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Gulf War Syndrome and the Ethics of Experimental Drugs Copyright 2006 Kos Semonski. All rights reserved.
Brothers, sisters, nephews, nieces, grandsons, granddaughters, friends, neighbors… we all have someone close that participated in the military exercise labeled Desert Storm. This was another American patriotic sacrifice. Send the kids off to war. They will fight for our freedom. They all took an oath to defend the Constitution of the United States from enemies both foreign and domestic. And without question, would risk their lives to defend our way of life. I know these words and pledges well, for in my youth, I served our country in the military: I chose to bind myself to that promise and charge.
The visions of war and of lost soldiers race through my mind as I write these words. Not so much that I experienced anything that gruesome first hand, but rather the permanent mosaic of war that was etched little by little into my mind’s eye by the training I received while on active duty, and then the Hollywood movies that I have seen since. You know those movies. The ones that leave you gaping at the screen with your mouth wide open in disbelief. Recent history points me to the film Saving Private Ryan.
If you have seen it, you will understand, if not, then I apologize for being unable to put into words the breath stopping horror I experienced with the opening sequence of that picture.
My tour of duty in the military showed me that while the “Lilly white – savior of the world” picture of the United States is taught to us in public school, Boy Scouts, Civil Air Patrol, etc., we (the United States) are quite accomplished at killing people. In fact, I would venture to say that we are the best in the world. No other country can kill as many people as efficiently as we can. What an accomplishment, huh? Let’s explore the other side of this ugly situation.
While we have made great strides with administering a massacre, we have also developed ways to counter the terrible weapons that we create to defeat our enemies. From gunpowder to tanks and smart bombs to lasers, every weapon that we create can somehow be countered. Enter the chemicals – nerve agents. This invention seems to be the most hideous of all. Introduce a chemical to the skin or lungs of an unprotected individual and you will have a very high likelihood of killing them. Not your traditional bloody death associated with wars of days gone by, but rather an agonizing journey from full mobility to According to Dr. Dane Jones of Calpoly, If you were exposed to nerve agents you would experience the following sequence of events. “First, your nose would begin to run, then your chest would feel constricted. Your vision would dim as your pupils contracted into pinpoints. You'd begin to drool and sweat excessively. Then would come nausea and vomiting, intestinal cramps and involuntary urination or deification. You'd twitch, jerk, and stagger as you're overcome with convulsions and possibly coma.
Finally, you're breathing would stop as your diaphragm and the muscles of your chest froze, causing you to die of suffocation.” Chemical warfare is a hideous inhumane practice, and must be abolished! During the Gulf War, the United States government had a solution to counter the horrendous possibility of death. However, their solution was experimental, and the government decided to administer this without disclosing the facts to the troops. The FDA (Food and Drug Administration) ruled that in times of war, they could use unapproved methods without having to disclose any information.
Let’s explore the Gulf War and the issues associated with non-consensual administration of an experimental drug pyridostigmine bromide. Pyridostigmine bromide, or PB was not FDA approved as a nerve agent pretreatment (Bacon, p.3). PB was used quite successfully for a disease called myasthenia gravis. This disease is an auto-imune condition that required significantly higher doses of PB for extended periods of time, so it was assumed that for nerve-agent pretreatment, shorter periods of treatment and lower In order to understand why this drug was chosen, we have to explore nerve agents and how they react within the human nervous system. Please refer to Fig. 1. It is a simplified diagram of a nerve cell and an explanation of normal and chemically inhibited activity.
A simplifiedpicture of acholinergicsynapse, with thenerve in whichacetyllcholine isformed and thereceiving side(muscles, glands,etc.) withreceptors.
Acetylcholine isformed andreleased from thenerve cell. Onthe other side ofthe synapse itbinds to a musclecell receptor fora split second.
The signal to, e.g. bend an arm or take a breath has now been transferred from the nervous system to the performing muscle. In thepresence of nerve agent the enzyme acetylcholinesterase, which is responsible for breaking down acetylcholine, isinhibited. The receptor keeps on sending signals to the muscle cell, which leads to muscle cramp.
We had antidotes for most of the deadly nerve agents, but there was one for which we had no post- exposure treatment: soman. According to Dr. Beatrice Golomb (Bacon, p.3), “… Iraq was known to have nerve agents available and militarized, and had used them against Iran and the Kurds. So the threat of nerve agent use was real.” Furthermore Dr. Golomb (Bacon, p.3) adds, “Existing treatments for nerve agent given after nerve agent exposure are effective against most nerve agents, including sarin, which Iraq was known to have. But they were ineffective against the nerve agent soman. Iraq was not known to have soman, but the Soviets had had it, and there was concern that it might have been made available to Iraq.” So, fueled by our own paranoia, the United States government decided to experiment with some new ideas for chemical warfare. And because of the FDA’s 1990 interim rule, which waives the need for informed consent for experimental treatments during wartime, PB (and other substances) were administered to the troops without disclosing any of the possible side effects to the individuals. In fact, if a solider refused to take the drugs, he or she was subject to court martial! As far as the United States Government was concerned, PB caused reactions in the body that were considered to be “good” when attempting to stop or slow the actions of soman. All the data from the research of myasthenia gravis enticed the scientists to want to try PB in the Persian Gulf. According to Dr.
Golomb, “… shorter-term use (of PB) for nerve agent pre-treatment was presumed to be safe.” Right now estimates range between 80,000 and 110,000 people claiming some symptom or condition that is diagnosed as Gulf War Syndrome. Instead of accepting responsibility, the United States government has attempted to dodge and hide from those people that served in the war. According to William Arkin, (Arkin, p.1) “It is an unsentimental yet accurate formulation that complies with the new politically correct stance: The sufferers are labeled ‘believers’ and a syndrome--if it exists as such--is a Furthermore, according to Janet Firshein, the FDA is attempting to make permanent their interim ruling of 1990. She claims, “a senior FDA official says that the rule should be made permanent because it is ‘a medically and ethically appropriate mechanism to handle investigational products’ in cases of Regardless of your belief or disbelief in Gulf War Syndrome, you must agree that when deciding on methods of medical treatment, the risks associated with experimental drugs or procedures must be fully disclosed to those to which they will be administered. Your assistance is required to stop the FDA’s attempt to remove the laws that protect individuals from non-consensual administration of experimental drugs.
Furthermore, your voice can help to stop production and deployment of chemical weapons. Take the time now to write to your Congressional Representative and demand retraction of the FDA interim rule of 1990, and implore the cessation of chemical weapon development, and deployment. After all, we all have Arkin, W. (Spring 1998). The gulf war and its syndrome. Washington Quarterly Vol. 21 Issue 2, p53 Ault, A. (1997, August 9). FDA seeks comment on Gulf War waiver. Lancet, Vol. 350, p.423 Bacon, K. (1999, October 19). Ken Bacon holds briefing with others on the Gulf War Syndrome. FDHC Firshein, J. (February 24, 1996). FDA persists in trying out drugs on combat troops. Lancet, Vol. 347 .
Jones, D. (No Date) Nerve agents [Online] Available:


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