In A Nutshell
From 1945 to 1955, Swedish researchers subjected uninformed patients of Vipeholm Mental Hospital to a series of tests to determine how teeth decay worked. The tests began as government-approved vitamin research but quickly deteriorated into experimentation with a diet of candy and chocolate, sponsored in large part by the local confectionery industry. Many of the patients had their teeth irreparably ruined, and it began a large conversation on the ethics of informed consent.
The Whole Bushel
In 1938, the National Dental Service was started in Sweden as a result of the fact that nearly all of the citizens of the country had cavities. Many suspected diets rich in sugar as the cause, but lacked the scientific research to back up their claims. The NDS recommended experiments, beginning in 1945, to study the rate of tooth decay, using vitamins to see if they reduced the onset of cavities. Vipeholm Mental Hospital, outside Lund, was the country’s largest facility for “uneducable retards” and was chosen as the perfect spot to perform the study.
None of the 660 patients, many of whom were too mentally ill to legally be able to sign contracts or documents, were informed of the study. In the two years of the vitamin studies, no satisfactory information was discovered, so the doctors at Vipeholm, in conjunction with the Medical Board and with the support of the local confectionery industry, changed the parameters of the experiments. Without informing the government, they altered the diets of all the inmates, almost exclusively feeding them candy or chocolate.
By the time a “normal” diet was reintroduced in 1949, at least 50 of the patients had their teeth irreparably damaged by the numerous cavities they accumulated from the study. In addition, the candy companies were not happy with the results of the experiments and, fearing the effects of its release, delayed the publishing of the study until 1953. Almost immediately, a debate arose in Sweden regarding the ethics of the experiments conducted on the patients at Vipeholm. In 1955, the parliament actually introduced a bill to halt funding for further experiments and to prevent the use of the Vipeholm patients in research. Some people in Sweden felt the end justified the means, especially because the subjects were mentally ill. As Elin Bommenel stated: “The Vipeholm researchers’ findings still hold up. In fact, we have them to thank for the excellent dental health that Swedes now enjoy. The price was paid by the patients with rotten teeth.”