New York City is home to many statues, some quite famous around the world, while others are familiar mostly just to the people who walk by them every day. Famous or not, though, for some of these figurines their days may be numbered. That’s because of a movement throughout the United States, set off by recent events in Charlottesville, Virginia. The focus of the movement, and various protests connected with it, has been statues of various leaders of the Confederacy that attempted to separate the southern states from the rest of the country in the middle of the 19th century. Such statues are located mostly in former Confederate states, but very large cities throughout the US, including New York, are also part of the discussion, since there are statues of people who are remembered increasingly for doing more harm than good. This includes Christopher Columbus, whose very iconic statue is located at a busy intersection also named for him. That’s Columbus Circle, where 8th Ave, Broadway, and Central Park South (W. 59th St) crisscross at the southwest corner of Central Park.
Debates over Columbus make international headlines, but the controversy has expanded to included figures in the history of science and medicine, which brings us toward the opposite corner of the park. Along 5th Avenue, at 103rd Street, stands a status of James Marion Sims, MD (1813-1883), who has a statue in Montgomery, Alabama, and another in Colombia, South Carolina. Sims is in New York City too, because he is considered to be the “father of modern gynecology”. He is credited with the first gallbladder surgery, with the introduction of many basic principles of antisepsis in surgery, and with the invention of a type of speculum and the ‘Sims position’, which is useful for rectal examination and administration of enemas and other treatments. He also pioneered the first effective procedure for a problem that mothers sometimes develop after a long, intense labor, called a vesicovaginal fistula.
The Sims statue may be removed though (in fact, this may be more likely than removal of the Columbus statue), because Sims’ work had many ethical problems. Very serious ethical problems. In the late 1840s, when he developed and perfected his surgical treatment for the vesicovaginal fistula, his test subjects were not volunteers. They were slave women and he operated on them without their consent and without anesthesia.
An article published in 1993 in the Journal of Medical Ethics describes how one subject had nearly died from use of an experimental sponge while undergoing the procedure for an hour in front of an audience of a dozen other surgeons. Meanwhile, Sims apparently operated on another slave 30 times.
The history of medicine has always been plagued with the issue of what to do in cases when somebody has made a contribution that ultimately saved many lives, but did so with very unethical research, or as a result inventing something that was intended as a lethal weapon. Mustard gas, for example, was developed as a savage weapon of World War I, but now is utilized as an anticancer drug to save lives. Another example is Henrietta Lacks, a woman who died of cancer at a young age, but whose cells were taken, without her knowledge or consent, and developed into a cell line that became vital for medical research and has saved countless lives.
There also have been instances research that was not just unethical in the first place, but also proved unnecessary. The key example is the notorious Tuskegee study, in Alabama, where African American men were subjects of experimentation for treatment for syphilis for 40 years, from the 1930s to the 1970s. The problem with this study was not only that the men who served as subjects were not consulted and not told that they had a sexually transmitted disease (they were told they were getting experimental treatments for ‘bad blood’), but also that there was an effective treatment for syphilis, not very long into the study. I’m talking about penicillin, which does not only treat syphilis, but cures it, if given early enough. The men were not given the penicillin. One thing that is very clear in medical ethics is that you have a treatment that works, you give that and you stop the research study.
Not everything in the history of medical research is positive, so the question is how will New York City resolve the issue when it comes to Dr. Sims?