Under the spreading chestnut tree I sold you and you sold me...

August 13, 2006 2:46 AM

Panel Suggests Using Inmates in Drug Trials PHILADELPHIA, Aug. 7 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. Cruel and unusual punishment?
posted by Unregistered User (41 comments total)

Panel can fuck itself.
posted by delmoi at 3:03 AM on August 13, 2006

Absolutely disgusting.
posted by sic at 3:43 AM on August 13, 2006

Is it disgusting if they volunteer?
posted by BuddhaInABucket at 4:43 AM on August 13, 2006

"The potential medical benefits outweigh the potential risks."

Same argument worked for embryonic stem cells. Just saying.
posted by brownpau at 5:00 AM on August 13, 2006

Blame Bush.
posted by vhsiv at 5:21 AM on August 13, 2006

How is it punishment? The inmates volunteer and are paid.
posted by noble_rot at 6:05 AM on August 13, 2006

Is it disgusting if they volunteer?

Does it constitute free and informed consent if you're locked up
in prison earning 41 cents an hour?
posted by PeterMcDermott at 6:17 AM on August 13, 2006

Ho hum
posted by thirteenkiller at 6:24 AM on August 13, 2006

Eugenics?
posted by blue_beetle at 6:36 AM on August 13, 2006

As long as they volunteer, and are paid, and are given the same disclosure that non-incarcerated people would be, I see nothing wrong with it.

Does it constitute free and informed consent if you're locked up
in prison earning 41 cents an hour?
posted by PeterMcDermott at 8:17 AM CST on August 13

Although the wage is irrelevant, yes it does constitute free and informed consent if it is completely voluntary and all information is disclosed beforehand. Yes many of them are of low IQ, but that would be the case if they were on the outside, and therefore eligible.

Someone has an ailment that no other drug can treat or manage. They hear of a new drug being tested that might work, but its unknown and a bit of a gamble. Does it matter if the person earns $1000/yr or $100,000/yr?
posted by Ynoxas at 6:38 AM on August 13, 2006

free and informed consent is not a luxury that prisoners are often granted. i agree that it'd be fine if they were able to consent. but, in a system where prisoners have almost zero power over even the most basic elements of their lives, abuse is bound to happen. it would be way too easy for prisoners to be "volunteered" against their will -- as the article mentions, this is why they banned the practice to begin with. the ones who stand to gain from this arrangement -- prisons and those who run and profit from them, drug companies, legislators who court the favor of corporate interest and public opinion -- have all the power. i just don't see this happening without it turning into a corrupt system.
posted by cubby at 6:58 AM on August 13, 2006

In 2000, several universities were reprimanded for using federal money and conducting several hundred projects on prisoners without fully reporting the projects to the appropriate authorities.

So why even bother with regulations if such experiments will incur the wrath of a reprimand?
posted by rolypolyman at 7:09 AM on August 13, 2006

The inmates volunteer and are paid

if the inmates are paid is that really volunteering? cash incentives for any clinical trial are never a good idea. sounds like coercion to me.
posted by brandz at 7:25 AM on August 13, 2006

If the wage is irrelevant, why is it that the majority of
people who volunteer for drug trials tend to be poor
people?

The old Anatole France quotation about the law forbidding
rich and poor alike from sleeping under bridges and begging
in the streets springs to mind.

Someone has an ailment that no other drug can treat or
manage. They hear of a new drug being tested that might
work, but its unknown and a bit of a gamble. Does it matter
if the person earns $1000/yr or $100,000/yr?


No, because their motivation for involvement in the trial isn't
an economic one, it's the prospect of extending their life of
improving their wellbeing.

However, when you're talking about testing new drugs on
people who aren't ill, simply to try and discern whether there
are possible side effects and what those side effects might
be, then I think income level is a very significant factor in
participation.

For example, I don't envisage many well-to-do people getting
involved in the sorts of trials that resulted in this.
posted by PeterMcDermott at 7:28 AM on August 13, 2006

Philly is the home of Glaxo SmithKline, by the way.
posted by wfc123 at 8:19 AM on August 13, 2006

This had been discussed at length in the medical ethics and research community and there is an overwhelming conensus that prisoners, like children and the cognitively impaired, consititute a special "protected class" of research subject who cannot be presumed capable of non-coerced, informed consent. There is a long history of abuse of prisoners in medical research, most notoriously in Nazi Germany (sorry for the Godwin, but it seems appropriate) but also in many other countries including the United States. As part of training required to be eligible for Federal research funds, all biomedical researchers must review some of these abuses. The current guidelines in no way prohibit medical research on prisoners (or children or the cognitively impaired), but they do give the populations additional protections. The goverment's rules, regulations, and educational materials are all availble through the Dept. of Health and Human Services website; specific protections for prisoners are here.
posted by TedW at 8:26 AM on August 13, 2006

You can't determine what you'll have for breakfast, lunch or dinner. You can't determine when you'll wake up. You can't determine when the lights will go out.

But you can decide to participate in an experiment involving a potentially hazardous drug.
posted by jason's_planet at 8:34 AM on August 13, 2006

But you can decide to participate in an experiment involving a potentially hazardous drug.

...and you decision is placed in your file, which is read during your parole hearing.

Sorry, there's no informed consent here, other than the sense of "Do it, or you'll spend more time in jail."
posted by eriko at 8:45 AM on August 13, 2006

Philly is the home of Glaxo SmithKline, by the way.

Home for much of Big Pharma, here and in the Delaware valley.

The reasons this is a bad idea are manifold, but looking past the obvious moral issues, mainly it would be bad science, doing drug trials on a population with poor health and compromised immune systems.
posted by Blazecock Pileon at 10:01 AM on August 13, 2006

I work on a couple of the prison conditions class actions in California, and get a lot of prison mail about medical care/lack of medical care/medical malpractice. Many many letters about prescription medications -- people not getting the prescription they need, people getting the wrong prescription. Pretty hair-raising stuff, and this is AFTER the system has been sued many times and has entered into consent decrees. (One guy was taken off cold turkey from an opiate he had been on for two years for nerve damage. As any vaguely aware person knows, and as the FDA label for the drug says over and over, you can't take someone off suddenly from an opiate. Our guy was vomiting and blacking out from withdrawal, and they didn't fix it until we intervened. ) So I have to agree with the quote in the article from the prison lawyer who talks about how weird it is to talk about inmates benefitting from cutting edge medical developments when they can't get basic antibiotics and other *minimal* sorts of care. Also, it's hard to imagine any "science" happening in prison. The conditions are so chaotic, all of the medical staff so compromised (the good doctors leave or resign themselves to practicing within their small universe of patient-inmates, the bad doctors stay and end up running things). If I ran the world, maybe I would let the pharmaceuticals test drugs on "consenting" prisoners if the companies agreed to take over and run the prison pharmacy and drug-prescribing at the particular prison and reach the standards of a private care before the tests began.
posted by ClaudiaCenter at 10:42 AM on August 13, 2006

Prisoners serving life sentences should have to participate in these trials as a mandatory part of their punishment.
Who should suffer more for our new drugs, innocent animals or guilty prisoners?
I would also like to volunteer their organs, blood, and bone marrow for donation.
We pay taxes to support their imprisonment, it's time to start seeing a little benefit on the flip-side.
Thank you.
posted by BillBishop at 10:45 AM on August 13, 2006

It seems a little strange to discuss the use of any drugs on people who don't need them.
posted by Brian B. at 10:57 AM on August 13, 2006

Who should suffer more for our new drugs, innocent animals or guilty prisoners?

I volunteer BillBishop!
posted by lumpenprole at 11:15 AM on August 13, 2006

Right BillBishop. We need to turn those pesky loss-leading prisons into profit centers. Then, when we need more "employees" to make the numbers for next quarter, we can just invent more crimes for people to be guilty of.
posted by b1ff at 11:24 AM on August 13, 2006

Why is this necessary? We already have a population of unwilling test subjects to perform these experiments on. It's happening today. They're called 'the military.'
posted by mullingitover at 11:34 AM on August 13, 2006

"Prisoners serving life sentences"
Under California's 3 strikes law, that could include shoplifters.
posted by 2sheets at 12:01 PM on August 13, 2006

Normal Volunteers. Strange as it may seem at first, special concerns surround the involvement of normal (i.e., healthy) persons who volunteer to participate in research...While the minimization of risks is an important requisite for any research involving human participants, the altruistic motivation of the normal volunteer's agreement to participate (i.e., of contributing to scientific knowledge for the benefit of society) heightens the concern for the risks to which such participants should ethically be exposed.

Yikes! This is apparently not true if you are a prisoner, are traumatized or comatose, terminally ill, elderly, in a racial/ethnic minority, female, a student, or the employee of the company whose drug is under consideration: all of these groups are considered to have limited or compromised agency, according to the US HHS document. And it seems that HSS is saying that either devalues their altruism, or precludes it.
posted by owhydididoit at 12:11 PM on August 13, 2006

let the pharmaceuticals test drugs on "consenting" prisoners if the companies agreed to take over and run the prison pharmacy and drug-prescribing at the particular prison and reach the standards of a private care before the tests began.
posted by ClaudiaCenter at 12:42 PM CST on August 13 [+] [!]

I think that's a fantastic idea.
posted by Ynoxas at 12:19 PM on August 13, 2006

From the article, referring to prisoner experiments in the 60s: "What started as scientific research became pure business"

Of course, Big Pharma is pure business already, so we've taken care of that problem. If they can rig it so that the warden gets a spiff for every prisoner he volunteers, then it'll be perfect.
posted by adamrice at 2:01 PM on August 13, 2006

Paging Dr. Mengele. Dr. Mengele please report to the prison drug testing ward....
posted by ilsa at 2:37 PM on August 13, 2006

Way to think like the Chinese, US Corporate Prison system!
posted by five fresh fish at 2:51 PM on August 13, 2006

Prison is a place where you cannot say no. I do not think that mindset would change for 'voluntary' drug testing.
posted by Malor at 3:40 PM on August 13, 2006

9/11 Detainee Freed After Nearly Five Years

This man, who had nothing to do with 9-11, rotted in jail for five years, wonder what the pharms coulda "researched" and "discovered" in all that time. Hell, he could cured hemorrhoids or something and we let him go...

Damn liberals...

Mengele, indeed.
posted by Unregistered User at 4:06 PM on August 13, 2006

The right to volunteer to participate in clinical trials is one of the things you lose when you're incarcerated. The panel is advocating that this right be restored, not that prison inmates be experimented upon against their will.
posted by ikkyu2 at 5:02 PM on August 13, 2006

The right to volunteer to participate in clinical trials is one of the things you lose when you're incarcerated. The panel is advocating that this right be restored, not that prison inmates be experimented upon against their will.

Hello? Have you read any of the comments? History has made it abundantly clear that there is NO DIFFERENCE between these two things. If prisoners are "allowed" to participate they will be coerced into participating. That's a near certainty.
posted by straight at 6:08 PM on August 13, 2006

straight: I don't think it is at all "abundantly clear" that there is "NO DIFFERENCE" between these things.

Just stating that something is so does not make it so.

Let's frame it another way. Do you believe that all inmates are intellectually inferior, and none of them are capable of choosing something of this nature? Do you think all inmates become mindless zombies the moment they are incarcerated, for any length of time, for any crime? You are then, in fact, in favor of further removing any choice and portion of independence from those incarcerated?

From the article:

Alvin Bronstein, a Washington lawyer who helped found the National Prison Project, an American Civil Liberties Union program, said he did not believe that altering the regulations risked a return to the days of Holmesburg.

“With the help of external review boards that would include a prisoner advocate,” Mr. Bronstein said, “I do believe that the potential benefits of biomedical research outweigh the potential risks.” [emphasis mine]

So, someone who would be considered an expert on prisons, and with all certainty more well versed on the subject than anyone in this thread, says it could be done with some oversight. That is a LONG FUCKING WAY from your position.

Tone down the outrage for just a moment, and realize this was a situation where, perhaps, the baby was thrown out with the bathwater.

Is it a simple yes or no? Not exactly. But it certainly is deserving of discussion, hardly the automatically dismissive tone most in this thread have posited.
posted by Ynoxas at 6:30 PM on August 13, 2006

Likewise, the use of prisoners for organ transplants. One criminal can restock the vital organs of a dozen victims suffering the loss of a dozen different organs. Eyes go to gramma, kidneys go to Stu, Uncle Pete can get that leg transplant he's always wanted...
posted by five fresh fish at 7:19 PM on August 13, 2006

Let's do it! I simply do not see how this could possibly be abused. Are there any groups that are more blame-free than the prison system or the pharmaceutical industry?
posted by Slarty Bartfast at 9:58 PM on August 13, 2006

That some sick-ass shit.

I say we bury the "safe" nuke-waste in the front lawns of the energy CEOs. And I say this panel should be the first to volunteer to be experimented on. That would be rEAL leadership.
posted by Twang at 1:27 AM on August 14, 2006

I wonder how the opinions would change if they were only going to test drugs on child molesters and pedophiles. After reading other posts, I have the feeling that support for such a program would be overwhelming.
posted by drstein at 10:04 AM on August 14, 2006

Hmmm...Can’t we just kill all the people on the influential federal panel of medical advisers?

Oh, wait, that’d make me a murderer. And then I’d be subjected to the very drug testing I’d opposed. Oh, the irony!
No, I don’t think prisoners should be given a choice whether to be tested on or not. They no longer have the right to make those decisions. They are wards of the state. As such they are under the power of the state and are the responsibility of the state. That means, ultimately, the people. We seek justice by the law. That is not some dodge by which we can make money off of those who are incarcerated or seek scientific advancement at their expense. They are not unhuman because of their crimes, they are simply criminals. No more, no less. The nature of their crimes, whatever the severity, does not change the nature of the law. And that is what we are seeking to do. Render a certain class of person as outside of protection of the laws which also protect us. Render them literally ‘beyond the pale’ and that is unacceptable. If anything prisoners are - and should be - more intimately tied to the law, restricted by it as well as protected by it, than other citizens, precisely because they are so vulnerable to social exploitation. I’m no liberal by any means and my heart doesn’t bleed for child molesters and the like, but corruption of any kind - even that directed at the corrupt, breeds futher corruption. Indeed I’d always thought it more aligned with liberal philosophy to grant exceptions to tried and true methods. The system we have in place now is working, it sucessfully prevents abuses of the kind that have gone on before and what’s more it satisfies the duties of the state to it’s citizens whether incarcerated or not. I see no reason to change it whatever “experts” chime in on it. God only knows who’s wallets they’re feeding out of. And I am more afraid of “influential panels” allied with drug or other corporations than any inmate. I can kill some bastard trying to molest my child. I cannot put my hands on the kind of juggernaut these dealings portend. An unjust man can be fought. An unjust method is another business entirely.
posted by Smedleyman at 4:29 PM on August 14, 2006