Pappworth , Maurice , 1910-1994 , physician

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Pappworth , Maurice , 1910-1994 , physician

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        Maurice Henry Pappworth was born in 1910 in Liverpool. He studied medicine at the University of Liverpool and graduated MB ChB in 1932. From 1938-1940 he was registrar and medical tutor at the Royal Infirmary, Liverpool, where he worked with Lord Cohen of Birkenhead. In 1939 he was told he would never get a consultant's job in a Liverpool teaching hospital as he was a Jew. He was conscripted into the Royal Army Medical Corps in 1941 and served for 4 and a half years in which he rose to lieutenant colonel and included service in North Africa, Italy and Greece. After the war he was offered jobs in other areas of England but held out for a post in London in a well known hospital, an ambition he never achieved. Instead he turned to private teaching and was a freelance medical tutor from 1947-1990, specialising in preparing medical graduates for the exam for the Membership of the Royal College of Physicians (MRCP). He also had his own private practice. He maintained that teaching in British medical schools was dreadful and held regular private courses to teach doctors.

        Many acknowledge Pappworth's teaching as getting them through the MRCP exam. There were occasions when half the successful MRCP candidates had been his pupils. In 1960 he published Primer of Medicine, which gained a popular reputation among medical students as a short practical guide to the art and science of diagnosis. Within 2 years there were 3 reprints and a second edition followed in 1971. Through out the 1950s and 1960s he became increasingly concerned when his postgraduate students informed him of unethical experiments that they had personally observed, and of descriptions published in medical journals of unethical experiments on patients in the UK and USA, despite informal guidelines such as Nuremberg Code. He wrote letters to the editors of journals publishing work he considered unethical, but they were often rejected for publication. Hence, he collected 14 examples of ethically dubious research, published in 1962 in a special issue of the influential quarterly The Twentieth Century. The first part of his article's title, "Human Guinea Pigs": A Warning", was used again for his later book in 1967. Human Guinea Pigs described 205 experiments in all, including examples of experiments on children, the mentally defective and prison inmates. 78 examples were from NHS hospitals. The book was particularly harsh on Hammersmith Hospital where the earliest cardiac catheterisation and liver biopsies had been carried out in Britain.

        At the same time as Pappworth was exposing experiments in Britain, Henry K. Beecher was also documenting unethical research in the US, but, he was not as criticised by his medical colleagues as Pappworth was. The British medical establishment were not amused at their dirty linen being washed in public, and he was told by members to be quiet. However, within 6 months of Human Guinea Pigs being published, the Royal College of Physicians (RCP) issued a report on the ethics of clinical research. It was Pappworth's activities in the late 1950s and 1960s that led to the Royal College of Physicians British code on ethics of human experimentation. In 1972, Pappworth spoke of belonging to a select band of less than 10 who had been members of the RCP for over 35 years. Despite passing the MRCP in 1936, it took 57 years for him (it normally takes 10-15 years) to be elected Fellow in 1993. Pappworth died on October 12 1994.

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