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To the Editor: Dr Dennis and colleagues¹ present recommendations for measures to be taken if tularemia is used as a biological weapon. The review includes data derived from several volunteer studies on tularemia. Although ethical guidelines today are considerably more specific and restrictive than the ones in force when these studies took place, 2 of these studies present ethical problems that should have called into question the propriety of using their data.

In 1 study,² tularemia organisms, attenuated but still capable of dissemination, were inoculated into volunteers specifically to establish clinical disease and then to test the comparative efficacy of treatment by chloramphenicol and streptomycin. These volunteers consisted of "laboratory staff and suitable volunteer patients from the wards of the medical service." Clearly, it is difficult to envision a patient suitable for the deliberate nontherapeutic introduction of a potentially systemic infection and treatment with toxic antibiotics. Furthermore, inpatients and staff . . . [Full Text of this Article]

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