Bogus Bioethics  

How an epidemic of baby-blinding can open your eyes to a pandemic of dangerous medical deceptions :

• rigged clinical trials,

• babies abused as guinea pigs,

• harmful intensive care nursery routines,

• phony bioethicists,

• complicit government watchdogs,

The American Eugenics Society was founded in the 1920s, and by 1931, 27 U.S. states had enacted compulsory sterilization laws against the “feeble-minded” and similar ill-defined groups, several years before Germany, as well as Switzerland, Denmark, Norway, and Sweden passed similar laws[2]. 

When Americans learned during the second world war about the mass murder of handicapped people to which forcible eugenics had led in Germany as a run-up to the Holocaust, the public call for such authoritarian measures fell out of fashion in the U.S.. 

However, doctors often tend to stick with the opinions they received during their study years.  The sterilizations continued quietly for decades in several U.S. states[3], and the only real change was that the American advocates of new eugenics programs had to switch to what some of them called “crypto-eugenics”[4] because the only feasible way to realize their ideal of “correcting nature’s mistakes” at their source was now by disguising their intentions.

However, some of the nursery doctors involved in that rigged oxygen study had initially discussed these intentions among themselves and published their discussion.  They had even exhorted their peers in writing to rid the world of that blindness-causing “defective germ plasm” by secretly killing the preemies suspected of carrying it. 

In May, 1949, a speaker in the discussion after the lead article in one of the American Medical Association’s flagship journals advised its readers in print against preserving the preemies at risk for ROP because they were “defective persons”.  He also proposed to ascribe their proposed deaths to “fate”, with the quote marks around that word already then suggesting the deadly deception these crypto-eugenic opinion leaders had in mind to make their eugenics-inspired solution a part of the medical doctrine[5].

The most effective means of preserving the weakest babies was and is to give them supplementary oxygen which had by then a solid and decades-long track record for saving their lives.  Accordingly, some nursery doctors launched a smear campaign against that breathing help to brand it as an “undeserved subsidy” that kept the so indulged babies from having to “fight their own struggle for oxygenation”[6].  

Those terms were recycled from the speeches of the eugenics movement which had opposed all social programs of aid to the poor as damaging distortions of natural selection.  They functioned as code words and resonated enough among conservative doctors to make a study of oxygen withholding palatable to them, despite its obvious risks to the weakest preemies.    

Although the study designers tried by now to hide their earlier stated scheme of killing the babies at risk for the blinding, their fraud is and was obvious from the details of their reported study protocol.  To prevent the survival of those unworthy “defectives”, they decided to withhold all breathing help for the first two days from all preemies born in the 18 study hospitals.  

During this most critical time of greatest need for immediate breathing help, 45% of those born there died in those first two days[7], compared with, for instance, 32% in their entire first month the year before the trial in one of those study hospitals[8].  

Only after so weeding out the weakest preemies with the most vulnerable lungs, who also happen to be those with the most vulnerable eyes, did these doctors enroll the survivors in the study.  Not including these pre-enrollment deaths blatantly biased their sample, but this heavy thumb on the risk-weighing scale enabled them to announce their knowingly false and fatal message that oxygen withholding had reduced the incidence of blinding without affecting the mortality rate. 

The physicians behind this deception were pillars of the pediatric and ophthalmological professions, and they jointly proclaimed their badly doctored trial result with great authority and pomp as a consensus of the most qualified top experts.  They did not mention that they had loaded the dice in their effort to end the surge of blind children that was by then overwhelming many schools in the U.S..  Instead, they slipped their crypto-eugenic euthanasia program for the early elimination of potential defectives into the neonatologist doctrine  under the guise of an allegedly risk-free prevention against the then still new but suddenly most common form of childhood blindness.

The resulting mad rush to oxygen withholding almost instantly ended the ROP epidemic because the babies who might have become blind died instead, plus many others. 

During the first decade or so after that bogus study, misled neonatologists around the world applied its oxygen withholding recommendation so strictly that in the U.S. alone, an estimated 16,000 extra babies per year appear to have died from the oxygen restrictions.  This mass infanticide ended an ROP epidemic which until then had affected there about 2,000 children per year and totally blinded up to about a thousand of them.  

However, no one counted these early deaths from that first crest of the oxygen withholding wave until many years later, and the much touted total victory over ROP helped to convince the U.S. Congress to greatly expand government funding for medical research. 

In the early 1970s, two researchers in England and Wales computed, by different methods than the above estimate for the U.S. but with remarkably similar results, that the oxygen withholding had caused in their country about 16 deaths for every case of blindness prevented[9]. 

There were also reports of a rise in cerebral palsy, spastic diplegia, and other forms of permanent damage to the surviving babies’ oxygen-starved brains.  When the magnitude of that carnage and the brain injuries became clear, and the 1960s culture in America led to generally more relaxed attitudes, the nursery doctors there tacitly relaxed the oxygen rationing rules a little in the mid to late 1960s, and some more of the smaller preemies began again to survive. 

Despite repeated attempts to replicate the results of that initial oxygen-blaming study, there is no evidence whatsoever for any link between oxygen administration and blinding.  However, the American Academy of Pediatrics never repudiated the original fraud-based doctrine.  Its members still restrict the flow of the life-saving gas to many preemies, and the result of their faucet-throttling is still often fatal.  

For instance, like the earlier attempts to replicate the findings of the big Cooperative Study, a trial held in Florida and published in 1987 showed again no link between oxygen and incidence or severity of ROP[10].  However, its authors reported eight percent more deaths in the group with the then recommended and tightly monitored oxygen levels than in the group with the theoretically same but less stringently enforced rationing.  Observations like this one should have led all well-meaning nursery doctors to reexamine the fatal risks of oxygen withholding, because the probability that this mortality increase might be related to the tighter monitoring was computed as 94%.  

Unfortunately, this is not enough of a danger signal for medically educated minds since their arbitrary convention considers a correlation as significant only if that probability reaches 95% or more.   Common sense and basic safety rules would mandate the removal of any avoidable risk that is even weakly associated with death or other harm, but this medical inability or unwillingness of judging safety risks to patients allows the oxygen rationing to continue.

Meanwhile, respected neonatologists admit in their meetings that the oxygen-blinding theory is unsupported and meaningless since no one can measure or control the independent oxygen concentrations in the retinal vessels where alone they would matter in that theory[11].  However, oxygen management is by now so deeply rooted at the core of intensive care nursery routines that it accounts for about a third of the billings from these usually most profitable departments of their hospitals, so it continues despite the harm it causes to the babies, and despite its total practical as well as theoretical futility. 

Moreover, some recently published studies of baby-blinding and oxygen appear now to signal a move back towards re-tightening the oxygen supplementation.  This trend is again in tune with the current pendulum swing back towards less permissiveness in the American cultural sphere, but it is unrelated to any scientific evidence, and again without any compassion for the preemies’ often desperate struggle to catch their breath. 

For instance, a study published in the February, 2003, issue of Pediatrics reported on its stricter enforcement of oxygen withholding parameters from 1998 on.   Unlike most other oxygen withholding studies, this one found a rise in the survival rate of the preemies, but that rate rose very slowly during the first two years and only then jumped up suddenly.  Similarly, its authors also described a striking decrease in severe ROP among the smallest preemies, but again only for the last two years.  During the first two years of the oxygen tightening,  the blinding rate remained almost the same as before.  

This delay before the major increase in the survival rate and the decrease in ROP suggests that both were likely to be related not to the oxygen policies but rather to some other change(s) in that nursery. 

One such change could well have been the switch to better monitoring equipment during the study, though not, as the authors propose, by making compliance with the oxygen restrictions easier.  The benefit from the better monitoring equipment may more probably have come from disturbing the babies less often with ear-piercing alarms. 

The trial policy was to not turn off the monitor alarms after increasing the oxygen flow until the baby’s blood gas levels returned to the preset range. This policy ensured that the affected babies as well as all their nursery neighbors were often exposed to long bouts of shrieking noise levels even higher than the already dangerous ones that are unfortunately common in other intensive care nurseries.  If the new monitors produced less false alarms, as the authors say they did, then the preemies were able to get more rest and even some fortifying sleep which a loud environment denies them. 

Despite the nursery doctors' manifest disdain for such gentle considerations, peace and quiet and rest are essential for all healing and restoration.  This effect alone could easily have accounted for the babies’ better survival, and also for their apparently greater resistance to the retinal damage from ROP.

Despite the better fit of this common sense alternate explanation with the observed delay in the improvements, and despite that delay, the authors described the ROP decrease as consistent after the policy change.  Moreover, in their abstract, which is all most busy readers see, they attributed it entirely to the rationing.  

The authors admitted that they could not rule out several confounding factors in their before-and-after comparison.  However, they did not examine the most obvious of those factors, and such generic warnings are as much of a ritual as the mandatory recommendation for further research at the end of a clinical paper.  Reports like this one create therefore again an unwarranted impression of progress against ROP with no penalties in the death rate, and they are therefore likely to lead back to tighter oxygen rationing in many nurseries.

Indeed, this just in: an Associated Press article by Lauran Neergaard reported on January 28, 2006, that one of that ROP study's authors, Dr. Kenneth Wright from the Cedars-Sinai Medical Center in Los Angeles, "is discussing a multi-hospital study with the National Institutes of Health to prove his findings".  Another researcher, Dr. John Penn at Vanderbilt University in Nashville, "says Wright's work supports his own research that keeping oxygen levels stable seems vital".  

Of course, this stated intention and collegial support for the desired outcome, as well as the profession's need to at long last justify its long-standing and nursery-dominating but pathetically flimsy oxygen withholding doctrine, preordain the results of that new proposed trial.  It is therefore now only a matter of time until most hospitals will again return to "maintaining the babies' oxygen levels at a constant but slightly lower level than usual", and until the wave of preemie suffocations hits another crest.

Like the initial rigged oxygen-blaming study, this more recent nod towards reducing the breathing help contradicts a large body of accumulated clinical experience about the brain’s continuous need for ample oxygen and the bad consequences of depriving it even briefly.  This mountain of experience strongly suggests that providing only minimal amounts of the life-saving gas to preemies in their hours of greatest need is likely to harm the most vulnerable among them, and to again greatly increase their risks of cerebral palsy, spastic diplegia, and other brain damage as well as death.  

But well-meaning nursery doctors conned by their concocted doctrine believe they do the babies a favor when they choke the flow of the life-saving gas.  For all anyone knows, the recent rise in the U.S. infant mortality rate may well be connected with that recent trend towards tighter throttling.

B: Blinding babies with nursery lights

All this harmful oxygen-management is for naught.   These high risks and costs and efforts provide no benefit at all against the blinding because they do not address its real and well documented cause.  Many solid scientific facts about light damage to eyes compel the conclusion that the obvious cause of ROP is the excessively bright fluorescent lighting which the American Academy of Pediatrics specifies for intensive care nurseries and which has an extra-strong output precisely in the most retina-damaging wavelength.  This is the same lighting which is used in slightly increased strength for the treatment of bilirubin and there requires mandatory eye patching  because it would otherwise quickly destroy the retinae of the babies exposed to it even briefly.  

Those typical nursery lamps irradiate the unprotected and still developing retinae of the preemies in just a few minutes with the dose of blue-light damage that the U.S. Occupational Safety Guidelines have set as the danger limit for adult workers that should not be exceeded over an eight-hour shift[12].  Neonatologists claim they try to recreate the environment of the womb where the preemies should normally have stayed, but they seem to forget that wombs are dark and protect those babies’ still unready eyes from light. 

All living tissues are at their most vulnerable stage during their formation when their cells are still migrating and differentiating, like those in the retinae of preemies.  And preemie eyes have none of the defenses against excess light that normally protect older people.  

Preemies can’t turn their head away from the ceiling lights or even from the sunshine that is sometimes carelessly allowed to reach their isolettes and even their eyes.  In Antiquity, it was considered among the most cruel punishments to make a condemned criminal stare into the sun, but modern preemies are often left exposed to the same destructive treatment out of blinding ignorance and neglect.

Preemies also stare a lot with their eyes and pupils wide open.  Even when they close their eyes, their translucent eyelids and still mostly unpigmented iris let through most of the radiation.  Also, their lens has not yet begun the varnish-like yellowing which protects adults from the most dangerous blue and violet wavelengths. 

To make things worse, preemies are exposed to many powerful sensitizers, such as medications and even high concentrations of oxygen which do no harm by themselves but can enhance the free-radical damage caused by irradiation.  They are also still deficient in many of the minerals and vitamins which might protect them at least partially against those free-radical reactions or help their damaged cells to begin their self-repair.  

The epidemiological evidence against the fluorescent lamps is also undeniable.  There was a precise parallel between their introduction in the U.S. and the sudden outbreak of the ROP epidemic there.  That same parallel happened again in the late 1940s and early 1950s across Europe and in many other industrialized countries as these lamps became available there after the war and the babies in their nurseries suddenly began to get ROP. 

Electron microscopie tells the same story.  It shows that under high magnification,  ROP-damaged retinae look exactly like retinae damaged by light.  In addition, countless experiments on animals from mice to monkeys and more have documented that precisely those wavelengths of light that radiate with the highest energy spikes in the spectrum of the Academy-specified fluorescent nursery lamps are also the most dangerous ones that can damage unprotected retinae most quickly. 

No one has ever disproved any of the evidence against bright fluorescent light.  To the contrary, even American nursery doctors know that their “bilirubin lights”, which they use as a treatment for preemies with jaundice, can harm immature eyes.   For instance, in 1970 a group of newborn piglets, chosen for the developmental and pigmentation similarity of their eyes with those of preemies, suffered marked retinal damage under those lights.  One of them became totally blind the next day after less than 12 hours of exposure, despite its heavy eyelids and thick eyelashes, and despite the unusually short latency time between the irradiation and its noticeable effects. 

These bilirubin phototherapy lamps are fluorescent lamps that shine only about three to five times brighter than the fluorescent ceiling lights in a typical nursery, and the intensive care nursery protocols mandate routine eye patching for the preemies exposed to them because of the eye damage they are known to cause.  

However, most American nursery doctors flatly deny that the almost as strong fluorescent ceiling lights could harm any baby, as if they had never heard of safety margins in the dosage of such powerful treatments.  For comparison, Occupational Safety Guidelines usually set exposure limits to toxic agents at about one per cent of the level that causes in test animals any discernible damage.

The nursery doctors continue this denial even after a trial on human babies found that shading their isolettes resulted in much less damage to those babies' eyes:

In late 1982, doctors in two Washington D.C. nurseries placed gray filters over the transparent incubators of the preemies and then compared the incidence of ROP before and after this partial light reduction.  Their shading produced the most dramatic reduction in both incidence and severity that any of the non-rigged approaches to ROP had ever shown.  For the group of babies with the highest risk of ROP, there was only one chance in a hundred that the eye damage might be a random coincidence and had nothing to do with the light exposure.  For all the babies in all the groups together, that chance was given as almost one in twenty[13].

Unfortunately, for some of the heavier subgroups the correlation fell slightly short of that magical 95% probability which doctors are taught to view as the so-called statistical significance level to be met when evaluating the efficacy of a treatment.  

And the study authors had called the shading a treatment instead of what it really was: a reduction in dosage of the almost bilirubin-strength irradiation treatment they had been administering indiscriminately to all babies under the ceiling lights.  This semantic confusion prevented the authors and their critics from realizing that the safety of the treatment with light, not the efficacy of its withdrawal, was the real issue.  

In safety assessments, one does not wait for harmful effects to reach the level of "statistical significance" to recognize them as a problem, and safety professionals take even a weak association with harm as a danger signal.  No caring parents would ever accept those lamps as safe for their baby if they knew there were 19 chances out of 20 that they could damage her or his eyes. 

However, their baby’s doctors dismiss that danger because from their inverted perspective they fail to see such a risk as significant.  They still match the description Molière gave, 333 years ago this February 10, for a typical doctor of his time:

"He's a doctor through and through, a man with more faith in his rules than anything capable of mathematical proof.  He would think it a crime even to question them.  Medicine has no obscurities for him, no doubts, no difficulties.  Full of headlong prejudice, unshakeable self-confidence, (...) he goes on his way purging and bleeding at random and hesitates at nothing.  It's no good bearing him ill will for the harm he does you -- he'll send you into the next world with the best of intentions and in killing you off do no more for you than he would do for his own wife and children or, if need arose, for himself."  (Translated by John Wood in "Molière: The Misanthrope and other plays, Penguin Books, London, 1959, page 258)
 

C: Continued cover-up

Some baby doctors went even beyond their stubborn flat-earther colleagues’ denials that fluorescent light could cause ROP.  Two pediatric retinal surgeons designed and co-directed in the mid 1990s another rigged study, this one to falsely exonerate the nursery lights from causing ROP.  This eye damage was by then again the leading cause of childhood blindness in the U.S., and it is typically treated with patch-up pediatric retinal surgery. 

Knowing that the blue-light-damage they pretended to study can accumulate to harmful levels in just a few minutes, almost as fast as eye damage from staring at the sun, the LIGHT-ROP authors covered the eyes of the babies in their allegedly protected group only after up to 24 hours.  That is 24 hours of unprotected exposure to bright and harsh wall-to-wall fluorescent light shining straight through the preemies’ still mostly transparent eyelids onto their still developing and therefore extremely vulnerable retinae. 

Predictably, and like several earlier shoddy eye-patching studies with the same crucial delay, the LIGHT-ROP study found no difference between its two groups since these had been equally over-exposed to the same multiple overdoses of irradiation during their most critical period.  This subterfuge allowed the study authors to falsely affirm the safety of the current nursery lighting practices which generate a steady stream of patients in need of pediatric retinal surgery[14].

"We believe there are compelling reasons to believe that light may play a role in exacerbating ROP."

"I have skimmed the materials you sent me on lighting and retinopathy of prematurity.  Obviously, whether a clinical trial is warranted depends on the prior evidence.  The matter would not be studied if there were absolutely no reason to suspect a connection; on the other hand, clear evidence of a connection between light and retinopathy would render a trial unethical (as well as unnecessary).  I do not know the state of the scientific evidence, nor do I have the time and expertise to review the matter.  Clearly, you have already brought the matter to the attention of the appropriate authorities."

"as efforts to support professional control by assuring the public that practitioners will use medical resources in morally responsible ways" [15].

Incredible as this may seem after all the much publicized condemnations of the Tuskegee Study and the Human Radiation Experiments, the current official U.S. "bioethics" rules still do not require the protection of research subjects from known existing dangers, but only from those dangers that are created by the research itself[16].  Never mind all the official “never again” speeches about those past medical abuses, the phony American "medical ethics" system still openly condones them.

Meanwhile, the oxygen-blaming and light-ignoring doctrine based on these frauds continues to cause daily much suffering to many children and their families around the world, and that suffering may be getting worse: 

ROPARD.org, the official medical fundraising organization for more research about “ROP And Related Diseases” attempts to confuse the issue again by falsely implying that ROP is related to other diseases, just as the original oxygen-blamers had done.  It also claims on its website that “ROPARD research has begun to identify a genetic link between premature birth and retinal detachment”[17].  There we go again.

ROPARD offers, of course, no more evidence for this alleged genetic link than there ever was for the “defective germ plasm” theory that led to the oxygen fraud, or for the healing power in even numbers of salt grains, but the history of ROP has shown that American medical and "bioethics" experts need no evidence.

American medical doctors have long held the status of a de facto sovereign profession, and the sad history of ROP confirms that some of them are allowed to fix their doctrine at will to fit their own ideological agenda, without concern for truth in their science or for their profession's patients.  ROPARD’s renewal of the ancient fictitious assertions about bad genes is now helping to set the stage for renewed crypto-eugenic efforts to weed out the weaklings who might carry those bad genes. 

The above recent study that wrongly credited tighter monitoring of the oxygen levels with reducing the incidence of severe ROP appears now to presage a return to providing again less breathing help, just in time  to coincide with the revival of the gene-blaming trend. 

That claimed genetic angle also helps to further divert attention from the medical carelessness about the fluorescent nursery lighting that actually causes ROP. 

Ironically, the U.S. “Born Alive Infants Protection Act” of 2002 and the guidelines for it issued in April, 2005, will now help to disguise the rise in mortality to be expected from the trend back toward tighter oxygen rationing.  That law was introduced and passed by opponents of abortion, and it requires even a miscarriage to be recorded as a live birth followed by a neonatal death[18].  This change in record-keeping will now artificially inflate the infant mortality rate, and it will allow the nursery doctors to ascribe the real rise in preemie deaths caused by any resurgence of the tighter oxygen rationing simply to this redefinition.

That Act mandates treatment for all “fetuses born alive” but fails to protect otherwise viable preemies from their doctors’ misled doctrine about what that treatment should be.  Such indifference to the fate of children after their birth seems typical of many anti-abortionists who care about babies only while they are still in the womb but then leave them in the purest eugenicist manner to the Darwinian struggle for survival of the fittest even though they may detest Darwin.  I have written to many self-proclaimed Pro-Life organizations and institutions to alert them to the ongoing mass asphyxiation of preemies, but none showed any interest whatsoever in ending or even probing this hidden euthanasia program against the born, or in helping to prevent their continued blinding. 

It may also be that these abortion opponents have as much faith in the infallibility of doctors as in that of their religions.  They follow venerable theological precedents when they debate fervently how many and which stem cell nuclei of unborn embryos can be transferred through the tip of a needle while doctors keep asphyxiating born preemies to save them from blindness.  They thereby revive the way medieval scholastics debated just as passionately how many angels can dance on the head of a pin while their colleagues in the Inquisition kept burning heretics to save their souls.  

The latest revision of the Catholic teachings about the afterworld now asserts that babies (and by logical extension also fetuses and embryos), who die without baptism become angels directly, instead of letting them linger in limbo as in the past.  The tip of that stem cell-sucking needle is thus making angels, and the old scholasticist debate has come full circle while the collateral killing continues.

Meanwhile, as this sorry euthanasia chapter in the history of American medicine is poised to repeat itself, another doctor involved in the study of ROP writes unctuously about the “Santayana Syndrome” which he named after the philosopher George Santayana's much quoted maxim that those who cannot remember the past are condemned to repeat it.  That doctor defines this syndrome as the persistent failure of the medical profession to learn from its long history of wrong ideas and patient-harming errors[19].  Yet, that same doctor as well as his editor and many of his colleagues refuse to acknowledge any of the glaringly wrong dogmas and patient-harming frauds in the medical approach to ROP or the continuing toll these take on premature babies and their families.   

The unwillingness of American medical officials to admit and correct these baby-harming and doctor-duping deceptions makes it important for caring neonatologists and future parents in all countries to examine the facts about ROP themselves and to discard those destructive parts of the American pediatric doctrine that are based on blatantly rigged research and a dangerously biased agenda. 

If the U.S. Government wanted to be consistent with its much professed concern for preserving the life of unborn fetuses and even unwanted frozen embryos, then it would stop its nursery doctors from  suffocating the weakest among the prematurely born.  And if it wanted to reduce its runaway health care expenditures, then it would also keep those doctors from routinely and unnecessarily inflicting life-long and very expensive cerebral palsy, spastic diplegia, and other brain damage on many of the survivors with their ill advised oxygen rationing and/or from blinding them with their nursery lamps. 

And commentators who want to reassure the public about the alleged self-correcting mechanisms in science should not limit their sampling to the visible part of the iceberg, that is, the occasional cases of frauds which happened to get exposed despite the strong stonewalling and error-preserving mechanisms in the medical doctrine.  They should also account for the many still unacknowledged and often harmful examples where this mythical self-correction plainly failed, as in the medical approach to ROP.

For more information and a detailed documentation of these frauds and abuses, go to www.retinopathyofprematurity.org 

H. Peter Aleff is an engineer who spent much of his career separating fact from fiction in technical reports.  While managing a factory that cured printing inks with ultraviolet light, he studied the U.S. Occupational Safety Guidelines for exposure to retina-damaging irradiation and discovered that the same principles applied to the fluorescent nursery lamps which had blinded his prematurely born son.  He also found that the entire official doctrine about this blinding is based on rigged research that flunks even the most basic smell tests.
 

Contact the author at retinopathyofprematurity.org
2097 Cottonwood Drive, Vineland, NJ 08361  USA
Fax 856-794-1393

© 2006 H. Peter Aleff. All rights reserved.