Human Subject Research and Medical Ethics in Colonial Southeast Asia

Project Information

COMET

Grant agreement ID: 101075877

DOI

10.3030/101075877

EC signature date 13 February 2023

Start date 1 June 2023

End date 31 May 2028

Funded under

• European Research Council (ERC)

Total cost

€ 1 500 000,00

EU contribution

€ 1 500 000,00

Coordinated by

UNIVERSITEIT LEIDEN
Netherlands

Periodic Reporting for period 1 - COMET (Human Subject Research and Medical Ethics in Colonial Southeast Asia)

Reporting period: 2023-06-01 to 2025-11-30

Summary of the context and overall objectives of the project

This research project explores the history of medical experiments conducted on people in Southeast Asia during the colonial period (1890–1962), specifically in what are now Indonesia (then the Dutch East Indies), Malaysia (British Malaya), and the Philippines (under American rule). It asks: How can the ethical practices in human subject research in colonial Southeast Asia be defined and explained?

Doctors in colonial Southeast Asia often used local people as test subjects to study diseases like leprosy and cholera. These individuals, including children, gave blood samples or received drugs with unknown side effects. Postmortems were done on the deceased, sometimes against the wishes of the family. But new and risky drugs such as Salvarsan to treat syphilis were also demanded from doctors by patients, because despite their side-effects they were more effective against the disease. This project studies the complicated relationship between dangerous experimentation and best treatment for the patient, with special attention for the ethical choices of doctors and the role of the patients.

Our team studies historical medical journals, archival sources and even novels, to better understand ethical practices in Southeast Asia. With two PhDs working on the Dutch East Indies and the American Philippines, and a postdoc specialized in British Malaya, we can reveal the scope of human subject research in the region and compare these three colonies. By understanding how ethics in medical research were shaped by colonial politics, religion, and local contexts and cultures, this project aims to provide insight into why past medical (mis)conduct occurred. In addition to studying the past, the project also examines how this history continues to affect us today.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

We have constructed a database, with all published articles in medical journals we found between ca. 1900 and 1950 that referred to research with human subjects. The database includes research that took place in the Dutch East Indies, in British Malaya and in the American Philippines. We found that thousands of people have been subjects of medical research in some way, but in very different settings and with very differing options to dissent.

The team has visited archives and libraries to study historical sources. Our analysis of these sources has shaped our choice of case studies. We have found that it is very useful to pay attention to and to compare different colonial institutions and settings: i.e. ethical choices were very much determined by sites such as the prison, army, missionary hospital, etc. We have also found that it is not impossible to take patients' voices into account

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

Our results can be important new advances in the history of medicine and (post)colonial history. Further research along the avenues we have identified will demonstrate the potential of our findings.