Edward Linsmier for The New York Times
Dr. Perry Hudson, 96, in South Pasadena, Fla. As part of a study he led in Manhattan, biopsies were taken on the prostates of alcoholic men, and testicles were removed in some cases.
A medical researcher from Columbia University, Dr. Perry Hudson, made the skid row alcoholics in Lower Manhattan an offer: If they agreed to surgical biopsies of their prostates, they would get a clean bed and three square meals for a few days, plus free medical care and treatment if they had prostate cancer.
Edward Linsmier for The New York Times
Dr. Hudson with a book about prostate surgery. Medical historians have criticized how he conducted an experimental study.
It was the 1950s, and Dr. Hudson was trying to prove that prostate cancer could be caught early and cured. But he did not warn the men he was recruiting that the biopsies to search for cancer could cause impotence and rectal tears. Or that the treatment should cancer be found — surgery to remove their prostates and, often, their testicles — had not been proven to prolong life. But he said in a recent telephone interview that he believed the treatments did prolong life. "I told them the cure rate is extremely high," he said.
As more than 1,200 men living in flophouses on the Bowery signed up for Dr. Hudson's study in the 1950s and '60s, neither his academic peers nor the federal officials overseeing his grants criticized his ethics, but times have changed. Two papers published on Thursday in the American Journal of Public Health and the Bulletin of the History of Medicine prompted medical historians to denounce this largely forgotten chapter in the history of government-financed medical research on vulnerable populations.
They said the Bowery study was unethical, because of both the powerlessness of the people who participated in it and the things done to them.
"The invasiveness of this particular research was really horrendous," said Alan Brandt, a Harvard medical historian who has written about the Tuskegee experiment, in which hundreds of poor black men with syphilis were left untreated to observe the natural course of the disease, a study that began in 1932 and was not halted by the United States Public Health Service until 1972.
Dr. Robert Aronowitz, an internist and medical historian who wrote the new papers, stumbled upon the Bowery study — which was led by Dr. Hudson, a urologist trained at Johns Hopkins, and paid for by the National Institutes of Health, among others — and was so troubled by it that he became consumed with documenting what had happened.
"Hudson used Bowery men because only desperate, poor, and unknowing men would participate," Dr. Aronowitz wrote. "It was unimaginable that the average American man would volunteer."
Dr. Hudson's colleagues did not question his use of down-and-out men with alcoholism, some of them mentally ill, or his failure to carefully inform them of the potential risks of his research, said Dr. William Parry, a urologist at the University of Rochester at the time.
In the 1950s, prostate cancer was usually discovered late after it had spread and was almost always fatal.
"It was an entirely different era," said Dr. Parry, now 89 and an emeritus professor at the University of Oklahoma.
In fact, as Dr. Hudson pursued his research, his work was widely cited in urological journals and textbooks and admiringly featured in a 1958 photography spread in Life magazine.
Dr. Aronowitz cites a popular history, "The Bowery Man," published in 1961, in which the author, Elmer Bendiner, reported that staff members at a city-run lodging house where study participants stayed helped Dr. Hudson ensure their participation.
"Once a man chosen for the study was persuaded to volunteer, the authorities lifted his meal ticket and returned it only when he had kept his appointment," Mr. Bendiner wrote.
Dr. Hudson himself makes no apologies for recruiting impoverished alcoholics. Now 96 and living in South Pasadena, Fla., he said in recent interviews that the men volunteered, they were not paid and they got "the best care in New York."
Doctors in private practice would never have allowed their patients to get biopsies since they assumed the disease was fatal, he said.
Dr. Hudson was 33 and had just taken a position as head of urology at the Francis Delafield Hospital, a public cancer hospital in New York, when he and his colleagues began recruiting homeless men in 1951. He got the idea of going to the Bowery when he was caring for a man who had been a Princeton history professor but ended up a homeless alcoholic living there.
At first, Dr. Hudson said, the Bowery men resisted his offers. He recalled speaking at one of the flophouses just before bedtime. "I had a lot of old vegetables thrown at me," he said. "I was talking about making a small incision in a very interesting part of their anatomy." But many eventually agreed to participate.
This article has been revised to reflect the following correction:
Correction: October 17, 2013
An earlier version of this article misstated the year that a photo spread on Dr. Perry Hudson appeared in Life magazine. It was 1958, not 1957.
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