A recent Institute of Medicine Report has recommended that drug testing be allowed on prisoners, thereby lifting a decades-old ban on this practice. The recommendation is drawing both criticism and support from government and industry.
I don’t think that recruiting prisoners to test experimental drugs is a good idea.
The Nuremberg Code is the cornerstone on which all regulations governing clinical research are based. This is a 10-point code that describes the basic principles of ethical behavior in the conduct of human experimentation. The code was written by judges who had presided over the “Nazi Doctors Trial” for which 20 physicians, all members of the Nazi Party, were charged with murder, torture and other atrocities committed in the name of medical science...
One of the Nuremberg Code’s points is that informed consent should be obtained without coercion.
Considering all the hand-wringing by ethicists and the general public about whether the poor in developing countries can freely give consent, I find it unfathomable that the Institute of Medicine Report would actually recommend testing experimental drugs on people who cannot make their own basic decisions about anything—food they will eat, clothes they will wear or when they will leave.
The New York Times reported that “supporters of such programs cite the possibility of benefit to prison populations, and the potential for contributing to the greater good.” These “supporters” are confusing access to good healthcare with a medical experiment. And, are prisoners really interested in “contributing to the greater good”? If the U.S. is party to medical experimentation on prisoners, as the Nazis were to it on concentration camp internees, what I see is a dangerous road ahead where non-prisoners come to believe it is their right to have their drugs tested on prison populations and not themselves.
It is imperative that Americans not adopt the attitude that drug testing should be conducted just on the prison population. The U.S. government has worked hard to make clinical research participation better reflect the population of patients who might be users of the drug post-approval. There is still a way to go before clinical research participation is truly representative of women and minorities and peoples from around the world. Allowing prisoners to be tested for clinical research will present a major setback to the public’s attitude toward clinical research participation and ultimately be detrimental to us all by possibly destroying the entire drug development process as we know it.
