Meeting May 22, 1974 re Exhumation Program

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Meeting May 2 2 , 1974 9:OO am Present: Marvin Goldman, Roy Talmage, Betsy Stover, Eugene Cronkite, Robert Rowland, William W. Burr, Sidney Marks, Walter Weyzen, James Liverman the Committee to gether to elect a chairman and decide how you want the thing to go and then give you a briefing or answer questions, are a lot of ethical considerations that are relevant. You may want us to bring you up to date on those things. to get to this meeting. He expects to be back about 10:15 or 10:30. He would like to listen to Bob Rowalnd discuss this program. He is waiting to present the reasons he feels the program is appropriate. Jim asked me to read the recommendation with regard to this committee that was sent up to the Commission. executive sessions on this. last meeting these recommendations were set up. I thought I would explain the mission then maybe we should leave Jim Liverman is very anxious The Commission has held several They regard it as very important. At the They read as follows: 1. A scientific committee chosen by the Director, BER, shall review the program of exhumation of the deceased and shall advise AEC as to whether the scientific merit of the exhumation program warrants its resumption at an appropriate later date. There is a prospect q f this whole thing breaking at about the time of the International Congress meeting in July. a press release in advance or it is likely to be picked up during the meeting. It is likely to become a matter of public interest at that time. until that time. Either there will be At present the exhumation program is at a standstill Marks: That is right. The potential is 10 and ultimately we want to get to a breakdown to the status of the 10. I have some material I an pass out. Feel free to interrupt at any time. Ask any type of question. (SMarks passes out certain papers) As far as the charge goes the purpose is to evaluate the scientific merit and the material available in the exhumation program. To date only one body has been exhumed? We do have four live patients three of whom have been studied in thp last year. This is a factor also --

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REPOSITORY: OFFICE OF HUMAN RADIATION COLLECTION: PLUTONIUM INJECTION INVESTIGATION FOLDER: EXTRA COPIES

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that there are also some people on which late studies are being done. There has not been disclosure to these people. whether they will want t o continue after the disclosure is made. have some material on the diseases of the patients that are deceased. The question has been raised about the diseases in relation to the value of the scientific information. They had no knowledge about the material being given? We found that in one case there was specific discussion. Cronkite: There wasa signed note on the patient ' s chart ? Marks: Right, that was a 1947 case. I have a table that pretty well presents that in the bulk of the cases in Rochester wedon ' t know for certain -- we can infer that maybe there was but we don ' t have any basis for knowing. probably won't be going on beyond the one case that has been exhumed. If there is a matter of continuing it and somebody picks it up and finds it as a matter of public interest - they feel that if the Committee can come through witha statement, this is highly important. Jim ' s feeling is that he would fawr going ahead with it. If it isa marginal thing, ifthe information t d be gained is relatively weak then the Commission may decide to ask that the program be discontinued because of the possib le publicity later. should probably give you the definitive information on the cases. are a total of 10 cases they went after. They have the definitive permission on one and on the other nine - i n some cases there has been refusal - up to this point actually in5 cases. There are5refusals. In discussing this with Bob he said in some of the refusal cases (SMarks passes outa paper showing the breakdown) the next-of-kin have refused but these are rather frail individuals and they are expected to die within a reasonable period of time and there is a policy of going after others or going after a court order if there are no survivors.This raises So there is some doubt Are you implying that nothing was discussed with the patient ? There wasa legend th st there was no disclosure to these 18 people. We can come back to that question later. The program Ultimately it boils down t o cases and Bob Rowland

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ethical questions and I talked to the General Counsel yesterday and he said he thought this was unethical. a t Argonne accepts it. next-of-kin ifthe next-of-kin does refuse.I think it would be well t o look a t it in the light of the Commission saying that you can ' t go this far that this is unethical in any case*ere the wife o r husband has refused or look a t it the other way i f the counsel says you can go after the whole batch it would b e another list of people. I think ut lim at ely it would be well to look atit both ways. recommend that the program i s worthwhile only fora few individuals. That is the charge as I see it. the Commission to evaluate whether the scientific merit of the program i s such that the Commission should go ahead with it or,if because of the adverse publicity, recommend that the program should notbe pursued or a limited program should be followed, terms of either going all the way or not at all. Burr : But there is a middle ground. exposed i n 1944 - are they being followed as enthusiastically as this groups of persons. Marks: There were not studies done until last summer. and it is still being studied. Marks: Most of them have survived. Apparently t h e General Counsel I think it i s something you might want t o look You can ' t go after a lesser person inthe order of Could you ina few sentences restate this charge. The charge isto come up with a recommendation that will enable We have always thought i n There i s a group of persons a t Los Alamos who were occupationally They have been followed more enthusiastically. This group was lost to us fora while. Wright Langham and Hernpelmann followed that group pretty closely were known amounts of plutonium and the others were not. Of the 24 I think one died of a coronary. The advantage that these people have over that group is that these

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program when w e can get permission. Marks: I think there are about 35 autopsies. Registry and it must be good, but that is quite apart from this. Cronkite: The question of adverse publicity with respect to the exhumation is whether it is justified by scientific gains. But you are going t o get in this day and age that human beings were given what is today several times the maximum permissible body burden. There is going t o be tremendous adverse publicity. is not t o be considered by this Committee a t present. Burr: I n balancing everything, how much scientific merit to going to get the data. Secondly, if there is I think it is a matter of judgement for the Cow is sion.If it is very valuable stuff you fight them toget it. Marks: The next-of-kin were told that the original injection was an unknown mixture of isotopes and that the isotopes were given originally as an experimental tfeatment. that someone has t o go back tothe next-of-kin and tell them they were not given the whole story and that these are the facts and then at that time do you want t o re-examine their permission. permission they are not going t o give it at this time. the flak it would be really small i n comparison t o what is likely to happen in July. this group today is supposed t o be looking a the merits and demerits of any further effort at the exhumation. I wonder i f it is appropriate for a committee like this to get into this at all. If there is / scientific merit then it is the end of it, if we think there is scientific benefit then w e give it tothe headquarters people here then they have t o make the decision. We have the Transplutonium Registry which does have an autopsy It is back inthe hands of Dag Norwood. We know w e must have that We anticipate this. There will be areal storm for at least Then you decide whether you are willing to take the flak Is there really enough there or isn ' t there. The Commission has virtually decided With regard to the publicity

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Burr: I think the committee can say that there is scientific and if there are alternatives you can get it this way. I think ultimately it has t o be a decision to be made upstairs. but you can get the same information by doing so and s o The decision must be scientific merit exclusing the publithere was scientific merit -- did they decide more or a little Cronkite: To get any suitable quantitative evaluation as t o what the impace of doing this -- it is impossible. Marks: That is right - that is a political decision. The Committee then went i n t o Executive Session and appointed Betsy Stover t o act as their Chairman. Stover: I want Bob Rowland to tell what he i s planning t o do, what you expect to learn and what is the overall scientific value of it. Marks: There wasa set of recommendations that went othe Commission in dealing with this plutonium injected into people situation and one recornendation said that a scientific committee chosen by the Director of the Division of Biological and Environmental Research shall advise as to the scientific merit of it. at. You are aware. You have a sheet that someboy else made up. I have done two things.I have an exhumation program under way on the plutonium cases and I have a physical examination program under way on the plutonium cases. recommendation w e might make with respect to the exhumation program. Stover: I think we need t o know what the exhumation consists of. If we went up tothe Commission that the committee decided We are addressing t h e plutonium You have been briefed on the cases that I have been looking I assume you are not interested in the physical T think it very clearly bears on our decision as to the Let me briefly overview. There are a t least four cases of the

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approximately 18 who were injected d th pl ut in i um in 1945 - 1947 alive today. There are three ewe have been unable to locate as t o whether they are really dead or still may be alive. Liverman: Two w e know about, the third defeats me. Rowland: I was skipping the americium one. dead. But we don ' t know. Liverman: How did we arrive at this on the table. Rowland: We call it unclear as to death. 10 and 1 2 are the only ones w e know about, I am not aware of what happened tothe cases we called This was amale who had Hodgkins disease and we think he i s We just arrived at that from Durbin ' s article, They are only dead tome when I have a death certificate in the file.Pat said a number of things that were not true in that report, autopsy had been refused,that case came out of the ground showing it was that was HP 4in the old records. we know to be alive. have been brought infor extended metabolic survey as a consequence of a medical problem, excreta was collected. The other was brought inat Dr. Waterhouse's suggestion and collections were obtained. Rochester. This started in about January 1973 Onthe one we exhumed it said that I have asked ChetRichmond to try to find the measurments Letme review briefly the four cases Three of them are i n t h e Rochester area, two of them

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and s o from those two hospitalizations we have received daily urine and Wright Langhams. Langham's predictions are apparently low. When you get out t o 1,000 days the excretion per day based on the amount w e assume were injected. (General conversations between several at one time that was impossible t o take down.) You would be off by about a factor of 10. Liverman: Have you taken into account the methodology? We have now analyzed same and compared results with Rowland: Los Alamos is running doubles of everything we have done. The early counts in discussing with people they tell me may not have been that bad. We will have atag on i t because w e have exhumed one case. do a radiochemical examination on the bone. We will get a ballpark figure on how they are. There is a third living case i n Texas. This was a man who had a osteosarcoma and was injected four days before his limb was amputated. This man has gone t o Rochester. We had a terrible time measuring the plutonium. H e has very little plutonium left.We thought for some time w e had the wrong man. H e was injected in the limb four days before amputation. We have now detected by pooling and analyzing and he does have 238 at levels greater than Eventually we will Stover: Have you confirmed i t is 238. Rowland: That has been done already. It is primarily clean 238. We now have some preliminary fecal data from the two Rochester cases and there is about 30% in the feces half in the urine. it would almost have been all urinary. There is a fourth case alive in Rochester but that person has not been brought into the hospital for a number of reasons primarily the person is not Christine Waterhouse's case and second there has been I would have thought after all this time

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no device or mechanisms to bring him into the hospital. W e got into the program asa consequence of the meeting in Salt Lake City on plutonium a number of years ago. people were still alive. turn the records over tome which she did.We contacted Christine Waterhouse and she has been watching these cases ever since. original Langham document. Durbin pointed out tome that these She talked to Joe Goldstein and Joe suggested she Her name appeared …