Hiba H., Karishma L. & Mark R. | Penn needs to face dermatologist Albert Kligman's legacy

This is part of a series on Juneteenth, the anniversary of the emancipation of enslaved people in the United States. In their columns, members of the Penn community evaluate slavery, Penn’s relationship to it, and how this informs our understanding of race today.

Medical institutions have a long and terrible history of abuse and exploitation of the Black community in the United States.  It is no wonder and indeed it has been the reasonable, rational response that as a result of these abuses, the Black community has often mistrusted these institutions. Further, the pandemic has only served to exacerbate racially patterned health disparities.

On Juneteenth, as we commemorate the emancipation of enslaved people in the United States, it is crucial that institutions reflect on and address the ways in which they perpetuate the oppression of the Black community so that they may uplift and prove themselves deserving of the trust of the community. Though Penn’s ties with systemic racism run deep, one specific history that Penn still has yet to adequately address is the legacy of Dr. Albert Kligman, a Penn dermatologist who conducted experimentation on incarcerated men, mostly Black, in Philadelphia’s Holmesburg Prison from the 1950s through the 1970s. 

Kligman is best known as the inventor of the popular acne medication Retin-A. His research was non-therapeutic, as it sought to test commercial cosmetic products, dermatologic medications, and infections on inmates’ skin without yielding any direct benefits and in fact risking possible harm to their health. He did not restrict his research to benign tests; controversially, he undertook experiments that exposed inmates to infectious diseases and chemicals. Most notably, one of his experiments exposed inmates to dioxin, a carcinogen and component of Agent Orange, the chemical defoliant infamously used in the Vietnam War, as detailed in Allen Hornblum’s 1998 book, Acres of Skin. Inmates were paid for their participation, but given their limited opportunities to earn money and that many were unconvicted and imprisoned because they could not afford bail, these financial incentives were inherently coercive. In the context of the prison, the inmates lacked autonomy, so informed consent to participate was not possible. Senate hearings in 1973 led by Senator Ted Kennedy specifically used Kligman’s experiments as an example of unethical research, and subsequently the Belmont Report established bioethics guidelines banning most research involving incarcerated people.

Kligman’s experiments left scars on these men both physically and mentally. For instance, one former inmate, Yusef Anthony, has publicly recounted his experiences in Holmesburg and how they continue to plague his health today. The family of one of the most prominent advocates for these men who was an experimental subject himself, Leodus Jones, has also detailed both the generational impact and contribution to medical mistrust specifically in the Black community from these unethical studies.

However, these experiments are just one example of how medical research institutions have unethically exploited Black bodies over the course of history. Consider the Tuskegee Syphilis Study and the story of Henrietta Lacks: in both of these examples, like Kligman’s experiments, doctors infringed on the autonomy of Black people, underscoring the importance of informed consent in biomedical research. 

As more has been uncovered about Kligman’s experiments, it’s become clear that despite the innovative impact they made in the field of dermatology, they have still caused irrevocable harm. This harm has not gone unnoticed in the broader dermatologic community: groups such as the Society for Investigative Dermatology have removed their association with Kligman, eliminating his name from the awards and lectureships that were once labeled in his honor. Penn, however, has yet to do the same.

For decades, there have been repeated calls to action for Kligman’s legacy to be addressed by Penn. Recent pieces published in 34th Street and the Inquirer, and the #PennReparationsNow protest intended to “demand accountability for Kligman’s prison experiments,” yet the University has yet to thoroughly address the issue. Currently, Kligman’s name remains across multiple arenas within Perelman School of Medicine. Professorships, research labs, and a lectureship all bear his name. Displays in the atrium of the Hospital of the University of Pennsylvania and at the Perelman Center for Advanced Medicine highlight his contributions to Penn’s legacy, and specifically Retin-A. By proudly displaying his name without context and neglecting to formally apologize or publicly consider reparations, the University implies that they don’t see the trauma that Kligman inflicted as worthy of acknowledgement or compensation. This is unacceptable.

As undergraduate students who have been researching Kligman for months, we recognize that Kligman’s experiments both enriched Penn and harmed subjects. The University has benefitted from the millions of dollars in royalties and donations that products such as Retin-A have brought in, and Kligman can be credited as one of the most significant figures who furthered the field of dermatology within his years of practice. These positives, however, came at the expense and suffering of vulnerable people, the mostly Black prison population, but also intellectually-challenged children and others Kligman chose as subjects. 

Exactly one year ago, President Amy Gutmann made Juneteenth a University-wide holiday to create “intellectual space to pause for critical reflection and honest (in many instances painfully so) conversations.” It’s time for Penn to have an honest conversation of its own. 

Penn, as an institution, must look inwards. The University has an obligation to regularly evaluate whether its current practices are truly promoting diversity and inclusion, and not just performatively offering statements against systemic racism. Penn needs to acknowledge and apologize for harming its surrounding community, no matter how long ago the harm occurred. Indeed, Penn facilitated and benefitted from Kligman’s research practices on vulnerable and marginalized populations, and must take responsibility. 

As students, we want Penn to stop waffling around about its past. We want Penn to confront the full picture of its legacy, admit its complicity in the Kligman experiments, and formally apologize. Beyond this, the institution must pursue practical initiatives to dismantle such environments that engendered this pain, suffering and medical mistrust, particularly for the Black community. Penn must proactively recognize its troubling history dating back to Samuel Morton and up to and including the recent revelations of using remains of Black children killed in the MOVE bombing. It is not a single incident, but rather a longstanding pattern of Penn using Black bodies without consent for the advancement of science and medicine. In reconciling all of these histories together, Penn would more credibly demonstrate that it is grappling with its past and looking for a better way forward.

Countless people have called for the removal of Kligman’s name from laboratories on campus and prestigious awards. Additionally, many have demanded that the University teach students about the human cost of Kligman’s research. 

This past pandemic year has disproportionately affected marginalized communities and shown us the social inequities built into our society. There is no better time to confront the direct harm Albert Kligman inflicted on vulnerable populations. As Penn moves forward, it must constantly ask itself whether it is working towards ameliorating its long-standing systemic problems. Only then will its commitment to equity, justice, diversity and inclusion have any real substance.

HIBA HAMID is a College junior from Royersford, Pennsylvania, studying Neuroscience. Her email is hfhamid@sas.upenn.edu.

KARISHMA LACHHWANI is a College junior from Cleveland, Ohio, studying global health and healthcare management. Her email is ls29kari@sas.upenn.edu.

MARK ROMERO is a College senior from Birmingham, Alabama, studying Health and Societies. His email is mgromero@sas.upenn.edu.