Early this year, a 28-year-old self-described biohacker named Aaron Traywick injected himself with an alleged herpes vaccine prepared by fellow amateur medical researchers. The injection, which was broadcast on Facebook Live, brought on a volley of criticism and ethical concerns.
Only a few months earlier, a colleague at the company Traywick founded, Ascendance Biomedical, injected himself with an alleged gene therapy for HIV.
It's unlikely either of these treatments worked, but they succeeded in proving how easy it's become for amateurs to experiment with infectious agents and other biological materials that were once restricted to trained professionals. While it's illegal to sell biohacked therapies or vaccines or to test them on human subjects, so far at least, the FDA does not explicitly forbid experimenting on yourself.
But is it ethical? I posed the question to McGill University bioethics professor Jonathan Kimmelman. He said the ethics of self-experimentation aren't clear-cut, but there's a rich history of doctors playing guinea pig in the name of science. He suggested I reread the 1986 classic Who Goes First by Lawrence Altman.
The stories there put the biohacking news into perspective. In 1955, for example, researchers Hilary Koprowski and Martin Kaplan thought they could improve on the rabies vaccine developed by Louis Pasteur, which had occasionally caused permanent brain damage, paralysis and death.
They started with a sample of live virus taken from a young girl who died of rabies. According to Altman's account, the researchers "attenuated" the virus by injecting it into chicken embryos. They let the embryos grow till they were almost hatchlings, then pulverized them in a blender and filtered it.
"From the filtered substance they made a crude experimental vaccine which contained decimated beaks, feathers and other anatomical parts," wrote Altman. This they injected into their own arms, and drew blood to show it was stimulating rabies antibodies.
Biohackers get the headlines these days with their self-experimentation, but mainstream scientists did it first.
Koprowski and a number of other researchers have said publicly that the only ethical way to test their hypotheses was to be the one to go first. Many others felt this way. In the late 19th century, Russian-born scientist Waldemar Haffkine injected himself with home-brewed vaccines for cholera and bubonic plague. English physician Almroth Wright not only injected himself with his own vaccines for typhoid and a bacterial disease called brucellosis, but also infected himself with brucellosis, discovering that he was not protected. He was sick for months.
In the late 1800s, doctors learned about the causes of food poisoning by eating contaminated cheese, milk and other food. In 1929, according to Who Goes First, a team of three doctors all consumed contaminated custard-filled cakes to investigate an outbreak of food poisoning.
Concluding that he had eaten a tainted cake, one of them was reported to exclaim from the bathroom: "This is wonderful!"
Others swallowed meat pies and sausages that had been injected with bacteria. In their quest to understand staph bacteria, doctors scratched themselves and then infected the wounds with bacteria derived from patients suffering debilitating infections.
At the beginning of the 20th century, medical sleuth Joseph Goldberger was commissioned to investigate an epidemic of a disease called pellagra, which caused skin ulcers, gastrointestinal distress and dementia. The disease was particularly rampant in prisons, orphanages and asylums, and Goldberger noticed that the doctors and nurses never came down with it.
The established wisdom was that it was infectious, but he suspected it was caused by poor diet. To test his hypothesis, he and some colleagues injected themselves with blood from pellagra patients, rubbed secretions from patients' noses and mouths on their own faces, and swallowed capsules containing urine, feces and skin taken from people suffering from the disease. He was right: The disease is now understood as a deficiency of niacin, or Vitamin B3.
As late as the 1970s, a physician nearly died from scarlet fever by injecting himself with staph bacteria taken from an infected leg that was later amputated. The experiment helped to demonstrate that staph, as well as strep, could cause the disease. A decade later, doctors connected such staph-induced cases of scarlet fever to a potentially deadly illness known as toxic shock syndrome.
Scientists have learned the hard way that vaccines or other treatments they tried on themselves still could kill others. It happened with a cholera vaccine in the 1880s and later with one of the early versions of the polio vaccine. Biohackers and traditional medical researchers both have to balance the desire to help people with the need to avoid killing anyone.
In the best instances of self-experimentation, the doctors not only survived but also learned something valuable. Biohackers might continue in this tradition, which among scientists has been replaced by more controlled experiments. But it would be a mistake to buy into the narrative that professional researchers are cowardly or stodgy, and that traditional medicine is just sitting on viable cures. Scientists have found cures for all the easy diseases and some of the hard ones. Hackers should be applauded for pitching in on the really hard ones, including herpes and HIV, so long as they don't promise any miracles.
Editorial on 06/10/2018