Madness in Fine Print

Harry Cummings remembers hearing voices and seeing images the very day he was discharged from the Army: "Voices told me all kinds of stuff about the government. It scared me." Cummings, 38, had done two Army tours, including time in South Korea, and had worked his way up to sergeant. After his discharge, he began wandering, hitchhiking from Seattle to Miami, living on the streets, getting by on odd jobs, before stumbling into Los Angeles in the summer of 1982. "A black guy gave me a ride from the California border and dropped me downtown. He gave me a few bucks and encouraged me to get help. I had only the clothes on my back, and I slept outside that night." The next day he talked to a cop and eventually was driven to the Veterans Affairs treatment center in West Los Angeles.

At the center, he told the doctor about the voices, the images. "I was mixed up, dirty, wired up and spacy," Cummings relates. "He said he wanted me to sign this paper for experimental research. He told me I didn't have an obligation to be in it. He said I could quit if I wanted, but he wouldn't advise that. He said the drugs they would be giving were completely harmless. He said the hospital would kick me out on the streets if I didn't participate. That was the word he used: kick."

Cummings signed, was formally diagnosed as paranoid schizophrenic, and says he spent the next five years in an experiment with a powerful antipsychotic drug. He suffered bad side effects: partial blindness, impotence, constant migraines. He says the researchers at the VA never allowed him to see an eye doctor and wouldn't let him change drugs. Only in 1987, after complaining for years, did Cummings finally manage to get out of the experiment and see other doctors. "My vision came back but not as good as I expected," he says. The VA last week said a "cursory glance" did not turn up Cummings' records.

Most of the country's 2.3 million VA patients are poor or mentally ill. And over the decades, many have signed up for experiments after doctors suggested that it was the only way they could receive meaningful help. Now, however, those methods of obtaining recruits for psychiatric experiments are undergoing a radical change, one that may transform the way schizophrenia is studied in years to come. This summer the National Institutes of Health rebuked the University of California, Los Angeles for serious "deficiencies" in setting up schizophrenia experiments that UCLA runs at the Veterans Affairs Medical Center in West Los Angeles. A UCLA experiment reported in TIME last year -- in which one patient suffered a severe psychotic breakdown and another committed suicide -- was formally sanctioned and is now said to be undergoing an ethics review by the American Psychological Association.

Other psychiatric studies around the country are coming under increasing scrutiny, raising fresh examples in the ongoing debate over experimental ethics. How can scientists be held accountable for harm to an experimental subject? Must individual rights always supersede the quest for knowledge? "This is an issue that has been around since the Nazi experiments," says Susan Knapp, the APA's director of publications. "If the conditions for a research project were unethical but the science is good, what do you do with it?"