and a documentation of patient-harming frauds in medical research
Preemies gasping for breath
are denied the breathing help they need
Oxygen was the ideal scapegoat. Incriminating it exonerated the preemies' physicians from fault for the clearly iatrogenic blinding and gave them the easy defense that the disease was an unfortunate but difficult-to-avoid side-effect of premature birth. They began to describe their role as trying to steer the babies between the Scylla of eye damage from too much oxygen and the Charybdis of death from too little, as if these risks were on the same level.
The more these doctors depicted themselves as the indispensable navigators, the more they enhanced their power in the intensive care nurseries which had previously been dominated by skilled nurses who knew from their daily experience that oxygen helped the preemies. They saw these nurses as "opinionated"33 but knew that they would yield to the ex cathedra authority of a big medical study.
The physicians in charge were so eager to condemn oxygen that they radically reversed its image. Not long before, oxygen had still been necessary for survival.
For instance, grant reviewers at the National Institutes of Health had in late 1949 criticized the grant application for a study of ROP outcomes with routine versus restricted oxygen by commenting
and approved the grant only after the authors promised to maintain the babies in the low-oxygen group a healthy pink color.
Similarly, a 1952 article about Current Trends in Premature Care said about the indications for oxygen administration:
Despite the regularly excellent results from such routine oxygen administration, the physicians who no longer liked the gas decided to put it on trial. They were so convinced of its guilt that they did not even try to hide the pre-condemned status of the accused.
For instance, one of the leading ophthalmologists and trial instigators expressed at the October 1953 meeting of the American Academy of Ophthalmology and Otolaryngology what he and his colleagues wanted the trial to achieve: he expected that oxygen would be "successfully incriminated"36 -- eleven months before even the preliminary data from its alleged evaluation became available.
Once the verdict from this kangaroo-court trial was announced, the medical establishment here and abroad accepted at once the oxygen-condemning allegations and made them the basis of the damaging but still current practice of oxygen withholding.
In their rush to gore the red cloth, the judges of oxygen overlooked that the pre-arranged trial findings contradicted a large body of clinical experience that had consistently shown oxygen as beneficial. They further ignored that there were no parallels in animal research, that oxygen's innocence was proven by the complete absence of ROP during decades of its use, and that withholding life-saving oxygen in an attempt to prevent blindness makes about as much sense as not tossing a life preserver because a burr on its edge could scratch the drowning person.
To be fair, not all physicians joined the bandwagon. Dr. Silverman tells in his account of the 1953 meeting held to organize the trial that
Unfortunately, those physicians who preferred expediency and herd-following over an ethical and scientific approach formed the great majority.
They knew that brain damage is less immediately noticeable than blindness, and the record shows that such initially hidden side effects did not interest the physicians who promoted the oxygen withholding study. They omitted any provision to check in the aftermath of their hit-and-run study for the morbidity which they knew would afflict the brains they had deprived of oxygen.
They were under pressure to end the blinding epidemic which the agencies providing services to blind people had begun to perceive as an urgent national problem. This political pressure made the study promoters skip the methodical or scientific approach and cluelessly jump into action for action's sake. Here is what happened, again in Dr. Silverman's words:
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