Stateville Penitentiary Malaria Study

The Stateville Penitentiary Malaria Study was a controlled study of the effects of malaria on the inmates of Stateville Penitentiary near Joliet, Illinois. The study was conducted by the Department of Medicine at the University of Chicago in conjunction with the United States Army and the State Department. The study is notable for its impacts on the Nuremberg Medical Trial and subsequent medical experimentation on prisoners.

Malaria
As the United States military fought battles in the Pacific theater during World War II, malaria and other tropical diseases hindered their efforts. The need for human subjects to test new antimalarial drugs was met by taking the research into the prison system.

Malaria Research Project
The Malaria Research Project was primarily conducted on a floor of the prison hospital in the Stateville Penitentiary. The study aimed to understand the effect of various antimalarial drugs on relapses of malaria, primarily from the 8-aminoquinoline group of compounds. The study marked the first human test of the antimalarial drug primaquine. For the experiment, doctors from the University of Chicago bred Anopheles quadrimaculatus mosquitoes. The mosquitoes were infected with a plasmodium vivax malaria strain that was isolated from a military patient.

In the study, each patient received bites from 10 infected mosquitoes. 441 inmates volunteered for the study. Infamous murderer Nathan Leopold participated in the study and later wrote about his experiences in his autobiography, Life Plus 99 Years. Over the course of the experiments, one prisoner died, suffering a heart attack after several bouts of fever. The researchers insisted that the death was unrelated to their research. The experiments gained much media attention and praise. Malaria research continued at Stateville Penitentiary for 29 years.

Nuremberg medical trial
In 1946, during the Nuremberg Medical Trial, defense attorneys argued that, ethically, there was no difference between research conducted in American prisons and the experiments that took place in Nazi concentration camps. The malaria study was specifically mentioned. Andrew Conway Ivy, medical researcher and vice president of the University of Illinois, served as a witness and consultant for the prosecution. Ivy encouraged Illinois Governor Dwight H. Green to form a committee to analyze the ethics of prison research. Green appointed Ivy to be chair of the committee and, though the committee never met, it produced the Green report. The report justified the experimentation on the Stateville prisoners. Ivy's testimony at the Medical Trial asserted that the Stateville malaria research was "an example of human experiments which were ideal because of their conformity [with the highest ethical standards of human experimentation]." The trial resulted in the formation of the Nuremberg Code, a set of principles concerning human experimentation. The code includes principles such as informed consent and the absence of coercion.

Effect on prisoner experimentation
Public opposition to medical experimentation on prisoners was scant during the war. The Green Report was published in the Journal of the American Medical Association and opened the door for legal, ethical experimentation on prisoners in the United States. The medical community in the United States largely regarded the Nuremberg Code to be applicable to war criminals and not to the practices of U.S. researchers.