first time in a full-blown way.

          It would be helpful because we haven't had a chance to
go through all of this, particularly with regard to the ethical
framework for intentional releases, if we could get comments from
Committee members about whether the framework that's proposed is
more or less acceptable to run with as a structure for report
writing and for further work, as well as the specific analysis,
but that's being proposed as something for Committee endorsement.

          Maybe if we could just take a look at it at our
leisure, which is Tab -- what tab is it? -- H(1)(1) and see if
we're willing basically to endorse this as the structure or
framework for looking at intentional releases, that would be a
very helpful step.

          If everyone is all right, I'd like to declare our short
break now and make it be very short, five or ten minutes at most. 
Then we will begin with the presentation from the subcommittee
and hopefully still have an hour and a half or so for Committee
discussion of strategy, blah, blah, blah.

          (Whereupon, a short recess was taken.)

          CHAIRMAN FADEN:  Would the Committee members please
come to the table?  We're going to go hard and fast here.  We
have a lot of work to do.  Come, guys.

          We're going to begin with the subcommittee report.  So
who's doing this?

          And we should have a document in front of us.  Is that
the document that was circulated yesterday?

          MS. CHANDROS:  Yeah, there were two.

          CHAIRMAN FADEN:  There were two documents.

          MS. CHANDROS:  There should be something everyone got
this morning, an update memo, four page.

          DR. MACKLIN:  There are two documents.  Let me identify
what those are.  The first one Anna is holding up that's dated
November 8, 1994, update research proposal review project.  Sara
is going to talk about that and tell you both where we are on
getting the proposals from the agencies and some additional
points that we have to discuss about quota sampling, and after we
do that discussion, we will then turn to a coding form that has
been prepared and is undergoing constant revision even as we
speak, and I'll say a few words about that.

          But first I think Sara knows so much more about what's
happening on these points for discussion that I'm going to turn
it over to her.

          MS. CHANDROS:  Okay.  Staff has been working on
implementing the quota sampling scheme that the Advisory
Committee adopted at the last meeting.  the first thing was to
get more materials on hand to get an idea of the universe going
back from FY 1993 and put together the new table of what exactly
that universe looks like.

          If you refer in your memo on page 3 under Roman numeral
two, that's the updated matrix, what it looks like now, going
approximately FY 1990 to FY 1993, and I'll be referring to that
throughout the presentation.

          We determined the goal was to get between three and ten
studies in each category, and these categories are divided
extramural and intramural within the five agencies we're dealing
with for this project and through four biomedical categories. 
It's diagnostic, therapeutic, tracer, and the epidemiological or
experiments of opportunity.

          We found that going back to 1990 we were able to fill
many more of the cells than we were previously, but there are
still a few that are questionable, but I think we came much
closer to achieving our goal.

          I should back up and say in obtaining these materials
we went back to the agencies who for the most part were very
cooperative.  We still are waiting on DOD extramural materials. 
So the table is not yet fully complete, but we're close to it,
and so that you can see on the table the denominator in each cell
is the total number of studies available from FY '90 to FY '93.

          In cases where there were more than ten in a cell, we
randomly sampled ten.  In cases when there were less, that's
indicated, like we have eight out of eight or three out of three,
and I should also add we decided to anchor these studies in FY
1993 and then went back as far as necessary, and it seemed that
going to 1990 was an adequate sample.  We kept it within the most
recent decade in which we're currently doing research.

          The next step, once we selected a maximum of ten
studies in each category, was to go back and obtain additional
materials on each study that we can use later for the evaluation. 
That involves going to the agency for certain materials and
ultimately going to universities or other research institutions
for certain materials.

          On the intramural side, we're going to get all of the
materials from the agencies, and these include the original
research proposal or grant application submitted by the
investigator to the agency and then the protocol submitted to the
IRB at the research institution, the consent form submitted to
the IRB, the consent form as approved by the IRB, and then the
IRB's final disposition letter.

          And the in addition, since we're going back to FY '90,
we want to get any documentation that would indicate changes to
the protocol over time.  On the extramural side, we're going to
only get the grant application submitted to the agency from the
agency and all the additional materials, we're going to go to the
universities for.

          We've actually begun to receive some of these materials
on the intramural side, and we have them on hand to begin working
on the evaluation, which will be discussed in a little while.

          The requests to the universities or the other research
institutions cannot be processed until we have a complete set of
materials, until this entire table is filled out.  So we're still
waiting on that one DOD piece before we can go ahead and
synthesize our requests because those need to be very concise and
organized.  So that's the one limiting factor we're waiting for.

          There's a few issues that have come up in the meantime
that I want to present, and we can talk about them now or they
need to be addressed before we can continue.

          In the selection of a parallel sample of nonradiation
studies, they're going to look something like -- they're going to
reflect proportionally the amount of studies that we see here in
Table 2, but to some smaller proportion.  I'm sorry.  I'm not
explaining that clearly.

          For every two studies here, we want to have one or we
want to have a one-to-three ratio.  Previously we discussed one
to three.  It looks like one to two might be more reasonable
given that we have a total of approximately 180 studies that
we're dealing with.

          If you go on to page number 4, we presented a possible
scenario for this for selection of a parallel sample.

          And then another question is:  do we want the parallel
sample to reflect the total population of radiation studies or
only the ones that we sampled?  I'm not sure how we should
proceed to that.  So we need to address that issue before we go
on.

          I think that presents the overview of this side of it.

          DR. GELLER:  Also, Sara, what about the issue of
eliminating cells where there are fewer than three studies?

          MS. CHANDROS:  Thank you.

          DR. GELLER:  That's a decision that we need to make.

          MS. CHANDROS:  Right.  

          DR. GELLER:  On Table 2, there are several cells where
there are fewer than three, even going back as far as 1985 in the
case of NASA, and whether we want to eliminate those cells.

          MS. CHANDROS:  We might choose to review them in a
nongeneralizable fashion just to keep them in the study, but know
that they don't fit with the quota sampling scheme that we're
talking about, but hold onto them to give us some indication of
what some of the agencies are doing.

          That simply means that the agency doesn't do that much
research, doesn't do any research in those categories or does
very limited numbers, but we need to figure out how to take that
into account.

          DR. MACKLIN:  Yes, because it raises completely
different issues.

          CHAIRMAN FADEN:  The floor is open for discussion of
the sampling, and then Ruth will present the evaluation issues
and we'll talk about those separately.  So this is comments or
reactions to what Sara's got here.

          I've been meaning to say you've done a wonderful job,
Gail and Sara, in pulling this together, and this is really
exciting.

          DR. THOMAS:  I guess we can talk details later.  It's
not -- so I don't want to dwell on these things.  Just a few
quick responses to a couple of the questions you raised.

          I would suggest that drawing the control sample you do
it in relation to the sample that you have drawn rather than the
population so that in some sense you can compare one sample to
the other most directly.  

          Again, it's not our purpose particularly to
characterize the universe of all government research,
nonradiation research.  We're not particular interested in that. 
What we are interested in doing is making comparisons.

          With regard to the small sample sizes, it's really
pretty academic what you do.  I mean there's not a lot of effort
being devoted to them anyway.  I would advocate including them,
and obviously any conclusions that one would draw about those
cells would have to be very limited anyway.

          Regarding the VA, are these totals of seven that you've
identified over the total 1990 and 1993?  I can't tell which,
whether that's because so far you've only looked in 1993.

          MS. CHANDROS:  I'm sorry.  Could you say it again?

          DR. THOMAS:  For VA, VA intramural, both VA, that's all
there is.

          MS. CHANDROS:  Right.

          DR. THOMAS:  There's only seven there.  Is that all
that they've done in radiation?

          CHAIRMAN FADEN:  Does that go back to 1990?

          MS. CHANDROS:  Yes, yes.  I'm sorry.  Yes.

          DR. THOMAS:  Okay.  Not much more you can do about
that.

          MS. CHANDROS:  Right.

          CHAIRMAN FADEN:  We could go back and fund some
investigators that were turned down.  These are sample size.  I
don't think it would be, but I don't think that would be very
legitimate.  So short of that, we're sort of stuck.

          Are there other suggestions for --

          MS. CHANDROS:  Well, the one other question was if
we're going to sample the parallel sample of nonradiation studies
based on the sample of radiation studies, what proportion should
we use there, one to two or one to three or something else.

          DR. THOMAS:  The resources permitting I would be more
comfortable with a larger sample just because as you start
carving it up by agency you're going to end up with some pretty
small numbers if you go one to three.

          CHAIRMAN FADEN:  Could I make a suggestion?  Given the
-- are there other comments from other members of the Committee?

          (No response.)

          CHAIRMAN FADEN:  I have this feeling, Duncan, that
there's a tremendous confidence on the part of your colleagues in
your advice to staff on these matters, and if it's all right in
the interest of Committee time, if we could deputize Duncan to
continue to work, to advise.

          (Laughter.)

          CHAIRMAN FADEN:  I mean I don't hear anybody else
jumping up and down with burning suggestions on this sampling
matter for good reason, and so it seems as if the most efficient
thing would be for the Committee to essentially rely on Duncan to
work with staff.  Whatever you all decide on these matters, I
think the rest of us will be quite satisfied -- is the correct
thing to do.

          Is that okay with everybody?

          (No response.)

          CHAIRMAN FADEN:  So now we go on to the part of this
project that involves everybody, and, Ruth, do you want to take
it from there?

          DR. MACKLIN:  Yes.  This is the coding form entitled
"Human Radiation Research Proposal Review Project Evaluation
Coding Form" that we passed out yesterday just before we left. 
This is the third version.  There will probably be more, and I
requested that you please look at this if you could overnight for
global comments, although specific comments will be welcome.

          Now, there are already proposed changes to what you're
actually seeing.  So it doesn't make very much sense to tinker
with these items right now or to view this as the final version,
but let me suggest the two main things we're interested in with
regard to the specific items, numbers one through 29, and that
is:  do any of these questions seem irrelevant or unnecessary?

          That is we don't want to gather information -- remember
this is a form that each of us will be using in reviewing the
proposals.  So we don't want to make this task more onerous than
it already is, and we certainly don't want to be checking things
off on boxes if the information is not going to be useful.

          So one thing when you look at these items, and we're
not going to do this right now, but if you could do it as soon as
possible and then convey the information to the staff, probably
to Gail, but if she's not there to Sara or to me, and we can then
eliminate with is eliminable.

          Also, if there's anything that's not on here that you
think is a question that is pertinent and important and should be
asked, we can help flesh out the As through Js or whatever, but
if there's anything missing here, we want to know that also.

          Let's give one example because Ruth Faden had one or
two suggestions for things that are on this form that are going
to be omitted, deleted because they seem absolutely unnecessary.

          Does somebody have that, remember what those are? 
Number 9.  Number 9 is on page 3, and it's about recruitment
process, and it asks about the procedures involved.

          Ruth can give her reasons for saying why this isn't
necessary, but this is an example of, yes, well, we thought of
this as having ethical issues, but how is that going to bear on
our judgment of the protocol, and the decision was it probably
won't.

          There was one more example, I think.

          DR. GELLER:  There were a couple of other examples that
involved combining questions.  The suggestion was that we combine
Questions 2 and 3, thereby eliminating three in its current form.

          DR. MACKLIN:  All right, but these are details, I mean,
just to give you an idea of what will be changed, but the kind of
thing we will seek your input as well.

          Yes, Jay.

          DR. KATZ:  In light of what Ruth Faden said, to the
extent possible, it's a long document.  If some of the questions
can be combined rather than going on for five, six pages, so much
the better, and it seems to me, you know, with respect to the
point raised by Ruth Faden about do we need anything about the
recruitment process, if one wants to at the very end, one can
sort of flag a number of things that may be omittable as
questions and just say, "If you have any comments to make about
the recruitment process, this, that, and the other thing," it
sort of flags something for the evaluator, and it may lead to his
or her making a comment, but if a number of these other items can
be flagged in that kind of a fashion, it would make the forms
less onerous.

          The only addition I would make is 29.  Is there
anything about the research -- oh, no, there are two things I
wanted to mention.  The first one is is there anything else about
the research that raises ethical concerns.  Maybe there should be
another half blank page added to it.

          (Laughter.)

          DR. KATZ:  You know, if there is anything, that's going
to be part of the meat of the inquiry.

          And finally, with respect to Item 2, and it applies
also to another, two in Item 2, it says now "yes," "no," "not
applicable."  That should be "yes," "maybe," "no," "not
applicable," because it won't really be a yes or no at times
because sometimes something is mentioned, but it's mentioned sort
of very much in passing and hopefully it will be elaborated on
with respect to 29, but I think you might want to consider having
a "maybe" item for two and 20.

          CHAIRMAN FADEN:  Well, the notion, I think, now in the
proposal is to take 20 and 21 and sort of combined it in some
way.

          DR. KATZ:  Oh, okay.

          DR. MACKLIN:  Yes.  In fact, Jay, we tried actually in
this version, I think, to account for any situation in which
these three choices, yes, no, or not applicable, do not cover all
of the options.  So you might want to say "yes, but not
adequately," or "only to a certain extent" or "poorly" and not
just "yes," "no," or "not applicable."

          And for those questions, I think there should be for
any question that admits of those additional options the comments
in the line underneath that says "comments," allows one to say,
for example, under three, "B and D are not adequately discussed."

          So that all the lettered items can be referred to under
these comments.  So we've tried to capture that.  I think we'll
try to take one more look to make sure that any time there's
something other than yes, no, or not applicable, there's a
comment line, and that's where that should go.

          DR. OLEINICK:  I have a concern with the ability to
capture information, as to whether the reviewer feels that the
study was worth doing.  You have certain questions here, for
example, number 13 that asks how accurate is the background
information and the rational.  If it's an area that I know
something about, I might be able to answer that quite directly. 
If it's in an area that I'm not familiar with, for example, if
I'm asked to review a protocol in cardiology, I may not be in a
position actually to address that question very well.

          And then the next question --

          DR. OLEINICK:  Could I just have a word on that one?

          DR. MACKLIN:  Yeah.

          DR. OLEINICK:  Would it help then to have an additional
category "unable to assess"?

          DR. MACKLIN:  I think that would be very important, but
I think we have to go one step further, which is to ask how much
do we want to be able to address the question from an ethical
point of view.  Do we want human subjects involved in this study,
if the study isn't worth doing?

          Now, presumably in the original peer review there were
reviewers who knew something about this subject and could address
it, and I think we have to just decide whether we want to ignore
that subject, figuring that it's unlikely that we're all going to
be experts to be able to evaluate that in every aspect, or we
need some more pointed questions to address it.  I mean one way
or the other.

          DR. OLEINICK:  And you're really talking about
scientific merit --

          DR. MACKLIN:  Scientific merit.

          DR. OLEINICK:  -- as opposed to number 27, which was
our attempt to get at --

          DR. MACKLIN:  Yes, I know.  There were two questions
here that asked -- well, okay.  That's sort of coming at that
question obliquely.  There was also the question of did the
investigator discuss the scope of the study.  Okay.  That's fine,
and that comes in in the proposal and in the consent form, and
again, it's all sort of dancing around the question, and we may
not want to answer that question.  We might want to say, "Look. 
We can't.  There's no way we can judge that."

          CHAIRMAN FADEN:  How about the following as a
compromise?  One suggestion would be 27 asks us to make a
judgment if each of us as the reviewer believes that the risks
are more than minimal.  Admittedly, again, you're imposing your
own sense of that.  Do you think the benefits to the subjects
outweigh the risks?  That's something that presumably in most
cases or in many cases we might feel we could do even if we were
not expert in that area.

          We might also have another item that says only for
projects that are more than minimal risk in the view of the
reviewer, just for efficiency said, we might then ask the
reviewer to make a judgment about scientific merits or how
valuable -- if it's not your area of expertise, then the
Committee could seek to have that protocol reviewed by somebody
who is for that issue.  How important or how good is this?  I
don't know what language, but something like that.

          So if it happens to be a radiation protocol that goes
to one of our radiation scientists, they might be able to render
a judgment on the scientific merit.  If it goes to one of the
rest of us or it happens to be one of the comparison projects and
is in cardiology or orthopedics or what have you, we could seek
outside consultation on that point, but only for studies where
the reviewer makes a judgment that the risk to subject is more
than minimal.

          Now, that's acknowledging that if it's worthless
research, you shouldn't even bother a human being as an ethical
matter, but as an efficiency sake, we sort of make a compromise
and say we only seek that where the risk is more than minimal.

          I don't know.  It's just a proposal.

          DR. MACKLIN:  I have forgotten right now why we
eliminated the basic risk-benefit assessment question.  That is,
the questions here only address the question of whether the risk
is greater than minimal and then, if so, is the risk associated
balanced against the potential benefit, but I thought on the
earlier version we had the fundamental question, and since most
protocols probably will be judged to be minimal risk -- they
usually are on IRBs -- then Nancy's question, is it worth doing,
is really in the IRB mode or in the way of evaluating research
answered by looking at the risk-benefit ratio.

          CHAIRMAN FADEN:  What are we going to do in those areas
where we don't have -- I mean do we want to have that expertise
sought somewhere else, particularly if it's nontherapeutic
research?  But even if it is --

          DR. MACKLIN:  Well, there are two questions, aren't
there?  One is do we need the fundamental risk-benefit question. 
Gail, do you remember what happened to that question and why we
don't have it anymore?

          DR. GELLER:  Well, are you talking about something
other than 22 and 23?  Twenty-two was definitely added after our
last conversation.

          DR. MACKLIN:  Yeah, but we're not asking for the risk. 
It belongs on the reviewer's subjective evaluation.  That is, it
really is in the last items where we're not asking descriptively
what these documents say, but we're asking the reviewer to behave
as if the reviewer were on an IRB and make a judgment about the
relationship between benefits and risks.

          Now, there are two reasons why a study may not be worth
doing, Nancy.  One may be its scientific merit can be so poor
you're not going to learn anything.  So it's got an infinite
benefit-risk ratio, in which case I mean it's really a scientific
judgment about the sloppiness of the science or the methodology,
but then the question is it worth doing is a different question. 
It's really the ethical risk-benefit ratio question, which
perhaps we ought to put back in here.

          CHAIRMAN FADEN:  Then we have to figure out some
mechanism where if part of the benefit would turn on evaluation
of the utility of the scientific information.  Those of us who
don't have the scientific expertise to render that judgment, and
we know that it's not going to be at all on this Committee for
some subset of the comparison proposals, would have to be
addressed.  We'd have to find some way to get that expertise in.

          That's why I was coming up with this compromise, but
maybe the compromise is too much of a compromise because if
you're right and most of these come out as less than minimal risk
--

          DR. MACKLIN:  If they come out as minimal risk or less,
then there's a whole dimension that's missing here.

          CHAIRMAN FADEN:  That's right.  If we do it that way,
that's correct.  How about if -- should we just struggle our way
through this, try to figure out some way rather than in full
Committee?

          DR. MACKLIN:  Yes.  Well, here was the proposal.  What
we were really hoping for were global comments, and these are
helpful in a way as global comments.  The subcommittee will be
back to work on this endlessly until it's complete, and that
should be soon because we should be receiving protocols
reasonably soon, proposals for review.

          What we are going to ask is two things.  The thing I
already asked, which is that everyone please look again at this
form and make any additions or suggestions for deletions and pass
that on to us immediately, and the second is if you were willing
to deputize, authorize the subcommittee to work out the final
form so that we can begin this process.

          I mean members of the subcommittee, raise your hand so
those who aren't on it can see to whom they're delegating this.

          (Show of hands.)

          CHAIRMAN FADEN:  It's a live subcommittee.

          DR. MACKLIN:  Yes, this is a large subcommittee.  We
meet by telephone.

          So if this Committee is willing to authorize the
subcommittee to finish up the form, then we'll have your input
following this meeting, and then we'll complete it.

          CHAIRMAN FADEN:  Is that okay with everyone?

          Good.  So what will happen is there will be a finalized
form before the next meeting, and so if you're not on the
subcommittee, you have two choices.  I mean you have the request
that Ruth has to send in your comments.  If you want to join the
subcommittee, you're welcome to do it, and we're going to get to
that in just a minute.  I mean if you really are very concerned
about how this form ends up looking, please join the subcommittee
because the decision will be made between now, and it will start
to be used hopefully before the next Committee meeting so that we
can get this done in a timely fashion.

          So it's sort of like "join us or don't complain"
basically.  That's what it comes down to, but it's a large group
already.  So it can be larger for anybody who wants to join us.

          DR. MACKLIN:  Is that it?

          CHAIRMAN FADEN:  Okay.  Thank you all very much.

          And now we go on to an extension of this discussion of
large versus small subcommittees.  There are so many things that
it would be good to do in the next hour and 15 minutes.  Let me
before I forget, Gail is going -- can you go ahead and circulate?

          One of the things we took off the agenda was a report
from the Oral History Committee.  In the interest of time,
there's a written document.  Please at your convenience, but
quickly, critically review that document and get any comments
back to Gail as quickly as possible at Advisory Committee
offices.

          Again, anyone who after reading this decides that they
would like to be very majorly involved in the oral history
project is welcome to join that subcommittee.

          DR. KATZ:  That's the oral?

          CHAIRMAN FADEN:  The oral history project.

          DR. KATZ:  It's coming out?

          CHAIRMAN FADEN:  It's coming now.  So I wanted to
announce it rather than having another piece of paper.  So please
put this away with a note to yourself that this is something that
needs comment and feedback back to the Committee, but we're not
going to discuss it now.  It's a report on where the oral history
project is going and seeks Committee input.

          But if we could please not look at it now, I mean, I
know it's a temptation, but put it away.  Rather than go through
a whole bunch of small points, just sort of working backwards
through the issue of subcommittees, I wanted to propose a
proposal for next month's meeting, which is something that I
worked on with some of the staff after the meeting yesterday, as
we were trying to figure out how to deal with this complex of
issues, and the proposal is as follows.

          The proposal is that the December meeting be given over
to these complex of large foundational framework guideline
setting issues that we have only inadequately had an opportunity
to address today, and to delay further working with particular
case studies or hearing from project subcommittee reports until
the next meeting.

          Let me tell you what the specific topics are to which
the December meeting might be devoted.  First, the issue of our
deciding what criteria we want to use for retrospective moral
judgment, essentially continuing the discussion that Ruth started
us on today.

          Second, the issue of remedies, which we started with
today, and ideally a discussion that linked the two would be what
we would be struggling for, some way of sort of putting this all
together.

          In addition, an interpretation of policies of the past,
typified by the exchange between Jay and Ruth about what are we
supposed to make out of the documents we have about consent
provisions or policies during the historical period of interest,
which will relate to issues of how we're going to understand the
retrospective moral judgment question, as well as as much as we
have available on practices during the historical period of time
of interest.

          So insofar as the oral history project has any data to
report, we would start to look at that and also what we can gain
from secondary sources, as well as the issue of national security
and secrecy, starting to take together then the questions of
ethical criteria and retrospective moral judgment, question of a
structure for remedies, putting that together with issues of
national security and secrecy, and what we can -- how we are
going to interpret the historical record with respect to
policies, which of course bears on remedies and bears on
retrospective moral judgment.

          How do we come to understand what these documents mean? 
And whatever we have available to us at this point on the subject
of practices during the historical period, which again gets to
issues both from the ethical framework point of view and the
remedies point of view.  Just what's our factual basis for
concluding what was normative practice at the time?  And then the
question of how relevant is whatever we know about what the
normative practices were for whatever position we want to take on
remedies and questions of retrospective moral judgment.

          How to structure, how to package those five important
topics during the two days is a real challenge.  I'm not sure
exactly how we're going to do it, but the proposal is that we
somehow devote the entire meeting at this pivotal time in our
deliberations to these big issues, trying to put them together
with the goal at the end of coming up with a tentative working
framework for both the question of moral judgment and ethical
standards, the question of remedies, and the relationship to
national security and secrecy.

          Now, we may decide to revise that framework as we start
to apply it to cases, but at least we are at a position now, I
hope, where we can try to come up with one, and if we cover that
we do not have consensus on certain key points as yet, we'll work
with that.  Okay.  We'll work with whatever we get.

          So that's the proposal on the table.  How does that
strike people as the agenda for December?

          Ken.

          MR. FEINBERG:  I have no problem with the agenda, but I
want to ask a question which picks up on a valuable point that
Jay made this morning, which is on the one hand, the way you lay
out the proposed agenda for December, you can't really talk about
remedies because a portion of the remedies chapter requires a
determination on the subject of things like retrospective moral
judgment.

          CHAIRMAN FADEN:  Well, we're going to try to put it
together.

          MR. FEINBERG:  Well, but when you say you're going to
try and put it together, you mean you're going to try and
circulate something in advance of the meeting?

          CHAIRMAN FADEN:  Oh, yeah.

          MR. FEINBERG:  All right.

          CHAIRMAN FADEN:  Oh, yeah.

          MR. FEINBERG:  Because you see, Jay is right.  I think
that -- and I guess I'm preaching to the choir, at least at the
chair -- but I think it would be a mistake to defer a draft
remedies guideline chapter until we debate retrospective -- I
mean it's time to crystalize.

          CHAIRMAN FADEN:  No, I think what needs to happen is
that the work that's ongoing needs to be connected, the staff
work.  In other words, the remedies group, you keep doing what
you were going to do.  Come up with more concrete proposals.

          The people working on retrospective moral judgment
papers for the Committee should continue to work on those.  Ruth
will continue hopefully to work with Allen Buchanan as some of
the staff and I have been working.

          Then maybe the real challenge for the staff is to try
to put those two together and say:  look.  Here's the
relationship, okay, between this position with respect to
retrospective moral judgment and this position with respect to
remedies.  See the links?

          That sort of thing.  Try to get it out and then lay out
for the Committee, you know, here are different packages or
different approaches we could buy into and have a debate about
those approaches.

          So it was not my intention to give the impression that
the work stop until we have this discussion, but rather that the
work continue so that the Committee can have as informed and
concrete a debate of these issues as the Committee possibly can.

          Ruth.

          DR. MACKLIN:  Following Ken's thought, I'm wondering if
there's some way to put it together in advance.  That is --

          CHAIRMAN FADEN:  Yeah.  Oh, yeah.  That's what I
proposed.

          DR. MACKLIN:  But in the following way.  If the
Remedies Subcommittee could think, as lawyers are wont to do,
hypothetically, if this determination is made about retrospective
moral judgment, what would then follow for remedies?

          So that all we'd have to do is fill in the antecedents
and the Remedies Subcommittee could begin the work of thinking
how it would fit, how the various remedies would fit against
different options.

          MR. FEINBERG:  I have no problem with that.  It would
be preferable, I think, if the various subcommittees working with
staff in the interim were to develop their own recommendations
and then the staff synthesizes --

          CHAIRMAN FADEN:  Let me propose the following.

          MR. FEINBERG:  -- before we meet.

          CHAIRMAN FADEN:  What I would like to propose is the
creation of a uber subcommittee, a super subcommittee, which is
to say take the people working on the legal stuff -- I shouldn't
say "legal" -- on the remedies stuff because we don't want it to
be fashioned that way, but the Remedies Subcommittee, and the
people who have been working on the ethics issue.  Make it one
subcommittee with the different working groups.  You should
continue to do what you planned to do, and the people working on
the retrospective moral judgment issues would continue to work on
those questions.

          The staff would try to put it together, but then it
would go back to this combined committee, subcommittee or
whatever, in advance of the whole Committee so that we could see. 
Has the stuff put this together?  You could critique it and
revise it and we'd get it better.

          So that what comes to the full Committee reflects the
combined efforts of these groups rather than keeping it separate,
letting the staff be the conduit, and hoping that it works out
okay.

          And I would also encourage other people who would like
to join that effort to join it.

          DR. MACKLIN:  Who's on the Remedies Subcommittee right
now?

          CHAIRMAN FADEN:  Duncan -- they happen to be sitting
next to each other.  I don't know if that was planned.

          DR. MACKLIN:  But I mean I don't -- there were
different ethics activities going on right now.  There is no
retrospective moral judgment subcommittee.  So far that's --

          CHAIRMAN FADEN:  No, there was an Ethics Criteria
Subcommittee under which this falls, which actually turns out to
be you and me because nobody else volunteered for it.

          DR. MACKLIN:  I was only going to say this is easily
solved.

          CHAIRMAN FADEN:  And Jay.  Did Jay volunteer for that? 
Did you volunteer?  Good.

          So it's Jay.  Jay was not at the meeting at which it
was formed.  So it's Jay, you and me.  So there's three of us. 
So there's three here.  There's three there.  I think it would be
very helpful if one or two other people would like to join either
to the these subparts or to the ethics subpart.

          Duncan had volunteered to be on the ethics subpart for
the part that dealt with intentional releases, if memory serves
me right.  So he was sort of already crossing over.

          But right now it's three people focusing on remedies
and three people focusing on ethical criteria within which
retrospective moral judgment falls, who would bear the burden of
trying to put together something for that part of it.  I think it
would be very good if maybe one or two other people could join
that.

          Ken.

          MR. FEINBERG:  On the ethical side of the super
committee --

          CHAIRMAN FADEN:  Super subcommittee.

          MR. FEINBERG:  The super subcommittee.

          Do we need additional people on the subject of
prospective guidelines to guide future research as a remedy,
which to me is a pivotal part of the remedies section which has
pervasive influence beyond radiation  That is a very important --
I don't know the first thing about it other than what I've picked
up in this Committee, which is a lot actually, but I wouldn't
venture to draft that.

          (Laughter.)

          CHAIRMAN FADEN:  I think it would be helpful.

          MS. KING:  Maybe it's because my mind at this point in
the day only works in staging.

          MR. FEINBERG:  Uh-oh.  This is body language, too, I
think.

          (Laughter.)

          MS. KING:  I think he's a great lawyer because he
understands body language.

          I think that that's a very important question that Ken
just raised.  Let me say I think that that won't be as hard as
the retrospective part.  So actually I think of this as in
stages.

          I would like December to take account of the task that
is the hardest for us, which is the looking backwards because the
case studies and everything else depends upon it, and then the
following month, Ken -- it's not that we shouldn't think about
it.

          CHAIRMAN FADEN:  That's okay.

          MS. KING:  I'm only talking about how to stage it
conceptually in my head.  

          Only because as I'm listening to the proposal, which I
think is wonderful because I'm very worried, as Ruth knows, about
the Committee getting around to deliberating and making decisions
rather than commissioning new projects and keep going to gather
more and more information.  So I'm very happy to see this shift.

          CHAIRMAN FADEN:  Right.

          MS. KING:  But if we are really to do that, then it
means that December needs to be a time for fewer presentations.

          CHAIRMAN FADEN:  That's right.

          MS. KING:  And more time for deliberation, and I think
if we get started on the hardest part we'll identify not only --

          CHAIRMAN FADEN:  My thinking was prompted from the
beginning by Jay's comment at the very start of our session that
we needed less reports and more time to talk, and that's quite
right.  So the notion would be the whole session next time
basically would be for the Committee to be debating stuff, and
with the goal of coming out with some decisions about how we're
going to operate, and if we find we can't agree in certain
pivotal areas, how we're going to proceed in the face of absence
of consensus, hoping always that we will reach consensus around
these issues.

          But that would be the goal.  Your suggestion that we
should do it in stages is okay.  Remember that we only have three
weeks to put this together.  So realistically if we could hold
off the part that is the general framework and the part that's
backward looking, that would be a big thing between now and then.

          MS. KING:  What I really think is that the sub-
subcommittees and super committee could maybe identify, as Ken
was starting to do, where we go right after December so we don't
have to wait until December to say it.

          CHAIRMAN FADEN:  That would be fine.

          MS. KING:  That's what I mean by staging, and I just
want to make that clear.

          MR. FEINBERG:  What I was going to suggest along those
lines is although December will not address prospective
guidelines, it sure would be helpful if one or two people not for
December but already were beginning to think about prospective
guidelines.

          CHAIRMAN FADEN:  We already have staff that are doing
that.

          MR. FEINBERG:  Fine.  Okay.

          CHAIRMAN FADEN:  And there is a staff project that's
ongoing which is trying to prepare for the Committee what the
current oversight, regulatory structure is and the effort with
respect to intentional releases reported on today is in that
spirit.  It's trying to say, okay, what's in place now so that we
can see whether we want to make recommendations.

          DR. MACKLIN:  I understand Ken's motivation for putting
this in the remedies category.  I mean that is why this is
something that's future looking, deterrent, but I think a crucial
piece is missing that may be provided -- it may not be -- by the
research proposal review project.

          That project is something that's going to give us the
kind of information about what, if anything, needs fixing at
least looking at those documents.  Now, there may be other things
that we're not even looking at that need fixing, but surely a
critical piece of information and what might have to go into any
such draft would be the results of the review of these proposals. 
So that's not an argument not to start thinking about it, but
it's to say that a crucial ongoing project is, it seems to me,
essential in being able to provide information for that.

          CHAIRMAN FADEN:  What we're anticipating -- by the way,
I called it a super subcommittee.  It really isn't going to be
any larger in number than the Protocol Review Subcommittee, which
has eight people on it or something like that.  So anybody -- so
it's not like more people couldn't join it.  It was just a
structure for putting those two subcommittees in a working
relationship for the purposes of producing something for the
whole Committee to consider in December, where the
interrelationships are already laid out, and the way to do it, I
think, would be for the group that's already constituted as the
remedies group to do what you were going to do anyway, but
quickly, and the group that was constituted over here, which
largely involves working with a manuscript from Allen Buchanan
that we don't have yet, would do what it was going to do quickly,
the staff producing a document that shows the connections between
the two.  I'm just repeating myself here, but so we're all clear.

          That staff document would go back to the members of
these two subcommittees for critique, would be modified, and then
all of the documents would be made available to the full
Committee.  Basically there would be an awful lot of reading for
the full Committee to do, but it wouldn't be the documents type
reading.  It would be these analytical proposals, including the
section on privacy and secrecy which Patrick has been working on. 
So there's a staff document that's being developed with Patrick
and other assistance that will be out there to push us on those
issues, that we could then all look at together, and we'd spend
the whole time in debate.

          So would that work?  I mean I don't know if it would
work.  Is it worth a try?

          DR. MACKLIN:  I'm sorry.  It's a dim memory at this
time.  Since we have all of these wonderful charts and have to
use them to justify bringing them, could we see the five elements
just even truncated, the five things on the board?

          CHAIRMAN FADEN:  That would be covered in December?

          DR. MACKLIN:  Yes, yes.  I really had a comment about
one of them, but we got off on other things, and that is the
national security.  I think you mentioned as one of the pieces
national security, and I don't feel I know enough about that.

          I mean we haven't had --

          CHAIRMAN FADEN:  Whenever we get into a discussion
these two come up.

          Is this working?  I feel like Oprah.  I'm going to
start walking up and down the aisles here.  Is it working now? 
Now that I'm all wired I want to sit down.

          The idea here is that we've got three big issues.  They
kind of relate to together.  The ethics criteria, which includes
this issue of moral judgment, retrospective moral judgment; the
remedies.  We've got to some up with some sort of structure for
remedies.

          We know that -- and when we start talking about these
issues, we butt off pretty quickly on this question of national
security and secrecy.  So we've got to start thinking anyway
about how that infiltrates.

          And then as we look at the question of the backward
looking remedies and also the question of retrospective moral
judgment, we have this issue of our understanding of what the
policies were during that period and our understanding of what
the practices were in that period.  We already know that we
haven't sort of debated as a Committee whether we all understand
the documents that have been put before us as meaning the same
thing.  So it seems as if we ought to have a discussion of that.

          The practices one is more primitive in terms of staff
work.  We don't have as much data available yet in an organized
fashion about what the practices were.  The oral history project
may have some preliminary data.  We can do some secondary source
stuff, but we can at least start to introduce it into the debate. 
So these would be the topics.

          Jay.

          DR. KATZ:  Well, we're moving now into --

          CHAIRMAN FADEN:  Is your mike on, Jay?

          DR. KATZ:  Yeah.

          -- into a wonderful direction, and I feel Pat's
feelings that the time has come for that, but you know, with
respect, for example, it's more complicated that that.  Take, for
example, with respect to retrospective moral judgments.  We also
probably under that rubric have to consider, after we discuss the
philosophical issues involved that Ruth Macklin was talking about
and Buchanan I would assume will talk about; assuming we want to
make some retrospective judgments in one form or another, what
kind of gradations are we going to introduce?

          For example, it makes a difference going back to
Auschwitz that human beings were just treated for research
purposes in a sadistic, brutal kind of fashion never before or
since recorded, theoretically in the annals of the history of
human experimentation, and making moral judgments about the
experiments themselves and a great many of them, in my view, are
not very different from some of the experiments carried out in
the civilized world both before Dachau and after Dachau and at
the time of Dachau.

          So the point I'm trying to make:  we have an awful lot
to do here, and I would suggest that for December in this short
time that we do not look for even completed kinds of draft
documents.

          CHAIRMAN FADEN:  Oh, no.

          DR. KATZ:  That, for example, we only force whoever is
writing what, as I suggested this morning after Ken was talking,
to really take certain positions and to maybe write a few
sentences or a paragraph here and there why and alternatives so
that we get sort of a coherent proposal, but in stenographic and
really outline kind of form because we can't do any more because
it has to come to us maybe a week before the meeting so that we
can really think about it.

          And there's a lot of thinking time involved here.  So I
would suggest that we do it in that kind of a fashion.  If you
want to write something more complete as a preliminary essay --

          CHAIRMAN FADEN:  I appreciate your comment, too, and
I'm sure the staff does, as well, that we would all have to
recognize that what would be coming wouldn't be a first draft of
the chapters that are going to be in the report.  We're looking
at something that basically gets the discussion going and allows
the debate to flow, and nobody should feel inhibited, that this
is, you know, their best work or a nuance to refined treatise on
the subject of either remedies or retrospective moral judgment.

          Duncan, did you want to get in on this.

          DR. THOMAS:  If you'll forgive me, a slight change of
subject.

          CHAIRMAN FADEN:  Sure.

          DR. THOMAS:  But it can be only temporary just because
I need to leave shortly.

          I agree with everything that's been said that the time
has come for us to take stock in this way and discuss some of the
big topics.  I presume that means that staff activity on the data
gathering side of things that up till now we've been doing
primarily by the case study method is not going to come to a
grinding halt.

          CHAIRMAN FADEN:  No.

          DR. THOMAS:  That probably can go without stating.

          And furthermore, it probably makes no difference if we
defer many of the case studies that we would otherwise be
considering next time.  If we do another medical experiment or
another intentional release we're not going to learn anything
fundamentally new.

          But I do want to look a little bit ahead because it
defers until January the next opportunity to do a case study, and
that's about the same time that we're going to start being
inundated with data from the oral history project and the subject
interviews and what's the third one?  The protocol review, and
we're going to have a lot to do those last four meetings.  Count
four, right?

          CHAIRMAN FADEN:  Yes.

          DR. THOMAS:  So the one thing which occurs to me that I
think we should make a conscious decision that we're going to
defer if that's what we decide.

          CHAIRMAN FADEN:  That's right.

          DR. THOMAS:  But the two kinds of case studies that we
have not yet addressed that raise a whole lot of new issues.  One
of them is the institutional case studies, and the other are the
intentional releases.

          Intentional releases are probably not such a big, new
dimension.  They're in a sense like the -- I said intentional
releases.  I meant experiments of opportunity.

          CHAIRMAN FADEN:  Right.

          DR. THOMAS:  Because they are similar to the
experiments of opportunity, and we may not learn that much new
from them, and we may decide that we don't want to pursue them in
any great depth.

          On the other hand, they do raise some new kinds of
issues, and we haven't yet made a decision about scope, how
deeply we wish to pursue these things, and staff does need some
guidance on how far to pursue that particular one.

          So I'd like to see just a little bit of discussion
about whether or not we really want to defer those two until
January.

          CHAIRMAN FADEN:  Mary Ann?

          DR. STEVENSON:  Can I add some similar concerns to
Duncan, not because I'm opposed to that first proposal, but of
the time constraints?  I mean could we compromise and maybe have
a day and a half for your proposal?  You don't think there's
enough time?

          CHAIRMAN FADEN:  I just have this feeling that it's not
going to work.  I mean my sense is that we're going to need the
whole time.

          One thought though would be a compromise, which would
be to try to accomplish something on both of those areas by memo
and through subcommittee in the interim.  In other words, if the
subcommittee in those two arenas could work towards proposals or
towards something, get it to the whole Committee, some of that
might be accomplished so that the discussion in January would be
more specific.

          My other hope is that if we reach any resolution on
these issues, these large framework, guidelines issues for the
Committee in December, that that would affect from that point on
forever, always how case studies would be written, in a way that
would advance our work.

          I mean we would have identified the arenas that we
consider to be the central ones for the work of this Committee,
and that would help structure, hopefully help structure, the case
studies as we get them from now on.

          So maybe if we have that compromise of trying to do
some things by memo and fax and E-mail on these other issues, the
two that have not -- I think you are right to point us to the
fact that these are two types that we have not considered in
collective debate at all -- and hope that the discussion would
sharpen our ability to address those two in January.  The
discussion in December would sharpen our ability to grapple with
those two and every other one after that.

          Would that be an acceptable sort of compromise?  I'm
looking at people who are concerned.

          MS. KING:  This is on this point.  Without going to
whether it's an acceptable compromise or not, one other
possibility, depending on how you actually plan the meeting in
detail --

          CHAIRMAN FADEN:  It's two days.

          MS. KING:  -- rather than how it's structured, is we're
all reading.  If we could read the case studies and set aside X
minutes for us to -- and have people who write them, you know,
here, but not present them, and we could just start to pull out
of the case studies.  I mean actually pull some things out of the
case studies that are very useful to me in thinking about some of
these questions.  That's another way of not necessarily taking
half a day, but at least it would accomplish, I think, some of
the things that you and Duncan would like to accomplish.

          CHAIRMAN FADEN:  Remember, too, that we --

          DR. STEVENSON:  I'm concerned that in hindsight we'll
discuss these in January and they'll bring up issues that we
should have been addressing in December.

          CHAIRMAN FADEN:  We'll try to work out a compromise,
but remember, too, no matter what, we have to set aside a good
chunk of time for public comment.  So when I talk about two full
days, we must set aside time for public comment.  So whatever
else happens, it's not truly two full days for these topics. 
It's two full days minus the time that we must set aside for
public comment.  I should have made that clearer.

          That's part of my concern about adding other things,
but maybe Pat's compromise of no presentations, some work in
between, and try to get that issue out.

          DR. STEVENSON:  Because I think one of the things that
was slated for December was the discussion of the children.  I
mean that's sort of included in institutional studies, which are
classically studies involving children, and I assume that those -
-

          CHAIRMAN FADEN:  My sense is though that, for example,
the subcommittee can keep on working and the staff keep on
working on those.  That's not the issue.  It's just that we won't
have any discussion.

          Dan, did you want to come in?

          MR. GUTTMAN:  What you certainly don't want is any
backsliding on the part of staff.

          (Laughter.)

          MR. GUTTMAN:  People sitting here saying they're going
to take Christmas and Thanksgiving and just go somewhere.  The
mid-road, I think, may be what Anna and Ruth are saying, which is
that the subcommittees can in essence function as the Committee
would to make sure that -- for example, in our mind internally
we've been thinking of December presentation on experiments of
opportunity, children, California's case studies; that the
relevant subcommittees can, in essence, impose a deadline so that
the subcommittees -- is that what you're saying -- get that, and
you'll know by December at the level of the subcommittee whether
that's reasonable, doable, and then the next month can be spent
changing it in relation to what --

          CHAIRMAN FADEN:  Whatever conceptual framework we come
up with.

          MR. GUTTMAN:  But it's not like we're in December and
people just say, "I'm working on" --

          DR. STEVENSON:  Well, that wasn't my concern at all.  I
mean is there a sense that the information or the issues that
might be raised from those particular studies would be important
for out discussion in December?  I mean critically important
perhaps.  That's why I think Pat's solution may be the best.

          The memos can be read.  Some sort of summary can be
read so that at least those things are included in the
discussions in the December meeting.

          MR. GUTTMAN:  That's possible.

          MS. KING:  This is kind of a debate that's kind of
crazy.  Really it's a crazy debate because what we're really
talking about in case studies is you're really talking about
practices to some extent.  I mean the way we got it there, the
policies and practice, we're making this very tight definition of
practices, but to some extent these case studies are telling us
the same kind of information, which sort of feeds into those
three.

          And I don't want to set anything into stone because I
think it's very hard to put an agenda together, but I think that
the sense is that there is some utility to case study -- at least
I share this -- to those first three topics, and the question is
how to work it in.

          It may be that the people on those subcommittees, if
there's not time, interject at appropriate times in the
discussion.  I mean there are all kinds of ways to handle this.

          CHAIRMAN FADEN:  Exactly.

          MS. KING:  But the idea is to do it all in December.

          CHAIRMAN FADEN:  What we can do is have reports on
those three topics available to the full Committee in a form
guided by the subcommittees.  Everybody will read it.  Okay? 
Whether we set aside time to discuss it or not or whatever, we
would rely on each of us to bring it up where it's relevant as
we're discussing remedies.

          Somebody would say, "You know, the UCSF case study
pointed out that this issue of where to place culpability really
needs to include the university president."  Let's say it comes
out that we would have to -- that's only --

          DR. RUSSELL:  That's a hypothetical?

          CHAIRMAN FADEN:  That's hypothetical.

          (Laughter.)

          CHAIRMAN FADEN:  That's purely hypothetical, but my
point is we could pull on those.  We should each consider
ourselves as having the responsibility of pulling not only on the
three that would have been presented in December, which will be
new reading for nonsubcommittee members, but all of the other
ones we've already had.  I mean that should all be in our head.

          That's part of the reason for having waited until now
to try this, is so that we would all have some understanding or
appreciation of what kind of was going on at the time without
necessarily having had a shared framework for imposing it.  Now
we've got this background.  Let's see if we can come up with
something like a shared framework, and as we're debating that
framework, let's all of us pull out examples from the case
studies that we've looked at already and the few that would be --
would that work?

          So it becomes each of our responsibilities to point
out, but we would have documents on those three topics available,
and we would all be expected to read it.

          DR. THOMAS:  I feel pretty comfortable with this
emerging consensus.  The briefing book is a great discipline. 
You know, it focuses staff effort on getting a commitment to get
something down on paper, and it forces us to read it, of course. 
It ought to force us to read it anyway.

          I also like the idea that we can draw upon all of that
material in the general discussion, but I, for one, find that the
general discussion of particularly these ethics criteria and some
of these other more nebulous topics kind of hard to follow after
a while.  Maybe that's just because I'm not a philosopher.

          I would still like to see one short block of time where
those people with sort of fundamental objections or major issues
to raise with regard to each of the case studies or whatever --

          CHAIRMAN FADEN:  Okay.  We can do that.

          DR. THOMAS:  I'm quite happy to dispense with the
formal presentation.  I think we learn less from the formal
presentation than from our discussion, but there needs to be a
time where those points which somehow don't quite ever come up in
the discussion of the other issues can get made.

          CHAIRMAN FADEN:  We'll try to structure some time for
that.  We'll work out something.

          DR. KATZ:  What kind of things do you have in mind?

          DR. THOMAS:  Do you mean which case studies?

          DR. KATZ:  No, I mean (inaudible) what you just
referred to.  Just the case studies or --

          DR. THOMAS:  At the moment we've only been talking
about two case studies being in the next briefing book, but there
may be maybe three if we include kids.  I don't know whether
that's ready for presentation or not.

          MS. KING:  I would say that it was very useful this
time and maybe we could do it more extensively next time if the
Committee itself would be disciplined as well, and that is the
focusing the discussion that was started this time I found very
useful.  I particularly liked the total body radiation.  Maybe
because it triggered my mind yesterday to think about some future
directions for the report.

          But I sort of really liked it very much when you gave
us a sheet and said, "Think these things."  I, for one, wouldn't
even mind if the staff got very adventuresome and said to us,
"You know, we think ultimately you may want to make
recommendations along the following lines.  Have you thought
about it?"

          I want anything that moves us to say, "Oh, that's a
terrible idea.  Throw it away," or, "that's a terrific idea. 
We'll start putting that one in our pocket."

          CHAIRMAN FADEN:  I think that's in the same spirit of
Jay's comment to the subcommittees directed to the staff, as
well.  We need to start having -- you know, it's provocative, but
it's useful, and then people should not take it as this is the
will or the word of the Committee.  This is out there.  Let's
debate it and see where we are.  You know, there should be no
more classified research.  Yes or no?  You know, that kind of
thing when we get to those sorts of issues.

          So I would concur just to get us moving so that we then
have a focus for seeing where the Committee is, you know, the
sense of the Committee is on some tough issues.

          I just got passed a note, and I brought it up last
time, which was the issue of extending the length of the
meetings.  Duncan pointed out to us that we don't have too many
more meetings left and an extraordinary amount of work to
accomplish in the course of those next few meetings.

          The response was, "Well, let's go from three to five
o'clock."  So that was an extension.

          Then yesterday was the suggestion that on the second
day we start at eight o'clock.  So that was also an extension.

          The issue emerges whether do we want to continue to a
half day on the next day.  Now, we can either not do that.  We
can not do it next time.  My own intuition is that we're going to
end up having to do it for at least the last couple of meetings
if we're going to get this.

          Not next time?  December.  All right, and it's also too
close.

          We will plan for it, okay, for January, February, and
March, and April.  Before going another half day, we'll poll
people and see how many people we would lose because I know
people have made commitments.  We will poll people and see how
many people we would have.

          Half day on either side.  How many people would we lose
on going either way, and we'll try to come up with something.  We
won't do it for December, except in December the second day we'll
start at eight and not at night and go to five.  So that we won't
tinker with December too much.  We'll only start an hour earlier
on the second day.

          And then we'll see what's happening.  We'll immediately
send out calendars looking to see how many people we would lose,
you know, which days, with an understanding that clearly the
closer we come to the end, the more important it is if you can
find another day in that month, the more likely it is that we
will be able to do the job that we would like to do, and we need
the collective time for debate.

          Yes, Ruth.

          DR. MACKLIN:  This is slightly off the topic, but it's
related.  I mean not only do we have to look at our calendars now
for those months and hold those times if they're not already
committed, because then they'll be gone.

          CHAIRMAN FADEN:  Right.

          DR. MACKLIN:  The other thing is, I mean, --

          CHAIRMAN FADEN:  Yeah, it's also a matter of the hotel. 
Can we get it, which is not trivial?

          DR. MACKLIN:  But my other point is we're setting an
agenda for December.  Then we're saying what we'll roll over into
January that we don't get to do in December.  So now I look at
this calendar and there's three more months.  I mean I find it
hard to think clearly about what to be doing in January without
somehow working backwards, too.  That is thinking of what we will
have -- I mean if what you've proposed is the product of having
worked backward, I mean, that's fine, but I mean it's as if we
know what we're going to do up to here, but --

          CHAIRMAN FADEN:  Somewhere by fax was a sort of every
month what we hoped to do.  I don't know where it is.

          DR. MACKLIN:  All right.

          CHAIRMAN FADEN:  It went out, but it may be that it
missed Ruth, and it was an attempt --

          DR. MACKLIN:  No, I'm sure it didn't miss me if it got
there, but I guess I don't see it being folded into this
discussion.

          CHAIRMAN FADEN:  Well, it changes the character of
December, bumping some stuff into January, and the issue is can
we pick up the slack, and that's why I'm proposing some extra
time, essentially to pick up some of the slack that the December
is eating up, but I think this is an inevitable high priority.

          It may be that the compromise we've discussed about
these other cases studies is sufficient so that we don't really
have to bump them over to the next month, and enough progress is
made on them.

          You know, it's not clear.  It's not clear.  We will try
another one, but I think the bigger question -- not "the bigger"
-- that's a big question, Ruth, and it relates to the question of
the priorities for the next several months, and I'll just share a
personal panic, and Dan is used to dealing with my panic attacks. 
We alternate, and that is how are we going to get this all done,
major panic.

          And one concern is remember that when we decided
originally to have all of these different experiment groups and
the experiments of opportunity, the notion was some of these
wouldn't pan out.  We wouldn't have to be writing all of them up.

          None of them are not panning out, which is to say
there's something to say about all of these.  It's very hard to
have a discussion about priorities.  What do we say about what
our priorities are?

          And rather than start that now, I was thinking that we
might also be thinking about what we see to be the areas or the
themes or the directions where this Committee can make particular
contributions, and that might guide the allocation of resources.

          I mean we've had two issues emerge this time where I
thought I heard the Committee saying, "We could really say
something here," and one was this topic of what procedures or
safeguards ought to be in place or how to address the question of
classified, secret research and secret intentional releases, as a
territory where this Committee might make some advances in the
public policy arena where there's very little public debate.

          And another was this issue of multiple -- I've
forgotten the term you used, Pat -- it was motives or purposes.

          MS. KING:  Motivation.

          CHAIRMAN FADEN:  Mixed or multiple, dual purpose or
triple purpose type work which has more similarities to stuff
that has been debated like the occupational physician or what
have you or the institution that plays two roles, but that we
might spend more time on this question than perhaps other
committees which have debated questions of research ethics have
in the past because of the particular character of our study.

          And we might think if there are any others and then say
back to staff:  push those lines of inquiry that feed into these
themes where we can make a particular contribution more than
other lines of inquiry that are on territory where other
committees and commissions have already done work.

          Does that sound like a -- am I right in identifying
those two, among others, but those two at least as to where this
Committee could make a -- I hesitate to say "unique" -- but
important contribution?

          Jay.

          DR. KATZ:  Look.  Everybody has been saying it now. 
Time is getting short, and I think what in my view I would
suggest that we don't continue this kind of discussion we've just
had in the last ten minutes today or next time; that between now
and next time you, Anna, and Dan sit down and come up with a
recommendation, your recommendations, then to be reviewed by the
Committee of the whole.  In the light of the time available, what
do you think we can do, should do, must do?  Which are possibly
expendable?  Which ones are definitely expendable?  And then we
will all react to it, but we'll start out with a document.

          And, secondly, that document should also include
whatever we select, what can we and the staff finish in the
period of time allotted to us, and that's becoming now a pressing
matter, and it's becoming to me a doubly pressing matter because
how are we going to negotiate the give and take of the draft
document, of the final draft document, because my hunch is -- I
haven't thought about it; I don't even want to think about it
because it's nightmarish -- is because there has to be all kinds
of back-and-forth between us both for purposes of clarifying the
report, for purposes of figuring out what we as individuals can
compromise on and cannot compromise on and how to handle this,
that, and the other thing.

          When is the report due, May?

          CHAIRMAN FADEN:  April 21st.

          DR. KATZ:  April 21st.  Midnight?

          (Laughter.)

          DR. KATZ:  I hate to say it because I really would like
for personal reasons to finish by April 21st, but you've got to
look --

          CHAIRMAN FADEN:  Jay.

          DR. KATZ:  -- at the problem square in the eye and say,
"Can we really do it?"

          CHAIRMAN FADEN:  Yes, and in the interim report we said
we would do our very best to bring it home by April 21st.  If it
took a couple of months more to do it --

          DR. KATZ:  But we need to decide that now.

          CHAIRMAN FADEN:  Well, I think we can take a hard look
at that in December as well.

          (Simultaneous conversation.)

          CHAIRMAN FADEN:  What we are committed to is bringing
it home as close -- you know, within shooting range of April
21st.  We in the interim report signaled, and I think we're
obligated that we're not here seeking to be continued for another
year or another six months or anything of that sort.

          We can discuss in December whether we think going
another two months makes the difference between a mediocre report
and a report we can all stand behind with greater, you know,
pride or whatever.  Those are the sorts of issues, but we must
remember in the interim report we signaled that we would not be
seeking any substantive --

          MR. GUTTMAN:  I think the word was "more than several."

          CHAIRMAN FADEN:  More than several months, was that the
--

          MS. KING:  At the risk of getting my head chewed off
forever and for always, we cannot underestimate the impact of the
past election.  My view is that you have to think no extension
because it's an uncertain shifting ground out there in terms of
money, appropriations and willingness to allow any leeway.

          Now, I don't like making those statements in public,
but it's done.

          CHAIRMAN FADEN:  You don't have a choice in this
Committee really.

          MS. KING:  But it's done, and I  think that each one of
you may want to go search your understanding of what just took
place and see if you think I'm making any sense or not.

          MR. GUTTMAN:  Can I add something?

          CHAIRMAN FADEN:  Go ahead, Dan.  Is your mike off
intentionally or unintentionally?

          (Laughter.)

          CHAIRMAN FADEN:  I just want to know which that is.

          MR. GUTTMAN:  The question, I'm not so much worried
about the many roads staff is pursuing because a lot of them have
some substance.  There are two kinds of questions.  One is that
we have fragmentary information about all of these experiments. 
We know that.  The more important question is this question of
what themes are, what does each one of you think are the one or
two or three things that are, after all the facts are looked at,
the contributions that can be made because those are the things
that -- we have more than anybody would want to read about human
experimentation for any average, you know, school child.  The
question is:  what are the themes you want to bring home through
all of those items.

          And that part relates to Pat's point.  What are the
things that most resonate with the kinds of questions that the
public is now interested in?  The thing that strikes me as most
interesting about what we've been looking at, two parts of the
spectrum, when Ruth gave her interim press conference, those of
you who saw the clips, the thing that made news was that there
were thousands of human radiation experiments, and Ruth tried to
artfully say, well, you know, that doesn't mean they're all
unethical or anything like that.  The numbers don't mean
anything.

          But ironically what we're really looking at and we
haven't really focused on is, you know, a major government
program that started in the '40s, the funding of isotope
research, and that is, in part, responsible for many of the
medical benefits that we had been saying we had to include in the
report dutifully.

          But those questions of, you know, the presence of big
government, the immense contribution that was made, which were
kind of obvious, you know, perhaps even cliched earlier are now
much more interesting thematic questions, and the same point. 
The individual rights which informed consent -- you know, the
balance of the individualism in relation to these things.

          In some respects it may be easier, I guess what I'm
saying, to write a report that's meaningful now in today's world
because the questions which might have been not asked, you know,
four months ago are now much more interesting questions about the
role of government and questions about, you know, why are we
funding all of these people.

          So what I'm saying is that what might be most helpful
from the staff's perspective is going back and looking at the
themes.

          CHAIRMAN FADEN:  I think Jay's proposal, and I think
it's the only way to do it, is for us to come up with something,
throw it out, and then the whole Committee can take it apart, and
then if it turns out that we end up with the same document or one
that's 180 degrees different, that we'll find out in the process,
but I don't know how -- Jay and Ruth.

          DR. KATZ:  Can you informally find out whether we can
get an extension or is that impossible?  Is that all in the
cards?  Is that possible?

          CHAIRMAN FADEN:  My preference has always been to just
work as fast as we can, as hard as we can, and only ask for an
extension at the last minute.

          DR. KATZ:  Yeah, but if Pat is correct that we may not
get it, I mean --

          CHAIRMAN FADEN:  It doesn't quite work that way.  I
mean there's no single person you call up and say, "Can I have
it?"

          DR. KATZ:  Okay.  It doesn't work that way.

          CHAIRMAN FADEN:  I mean it's --

          MR. GUTTMAN:  How does it work at law school?

          DR. KATZ:  We have a democratic process.  We all
decide, including the students.

          CHAIRMAN FADEN:  Nobody is going to notice us for a
while, we hope.  We want to proceed on the assumption that there
is broad spectrum interest in our doing our work well, and we
will go ahead on that assumption, and we're just going to try to
do as much as we can as quickly as we can.

          I don't know how to factor in Pat's comment.  I think
that for lots of reasons it would be good if we could finish on
April 21st.  If we can't, you know, if it some out three or four
weeks later, I don't think anybody's going to shoot us.

          MS. KING:  That's right.  I don't think it should take
a month or two.

          CHAIRMAN FADEN:  Right.  Nobody is going to say, "Okay. 
I'm sorry.  Your report wasn't out by midnight April 21st.  It
can't come out April 30th or May 15th," or something like that. 
That's not what we're talking about here.  I think we'd rather
keep it in that spirit.

          We are going to work as fast as we can, as hard as we
can to bring it home on time, and if we slip by a short period of
time, we will slip by a short period of time, but it would not be
because we haven't tried.  I don't know what else to say on that
issue.

          DR. KATZ:  Staff thinks that's another problem?

          MR. GUTTMAN:  Staff is working for nothing.

          (Laughter.)

          CHAIRMAN FADEN:  Let us do a little bit more homework,
and we can bring this back next time, as well.

          Before we conclude -- oh, Ruth, I'm sorry?

          DR. MACKLIN:  No, just what I heard you say a moment
ago was that you and the staff are going to bring to us
proposals.  I mean the most important things and the themes, et
cetera, but my question is:  how does that relate to what I
thought we must do, which is respond to our charge?

          I mean is that within the charge --

          CHAIRMAN FADEN:  Oh, sure.

          DR. MACKLIN:  -- of setting priorities?

          CHAIRMAN FADEN:  Right.

          DR. MACKLIN:  Is it going beyond the charge?  I mean --

          CHAIRMAN FADEN:  No, it would be within the charge, but
we've embarked on so many different avenues of exploring that
charge.  So the issue is what parts to bring up.  It's a priority
setting issue, sort of what parts to bring home with more detail
or more refinement or with more attention by the Committee and
the staff.  It looks like we clearly -- I mean there are so many
things that could be done under the context of this Committee's
charge, and it's very clear we can't do them all.

          It would be consistent under the charge, for example,
to render judgment about every single individual experiment if
the Committee chose to do it as an illustration, but, yeah, your
point, it has to be within the charge of the Committee.

          Anna is pointing out to me that there are reasons to
try to want to combine some of the subcommittees.  They have some
of the same people on them.  It would make it administratively
much easier.  Two in particular.  We have two groups working on
institutional case studies, UCSF and Oak Ridge.  Can we make it
one subcommittee on institutional case studies because you're
going to be dealing with the same sort of thematic issues, are
going to be the same, and you can learn back and forth.  Hey,
this worked with the UCSF one, but let's try it with the Oak
Ridge, and so on.

          So is that all right with everyone?

          And the other is the biodistribution and radioisotope
group, two groups.  If they could be made one group for purposes
of guiding staff work, that would be helpful because, again,
there are overlapping issues and questions.

          And Anna has one more proposal.  Why don't you go on
mike so we can do it?

          MS. MASTROIANNI:  The other one is the healthy adults
group and also the external radiation with patients.  Given that
TBI is so far along and we had a presentation on that, the
subcommittee could continue to do follow-up on TBI, but then they
would really turn to finishing up some of the healthy adults, and
also part of the healthy adults was done with prisoners.

          Is that okay?  Great.

          DR. MACKLIN:  So what's getting combined here?

          MS. MASTROLANNI:  The institutional case studies --

          DR. MACKLIN:  No, no, no.  Just the last ones.

          MS. MASTROLANNI:  External radiation with patients and
healthy adults.

          CHAIRMAN FADEN:  In other words, the same subcommittee
would be dealing with the issues having to do with patients and
with well persons.

          It makes for fewer phone calls.  It means that many of
you were serving on multi -- you'll be doing the same amount of
work, only it'll be in the context of fewer --

          DR. MACKLIN:  Just one other possible combining.  We've
been talking about remedies and ethics criteria.  Now, the ethics
criteria, as I see this, Lois is here.  It says "info only,"
whatever that means.

          CHAIRMAN FADEN:  She wanted to be notified of the
proceedings.

          DR. MACKLIN:  And Duncan, it says intentional releases. 
Now, does that mean he was only on this committee for the purpose
--

          CHAIRMAN FADEN:  That was his request, that he was
particularly interested in an ethical criteria with respect to
the judgments about intentional releases, but he probably could
be persuaded since it's now one committee anyway.

          DR. MACKLIN:  That's now one committee.

          CHAIRMAN FADEN:  Well, that and the remedies now are
sort of one committee with two branches, one subcommittee with
two branches.  So basically de facto Duncan ends up on it anyway.

          There are two areas that don't have subcommittees, and
we can decide either to fold them in or make them separate ones. 
One is the work that staff continues to do on national security
and secrecy, and the other is the work that staff is doing on
interpreting history, but the ethics policy history.  In a way
you could argue that just goes under the ethics criteria
committee, arguably.  I mean it's the reconstructing what the DOD
-- one of the things we'll talk about in December, reconstructing
what the DOD policies were and what the AEC policies were and
what HHS' earlier policies were.

          It hasn't formally been stuck under anything, and
obviously an awful lot of staff work under Jonathan's leadership
has been going in that direction, and then there's the
secrecy/national security stuff.

          So can I make a proposal that the policy part that
Jonathan has been leading go under the ethics/remedies
committee's purview?  Is that okay because it's clearly relevant
to both questions, ethics --

          DR. KATZ:  Could we keep the ethics in December?

          CHAIRMAN FADEN:  Right.  They're going to be connected. 
Imagine a bridge or however we put it together, however we
imagine them connected.

          And then the issue is where do we want the national
security/privacy work being done by the staff guided.  It needs
some committee anchor.  I hesitate to create another
subcommittee.

          DR. OLEINICK:  Well, rather than form a whole new
subcommittee, I was going to say it seems logical to put it with
the intentional releases.  It's been of interest to that
committee, although not solely to that committee.

          CHAIRMAN FADEN:  All right, and insofar as it spills
over to biomedical experiments, you won't take that on as well. 
I just want to make sure that major staff projects have committee
homes basically so that the committee staff know with whom
they're working.

          Does that work, Anna?

          MS. KING:  Can I suggest that you all go back and
figure it out and line up the people and see if the committees
are balanced adequately?  In your opinion, if they're not, then
you just call people up and say, "Can we shift you around?"

          CHAIRMAN FADEN:  Is that agreeable with everyone?  So
you may be asked to serve and you will agree.

          MS. KING:  You can't get blood out of a turnip, Ruth,
but you can at least call.

          (Laughter.)

          CHAIRMAN FADEN:  We're going to be very bled dry by the
time this Committee is over.  there's no question about it.

          The concern about putting it with intentional releases
is that there are a whole set of issues having to do with
classified biomedical research.  I'm not sure the fit is that
well.

          (Simultaneous conversation.)

          CHAIRMAN FADEN:  You know what.  Let me follow Pat's
suggestion.  We may want to take the secrecy thing and create
some sort of a bridge again, you know, like a bridge one, kind of
like the bridge between the remedies and ethics criteria we want. 
We may want to bridge the intentional releases with some other
group and say that's the oversight for the secrecy/national
security stuff.  Is that okay?  Because they raise issues about -
- right, exactly.

          All right.  I think we're falling apart here as a human
matter.  We have ten more minutes, so we're not officially
disbanded until Phil comes here, just so you know.

          (Whereupon, at 4:46 p.m., the meeting in the above-
entitled matter was adjourned.)