Internet Source: Public Anthropology: Engaging Ideas, May 27th 2001
Source URL (Archive.org): http://www.publicanthropology.org/Journals/Engaging-Ideas/RT(YANO)/Turner1.htm
ROUND ONE
Ethical Issues Arising From Patrick Tierney's Darkness in El Dorago and the Ensuing Controversy
Terence Turner
Cornell University
Patrick Tierney's book, Darkness in El Dorado, his New Yorker article, "The Fierce Anthropologist" , and the controversy to which they have given rise have raised a series of ethical issues, some stemming from the content of Tierney's writings, and some from the conduct of those involved in the controversy. Amid the barrage of charges and counter-charges, the most important ethical issue, namely what, how and why the Yanomami have suffered from the actions of those who have come to study, document, film, convert, aid and otherwise impinge upon them over the past thirty years, has tended to get lost.
Very few of the messages and postings relating to the controversy have paid serious attention to the condition of the Yanomami themselves or their views, and most have tended to ignore ethical issues altogether. Instead, the outpouring of e-mail messages and postings by defenders of Neel and Chagnon over the past several months has been almost exclusively concerned to defend James Neel and Napoleon Chagnon against Patrick Tierney's allegations. The most common basis for dismissing the criticisms has been the charge that Tierney, and other critics of Chagnon such as Leslie Sponsel and myself, are primarily motivated by some combination of hostility to "science" and unwillingness to face the hard truths about the Yanomami and other primitive people revealed by Chagnon's scientific approach. The implicit sub-text seems to be that if the critical allegations against Neel and Chagnon can be refuted on scientific grounds, then the ethical questions raised by critics about the effects of their actions on the Yanomami can be made to go away. This tropic use of "science" is epitomized by the attempt of leading partisans of Neel and Chagnon to use Tierney's errors in the chapter on the measles epidemic concerning such scientific matters as whether the vaccine used by the expedition to vaccinate the Yanomami could itself have caused the ensuing measles epidemic to discredit his entire book.
The main issues raised by Tierney's critical accounts of the 1968 AEC expedition and Chagnon's actions, however, concern the ethics of scientific practice: they imply no attack on science as such. Any discussion of the ethical issues raised by Tierney's work ought to begin by giving Tierney credit for raising important ethical issues. Science is not a substitute for ethics, scientific findings do not obviate ethical issues, and scientists, particularly those who work with human subjects, have ethical responsibilities. In this connection, the words of the report of the Brazilian medical team of the Federal University of Rio de Janeiro on Chapter 5 of Tierney's book (his account of the epidemic), otherwise highly critical of Tierney, are apropos:
The positive aspect of the polemic raised by chapter 5 of Tierney's book, despite its serious documentary and conceptual failures and its lack of demonstrative rigor, is in the fact that it has made possible a more profound discussion reflecting upon the ethics of research among indigenous populations and minorities in general, not only in biomedical research, but also in other spheres, such as anthropological research, which, in the case under discussion, was strictly associated with biomedical research. (de Castro Lobo et al.: Section 7, Sub-section "Ethics of research on indigenous peoples: past and present")
The ethical issues in this controversy, however, have not been confined to the actions of Neel, Chagnon and others toward the Yanomami. The conduct of the controversy has raised important ethical issues of its own. One ethical imperative is clearly to correct the errors of Tierney's account (and the memo that Leslie Sponsel and I sent to the leaders of the AAA summarizing Tierney's allegations and calling for their investigation by the Association), to prevent the damage to individual reputations they might cause. As the authors of the memo that became the vehicle for the dissemination of these errors (albeit against our wills and without our consent) we have assumed responsibility for researching and publicizing relevant aspects of the conduct of the 1968 AEC Orinoco expedition (see below). Another ethical issue was posed by the leaking of our confidential memo on the internet by a party or parties unknown. This was a breach of trust as well as a legal breach of copyright. The consequent sensationalized exploitation of the contents of the memo in the media led to a number of distorted and untruthful reports, which Sponsel and I have sought to correct at every opportunity (e.g., in lectures, letters to the editor, postings on the web, published columns and articles, and media interviews).
Finally, the outpouring on the web in defense of Neel and Chagnon has not stopped at correcting Tierney's errors, but has produced a rich crop of tendentious prevarications and untruthful assertions that raise ethical problems all their own. Some of the loudest defenders of Neel and Chagnon have attempted to discredit the book as a whole by reference to its flawed treatment of the epidemic, while avoiding discussion of the many parts of the book for which there is abundant evidence in the public record and the testimony of other anthropologists, missionaries and Yanomami. Some of the most violent attacks on Tierney's book, in sum, seem directed as much at distracting attention from the truth of many of its allegations as at exposing its relatively few (but important) errors. There has been a good deal of "spin", in short, along with some well founded criticism, in the attack on Tierney.
90% of the controversy over Tierney's book has focused on the less than10% (one chapter out of 18) devoted to the measles epidemic and the AEC Orinoco expedition of 1968. The remaining 90% deals with completely different issues, most of which concern Chagnon's activities and their effects on the Yanomami. Tierney's accounts of the more ethically problematical of these actions and effects are on the whole accurate and well founded (e.g., the political damage done by Chagnon's demeaning characterization of the Yanomami as violent savages incapable of peaceful self-government, his unfounded calumnies against Yanomami leaders and NGOs dedicated to supporting and aiding the Yanomami, the disruptive effects of Chagnon's field methods and actions on Yanomami communities, and his joint attempt, in collaboration with Charles Brewer-Carias and Cecilia Matos, to get a large tract of Yanomami territory in the Seapa valley converted into a personal research park under their joint administrative control).
Most of these actions and events were already common knowledge among anthropologists, missionaries, journalists, medical personnel and government functionaries who have worked among the Yanomami, not to mention the Yanomami themselves, who are rapidly becoming more vocal in their own behalf. Most have been reported in the Venezuelan and Brazilian press, made the subject of published critiques by other anthropologists who have worked with the Yanomami, and been the object of collective protests by the anthropological associations and professions of those two countries. Because of the intense opposition his practices and statements have aroused, Chagnon has repeatedly been denied permission to enter Yanomami areas in both countries. Tierney's chapters on Chagnon add many new details and fill in many of the gaps in this public record, but the broad outlines of what he reports are already well established and independently documented.
When Leslie Sponsel and I were sent the galleys of Tierney's book by the publisher in July/August 2000, we decided that our responsibility as members of the AAA was to warn the Association of the seriousness of the allegations and the need for an investigation. When the memo we sent to the AAA leadership summarizing Tierney's allegations was made public without our permission, the result was a media furor in which exaggerated and sensationalized versions of the allegations we had summarized were presented as assertions of fact by us, rather than reports of allegations by another, that we were reporting to call for their investigation. Apart from the distortion of our own position, this resulted in the circulation of allegations damaging to the reputations of those named in them, without prior investigation by qualified reviewers, such as we had called for in our memo. Under these circumstances, it seemed to us that we bore an ethical responsibility to speak out in the media against the distorted, unfounded, and unconfirmed versions of the allegations that were circulating, and also to do what we could to investigate the most serious allegations ourselves. These tasks acquired additional ethical urgency as we realized that some of the allegations were not true.
The most serious and also the most questionable of Tierney's allegations dealt with the 1968 AEC expedition led by James Neel, and the epidemic of measles that broke out among the Yanomami it was vaccinating. Of these, the most serious were that the vaccinations themselves might have caused the epidemic, and that this might have been done intentionally as part of an experiment (these suggestions and others in the galley proofs of the book were withdrawn or modified in the published version). I accordingly set out to check with independent medical experts on the possibility that the Edmonston B vaccine used in the vaccinations might have given rise to transmissible cases of measles. The result of these consultations was to confirm the judgement of Dr. Samuel Katz and other medical experts that the vaccine employed by Neel's expedition could not have caused transmissible cases of measles. I immediately sent an email to Dr. Katz informing him of this result (this message was immediately posted on the web page of the society for evolutionary psychology, presented in such a way as to suggest that I had repudiated Tierney's whole book; a follow-up message which I sent affirming that I continued to find other parts of Tierney's account to be well-founded was never posted).
The point about the inability of the vaccine to cause the epidemic, of course, was only a first step toward working out what had actually happened. It left unanswered most questions about the nature of Neel's ideas and intentions, and about the conduct of the expedition as it struggled to reconcile its research program with the humanitarian demands of medical prevention and care. The major source of information on these questions was known to be the collection of Neel's papers and correspondence in the Archive of the American Philosophical Society in Philadelphia. I therefore undertook to make a comprehensive search of Neel's papers in the APS Archive. I was able to visit the Archive in December, and go through all the documents I could find relevant to Neel's Yanomami research and the 1968 AEC expedition, including Neel's field journal. Together with my research assistant, John Stevens, I have produced an annotated index of the field journal and all the letters and documents. Copies of this index have been furnished to the Venezuelan and AAA investigative commissions, and will be posted on the University of Connecticut web site.(Stevens and Turner 2001)
The picture that emerges from these documents of Neel's motives, ideas and actions in planning and leading the 1968 AEC expedition, as well as the conduct of the expedition as a whole in carrying out the vaccination campaign and reacting to the epidemic, differs in a number of critical respects from Tierney's account (and therefore also from Sponsel's and my memo, written as a summary of that account), as well as from those of many of Neel's and Chagnon's defenders on the web. On the other hand, it converges on essential points with the report of the Brazilian medical experts organized by Bruce Albert. While the new data do not support the more extreme assertions and suggestions of Tierney's original galley text, such as that Neel might have deliberately caused an epidemic of measles, or knowingly risked doing so, by using a "contra-indicated" vaccine, or that he contemplated or actually executed an "experiment" that he knew risked medically serious or possibly even fatal consequences for some of his Yanomami subjects, they do support other points of Tierney's account, and indicate certain ethical problems with Neel's and the expedition's approach and conduct that neither Tierney nor others have noted. There was, for instance, a definite research purpose for the vaccinations, as Tierney insisted. The papers also provide negative evidence that supports two other points made by Tierney: there seems to have been no attempt to secure informed consent from the Yanomami either for the taking of biological samples or for the vaccinations, which would have been called for given that the latter also formed part of a research program; and there is no evidence for any formal permission from either the Brazilian or Venezuelan governments for any of Neel's expeditions to either country. They also provide confirmation of Tierney's assertions that the vaccine did in fact cause extremely severe reactions that led to social complications (social panic, flight from villages where treatment was available) that did in some respects exacerbate the effects of the disease. On another disputed point, while the APS papers provide further evidence for Neel's genetic reductionist and eugenic beliefs about a relationship between leadership, reproductive success, and genetic endowment and the central role of this genetically-based complex in determining Yanomami social and political organization, they show that the eugenic ideas had nothing to do with the vaccination program and the research purposes it served, as we speculated they might have done in our memo. Finally, they make clear that the expedition routinely provided medical care while it was in Yanomami communities, and attempted to extend medical help by providing medicines and vaccine to missionaries, although there were indeed occasions when the expedition moved out of villages where sick people needed care to get on with its scientific itinerary (we had misunderstood Tierney's account of such an occasion to imply that the expedition refused medical treatment on Neel's orders, and mistakenly said so in our memo). We regret that the unauthorized circulation of our memo caused these erroneous claims and suggestions to be disseminated to the general public before they could be properly investigated, as we had called for in the memo, and we regret the pain this must have caused to James Neel's family and friends. As a result of my research on Neel's own papers, I am now in a position to correct these erroneous reports.
The controversy that has blown up around Tierney's book has focused so heavily on the 1968 measles epidemic that it came as a surprise to discover from reading Neel's field journal and correspondence that measles and matters associated with it, such as vaccinations and the type of vaccine to be used, held a relatively low priority for Neel, both before and even during the epidemic. This relative lack of importance that Neel attached to medical work and even the research value of the vaccinations by comparison with the other kinds of data he planned to collect affected Neel's (and hence the expedition's) planning and conduct both before and during the epidemic.
Neel originally planned the expedition for the purpose of collecting blood samples and other biological data (specimens of urine, stools and saliva, anthropometric measurements, etc.) that would have a bearing on his research into genetic variation among and within indigenous communities. This research purpose remained his top priority throughout the expedition. He was interested in epidemic diseases , specifically including measles, for some of the same reasons, because as "natural stressers" they exercised important selective pressures, and because by observing the levels of antibodies generated by a "virgin soil" population like the Yanomami to such diseases, or to vaccinations against them, he would be able to test the theory that Amerindians and other isolated populations were equally capable in terms of genetic endowment of producing antibodies for them as long exposed populations. The vaccinations, in short, were originally planned primarily as a research tool for eliciting the production of antibodies (although Neel also thought of them as serving a humanitarian medical purpose). The specific type of vaccine seems to have been a matter of relative indifference. Far from deliberately selecting the Edmonston B vaccine for its reactive properties, his correspondence leaves the impression that he simply took it because it was what the U.S. Pharmaceutical companies with which he was in contact were prepared to give away free (they were probably dumping their inventories to make way for the new Swartz version of the vaccine, that was about to become the new world standard).
It is clear from the papers that Neel planned the measles vaccinations for his own research purposes and began soliciting donations of vaccine months before he heard the first reports of the outbreak of measles among Yanomami on the Brazilian side of the border with Venezuela. When he received reports of the outbreak of the epidemic in Brazil, and then of its advance into Venezuela, he responded by shipping 1,000 units of vaccine (without accompanying gamma globulin) to the missionaries with the threatened Brazilian Yanomami villages, but made no other changes in his plans or preparations. He knew from reports from missionaries, and also from a conversation with the head of the Venezuelan Indian Agency on the night before his departure for the field, that the epidemic was moving down the Orinoco and had also reached the Ventuari , so he had every reason to believe that time was running out before it would reach the villages he was heading for. From a medical point of view, the prudent move would have been to try to vaccinate all the villages he could reach immediately upon arriving in the area, leaving his blood and stool sampling until later, but he made no such alterations in his previously planned itinerary. He did not even formulate a plan for defending the region against the epidemic by vaccinating at the main points of access to the area until the epidemic actually broke out in the villages where he was working, after he had been in the field for a month. He wrote several times in his journal of how great a burden the vaccinations had become because they were taking too much time away from the research tasks of expedition personnel. In planning for the last part of the trip, he wrote of the need to set firm priorities for the various research tasks, starting with the collection of blood samples, and only after completing them "then vaccinate--if at all."
The Brazilian team, after rejecting Tierney's suggestions that the expedition might have caused or spread the epidemic by its use of the Edmonston vaccine, or sought to produce heavy vaccine reactions as part of an experiment, presents a plausible alternative theory of the origin and spread of the epidemic. Starting from the proposition that the epidemic, having originated in Brazil rather than the Orinoco (which now seems established beyond dispute), reached a number of the the Orinoco villages a few days before the expedition arrived and began vaccinating. Given that vaccinations applied three or more days after exposure are ineffective in preventing the outbreak of the disease, this meant that in many cases the expedition's vaccinations came too late to do any good. It is also why, the Brazilian experts suggest, measles appeared to break out in reaction to the vaccinations, as the witnesses cited by Tierney testified. Rather than the measles breaking out as an effect of the vaccine, the Brazilian team suggests, it was the ineffectiveness of the vaccinations, owing to their lateness, that allowed the measles to break out within the normal period for incubation of reactions to the vaccine. In the Brazilians' view, in short, it was above all the failure of the expedition to move fast enough to get to many of the villages before they became exposed (or at least within the three day grace period after exposure, during which vaccinations could still be effective) that was responsible for the failure of many of the vaccinations to prevent the onset of the disease or to stop the epidemic.
. . . if measles reached the region before the team arrived, the planning and organization of their movements - regardless of whether they gave priority to either medical care or research - probably had a greater impact on the failure of the vaccination (since immunization took place later than 3 days after infection) and the lack of control over mortality (due to the ill-preparedness of the team for dealing with the serious complications of measles, mainly pneumonia), than on the spread of the epidemic.
Revising the "planning and organization of their movements" - i.e., the research itinerary that called for spending enough time in each village to collect enough samples to reach the target of 1,000 blood specimens - to permit the most rapid possible vaccination of all the villages within the expedition's reach would however have required giving the vaccinations top priority at the expense of the tightly planned research program, in effect abandoning the target sample sizes for blood and other specimens and settling for less significant research results. As a number of entries in his field journal make clear, Neel never entertained this possibility, but single-mindedly pressed on for collecting the maximum possible amount of blood samples, while sacrificing collection of some other types of data (e.g., anthropometry, dental impressions) to allow more time for vaccinations and medical care.
To sum up: Neel's unwavering prioritizing of the scientific research goals of the expedition over the needs of more effective preventive measures against the measles epidemic (more timely vaccinations), and more effective medical care for patients suffering from reactions to vaccinations as well as from measles itself, undermined the effectiveness of the vaccinations and care he did provide and thereby contributed to a "failure . . . to control mortality" (i.e., the death rate from the epidemic). Ultimately this may have contributed to the failure to stop the spread of the epidemic, which despite Neel's claim to have "averted a real tragedy" by the vaccinations, continued to spread and rage on for months after the expedition left the field. This has to be set against the undoubted overall beneficial effect of at least some of the vaccinations in saving many Yanomami lives. Given the time Neel had allotted for the expedition and the quantities of specimens to be collected he had set as its goals , there was no way he could have succeeded as he did in collecting his thousand blood samples and other specimens and also optimally met the medical needs imposed by measles epidemic. He ended up making some sacrifices on both sides, but more on the medical than the research side. These sacrifices were ethical choices. In the making of those choices, the scientific requirements of studying the Yanomami as a biological population took relative, though not absolute or exclusive priority over the requirements of assisting the Yanomami as a people--i.e., as social communities of individual persons facing a medical emergency.
This seems to me to be the main point that subsumes the more specific ethical questions that have been raised about the practices of the expedition. All of these specific issues go back to the general problem of the relative lack of importance Neel allotted to medical and social issues in comparison with his own research goals. This attitude, it seems to me, was essentially a matter of Neel's intellectual orientation, although it turned out to have ethical consequences in the context of the epidemic. It is clearly not an intrinsic corollary of scientific research or attitudes per se. To criticize Neel for the ethical implications and consequences of this attitude in his conduct in the epidemic, in other words, is not to attack "science" or to question the value or propriety of scientific studies of human populations at either the biological or the social level. Rather, it is to call attention to the ethical implications of choices and acts of individuals faced by conflicting demands under circumstances that made it impossible fully to satisfy personal goals, scientific interests, and humanitarian values at the same time.
REFERENCES
De Castro Lobo, Dr. Maria Stella, Dr. Karis Maria Pinho Rodrigues, Dr. Diana Maul De Carvalho, Dr. Fernando Sergio Viana Martins
2001 Report of the Medical Team of the Federal University of Rio de Janeiro on Accusations Contained in Patrick Tierney's Darkness in El Dorado. (Tr. Catherine Howard )
Ferguson, Brian
1995 Yanomami Warfare. A political history. Santa Féé : School of American Research Press.
Neel, J. V., Centerwall, W. R., Chagnon, N. A.
1970 "Notes on the effects of measles and measles vaccine in a virgin-soil population". American Journal of Epidemiology. 91(4): 418-429.
Stevens, J. and T. Turner
2001 Index of materials from the James V. Neel papers in the archive of the American Philosophical Society. MS.
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