Oak Ridge Associated Universities Statement (Encls.)

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OAK RIDPJC MSOCIATCD UNIVERSITIES Oak 2idg0 Associated Universities announced on Sept. 25 that its medical research program was Laing redirected and that, as a result, the amall hospital it a a in tain s would be closod the week of Oct. 1 4 . The annourrcement ;;Jointed out that sone patients woulci continue to be treated as outpatients. were i n progress with the Oak Ridge Slospital of the Xe tho dist Church to make arrangements for those patients who migr it require continuing I t also noted that iiiscussions hospital care €or some time under the direction of OWL' staff yhysicians. Since that announcement, however, tharo has bean some misunder-. standing by the public and by sone patients as to the future treatr=,cnt It ior and always has bean the intent of the Atomic Enor5;y Cods sion and ORAU that patients currently under the care of OMt ' physicians w i l l continue to receive ths medical care they need. detaila and nature of this care is a matter for the patients,in consultatfon with OPAU physicians, to determine i n order to assure continuation of proper medical treatment. will also wish to consult their private physicians. Many patients, of course, In order to in sure continuing care by the ORAU physicians, ORAU ha8 for several weeks been discussing patient admission and financial arrangements with area hospitals, principally the Oak Ridge Iloayital of the Methodist Church.

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ORAU w i l l con2lete suitable arrangenents to assure continuity of medical services prior to ClOS hg its hospital facility.

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Pursuant to discussions held with y e w office by our Assistant Dirccbr paut ?.I. Elza over t?x past GcveFal days, this is to rcqucst selvicea of ycur Hospital and to give notificatfon of changes necessary in our Rrrcbaso Ordzr # OrJW p h s to tcrminats October 18, 1974 the clinlcd progmm nr0vidLn.f bed cme for patients. W e now I---vom e paticnts in our boapital who will require throv-gh next June SOU3 your hospital is requested to ncccpt these patients for hospitalizationupon adxnittmca by our medical staff who will continue to direct their cnre as &uittm physfcfms. This catezory of mtients i B not expected to exceer! a total of five. The Satients would ba n M t t e d in your hos?ital'c regular mMncr and w i l l bs subject to usal and customary c h a ~ c swhich are to be collected from the pztient to the extent they nay now h v e hosnitalimtion or Medicaro coveraye. CaWU will pay 031;IiiCp Hospital of the XeIethodist Church, upon receipt of ftcmized invoices, all n o m a l and customary cfiaqces not coUectiXe fmm the mtcie&, It is un&rsto;xf i k a t patients auri physicians wadd conform fully with your hospital policies and proccdma. In addition to tho bed paticnts our et df will continue to ~ c 8out-natients, 8 few of ~Aiornmap m i r e brief hospitalization from timo to tfme. Our medical staff ill schedule thzse one- to faur-day h0sr)it.d periods for the latter part of the week. Charges wauld bet handcd aa described nbove, Our clfnfcal medical etaf€ is composed of tho following physicians: Helen Vodoplck Goswitz, M.D.

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Oak Ridge Associated Universities Information Services Departrnen t P. 0. Box 11 7 I Oak Ridge, Tennessee 37830 Area Code 615 I Telephone 483-84 1 1 FOR RELEASE: Wednesday, Sept. 25 Oak Ridge, Tenn.--The medical research program at Oak Ridge Associated Universities (ORAU) will be redirected to emphasize basic biomedical research and research into the use of radiopharmaceuticals in the diagnosis of cancer, it was As a result, the small hospital maintained by ORAU in Oak Ridge will be closed the week of Oct. 14. Some patients will, however, continue to be treated as outpatients. Discussions are being held with the Oak Ridge Hospital of the Methodist Church to make arrangements for those patients who will require continuing hospital care for some time under the direction of ORAU staff physicians. The 30-bed ORAU hospital at one time operated near capacity. In its 23-year history, more than 2500 patients have been admitted for treatment. In recent years, however, the number of patients in the hospital has averaged only about seven, although it has been treating approximately 4 5 outpatients

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ORAU's medical division has been an important cancer research center since it was formed at the request of the Atomic Energy Commission in 1950. In keeping with this, ORAU and the University of Tennessee are discussing the development of a clinical program with the East Tennessee Cancer Research Center, which is to be located at the University of Tennessee Memorial Research Center and Hospital in Knoxville. The medical division, working in collaboration with Oak Ridge National Laboratory, has been a leader in the search for radiopharmaceuticals that can be used in cancer detection and therapy, in a program under Dr. Raymond L. Hayes. After the closing of the inpatient facility, the research program in diagnostic uses of radioisotopes will continue to be carried out on an outpatient basis under the direction of Dr. C. Lowell Among the division's better known nuclear medicine programs is the Cooperative Group to Study Localization of Radiopharmaceuticals. The group includes staff members of 16 medical schools and hospitals. The medical division is also a leading center for research and training in the management of radiation injuries. Dr. Gould Andrews, chairman of the division, and senior scientist Dr. C.C. Lushbaugh are considered authorities on the treatment of radiation p.3 accident victims. This program is expected to be expanded in - cooperation with Roger Cloutier, chairman of the special training division of ORAU; the health division of Oak Ridge National Laboratory; and the Oak Ridge Hospital of the Methodist Church.

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.I The division has two important centers of basic biomedical research: the biological chemistry group under ' Dr. Fred Snyder and the Marmoset Research Center under Dr. Nazareth Gengozian. Both of these programs will continue, probably on an expanded basis. Snyder's team is concentrating on the study of fatty substances, called lipids, and their function in cells. This team has discovered a rare group of lipids characteristic of most cancerous cells in animal and man. It is hoped that the results of this research will eventually contribute to the broader goal of prevention, diagnosis, and treatment of cancer. The Marmoset Research Center, with its large colony of the South American primates, is focusing upon studies in immunology and cancer of the colon, which the marmoset In addition to these teams, the medical division conducts a variety of other basic biomedical research efforts, supported both by the AEC and other government and private agencies. ORAU is a nonprofit educational and research corporation of 4 2 universities and colleges in the South. It operates under a prime contract with the AEC, as well as with funds from other private and government organizations.

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“und the Industrial Revolution man was largely confined to the fertile sites *r the earth.“ These sites, which provtc , the plants and animals which remain his mation growth. Man is being poorer land. taking with or less unsuited to the * LDC‘s have a wide trariety of indigenous crops. These are not as productive .-- hybrids under present conditions. bu. may he advantageous for some LDC’s to ing fast-growing trees for fuel in rotation with food plants. Multiple cropping of several crops in the same field may be oker, he sees far loo little evidence of concern in influential political quarters. The possibility of change in that respect may be read into the scheduling of cal Diversiry in Washington on 16 to 18 Danment and AID. The agenda calls for the answer to higher production in other,-/a discussion of “crop -and noncrop ‘ plants, trees, domesticated and wild ani-places. The point, says Ashton, is t h s total- mals, microbial organisms, ecosystems. should be encouraged, Suggesting that ing applications.” About 100 resource the small-is-beautifdamroach to alter- managers and technical experts from the tion of germplasm reso&s, a lag i n - b ve tech nb adv-&ted by Ernst policy is also deplored by some. Ashton cedes that the problem is example, as well as nongovern organizations such as the World Wild1 a narrow range of yof’s. Population Fund and International Union for the growth, a show bf arable land. and Conservation of Nature, says Ashton. rising oil p,&s make it advisable to But “there is a lack of communication. consider different approaches. Many Nobody is running the show.” MoreUnited States are being invited along with some foreign participants. The aim is to consider steps the United States might take to preserve biological diversity throughout the world. Since the strategy session is the first such conference convened by the Reagan Administration. *s considered a boost for biological e the voices crying in the ness is fast disappearhg.-JoHN WALSH Gore Investigates Radiation Clinic Hearing finds no evidence that patients were mistreated in research on space hazards Congress recently looked into some tients at a hospital in Tenaessce were given nontherapcutic doses of radiation The results we= mixed. While the findcare at the clinic, they did not substantiate the charges of misconduct, which bad received national attention in August The hearing was held on 23 September before the House science and technology subcommittee on investigations, chaired Tenn.). Gore picked his way carcNly through the evidence, hying out a record that essentially faults the clinic for operating at less than the highest medical standards in the 1960’s d 1970’s. but fails to support the charge that patients were used in a caUous fashion to generate data on space hazards. Much of the testimony focused on the case of Dwayne Sexton, a child with acute leukemia who was treated at the Institute of Nuclear Studies (INS) in Oak Ridge, Tennessee, from 1% to 1%9. He to produce data for the space program. ings raised questions about the quality of SCIENCE. VOL. 214. 23 OCTOBER 1981 died there in 1%9 at the age of 6%. EarIy press accounts suggested that Sexton was needlessly given radiotherapy as part of a program to collect data for the istration (NASA). The evidence did not support this allegation. Indeed, the hearing produced tittle new information on Witnesses did raise questions about the quality of care Sexton received, however. One physician said that it may have been wrong to involve the child in an immunologic experiment at INS before he had been given a standard course of chemotherapy. Gore questioned some of the former INS researchers about the wisdom of conducting experiments in which people were exposed to radiation at low dose rates for prolonged periods. But medical witnesses said the experiments seemed reasonably well run, given the state of knowledge about radiotherapy in the late 1960’s. The inquiry was limited because there were many gaps in the record. Andrew Stofan, a NASA oficial, disclosed that all of NASA’s documents on the INS research. which ran from 1964 to 1974, had been thrown out in the course of routine housecleaning. auld Andrrws, INS’ chief medical investigator, whose testimony would have been valuable, The INS clinic was closed in 1974 after a review committee decided that it would cost too much to bring the facilities into compliance with the health and cleanliness standards enforced at that time by the big insurance companies. The staff and facilities were incorporated into the Oak Ridge Associated Universities. As the hearings revealed. INS had several goals, which at times may have been in conflict. First, the clinic sought to help cancer patients by giving them a variety of treatments, including chemotherapy, which one INS staffer referred to as a “competitor’. with the clinic’s specialty: radiotherapy. A second goal was to develop new techniques for treating cancer with radiation. Third, some of the researchers were being paid by NASA to collect information on the effects of small doses of radiation on man. NASA wanted to know, for example, died last year.

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whether the radiation emitted by solar flares would fatigue or sir i astronauts The fundamental questions Gore asked were: Did the Institute’s desire to collect experimental data affect choices oftherapy, and did the therapy harm the patients? The hearing demonstrated that some of the research was closely coordinated with the effort to collect data for NASA. It did not show that patients were harmed or deprived of good rnedical care because they participated in experiments. In fact, many were given conventional therapy and benefited from it. Those who volunteered for expericonsent forms used did not lneet the The Sexton case did not cast light on ation studies of interest to NASA. Sexton, after all, was exposed to a high level of radiation. officials who were at INS argue that the Sexton case would not have been included in NASA’s data bank under any circumstances, because NASA was interested only in adults. Nevertheless, Gore did produce evidence showing that INS researchers felt pressure to !%id data for NASA. In the example that Gore cited, the INS’mediin what he considered unethical experiments involving prisoners in California ._ mentation had failed to respond to stand a d treatment. That, at least, was how the system was supposed to work. Whether or not it did in every case is not Mary Sue Sexton, mother of Dwayne, told the subcommittee that she felt she misled” by the physicians at the INS clinic. She had not felt that way at first, she explained, but only after she learned recently from ajournalist that her son might have lived if he had been given a course of standard maiatenance chemotherapy. Instead, he was given a partial course of chemotherapy and then an The treatment failed. The child was then and, when all else had failed, a single large dose of gamma radiation. Although Mrs. Sexton said that she was not fully informed of the risks that she and her son were taking, she did sign a consent form that described the proposed experiment in simple terms and noted that conventional treatment had been freely offered as an alternative. The Sextons clearly volunteered. The subcommittee called on two scientists as independent commentators: Robert Wiernik, director of the Baltimore Cancer Research Center, and Eli Glatstein, chief of the radiation oncology branch of the National Cancer Institute. Neither found any evidence in the material produced for the hearing that patient care at the INS clinic had been altered to suit NASA’s needs. At the same time, they said, the research protocols and Untried f o m of immunologic therapy. refused to participate in what he considered unethical experiments involving prisoners in California, as had been proposed with “enthusiasm” by a NASA Gore also quoted from an INS budget report to NASA on lowdose radiation experiments planned for 1970 which said: “An active canvassing program for increasing our utiiization of these facilipate that this program will produce a greater intlux of patients than we have experienced in the last 2 years.” The same memo informed NASA that “We …