A Different Kind of Trial for Prisoners

A major problem for the California prison system has been the finding that the incarcerated have woefully inadequate medical care. Basic medication like antibiotics are unavailable, and even when available can't be given because of a lack of professional staff to write the script and then oversee its administration. That's why a recent article in the NY Times gave me chills when I read it.

An influential federal panel of medical advisers has recommended that the government loosen regulations that severely limit the testing of pharmaceuticals on prison inmates, a practice that was all but stopped three decades ago after revelations of abuse.

The proposed change includes provisions intended to prevent problems that plagued earlier programs. Nevertheless, it has dredged up a painful history of medical mistreatment and incited debate among prison rights advocates and researchers about whether prisoners can truly make uncoerced decisions, given the environment they live in.

...The discussion comes as the biomedical industry is facing a shortage of testing subjects. In the last two years, several pain medications, including Vioxx and Bextra, have been pulled off the market because early testing did not include large enough numbers of patients to catch dangerous problems.

And the committee’s report comes against the backdrop of a prison population that has more than quadrupled, to about 2.3 million, over the last 30 years and that disproportionately suffers from H.I.V. and hepatitis C, diseases that some researchers say could be better controlled if new research were permitted in prisons.

...“It strikes me as pretty ridiculous to start talking about prisoners getting access to cutting-edge research and medications when they can’t even get penicillin and high-blood-pressure pills,” said Paul Wright, editor of Prison Legal News, an independent monthly review. “I have to imagine there are larger financial motivations here.”

The article goes into some depth in describing the scandalous testing done on prisoners in the 1970's, especially at one prison. There was no oversight of the programs, and many prisoners from that period continue to suffer the consequences of the clinical trials in which they participated. Because of those programs, most clinical trials were stopped at the prisons.

Now, a panel suggests reopening that door under stricter guidelines and federal oversight. The ethics of the whole idea still haven't been fully addressed. While testing is part of any research, and while that research needs to continue, it's hard for me to see how those who are incarcerated really have the basis for an informed consent. Many can't read, many more have less than adequate education. They are locked away in a system which doesn't provide even the most basic of medical care. The prisoners may not be nice people, but surely they are still entitled to certain basic rights.

I think this is an horrendously bad idea. If PHARMA wants test subjects, let them go to the general public outside the prison walls, those who at least have a shot at medical care.