Drug Testing: Cycle of Abuse on US Prisoners

By LeiLani Dowell

The federal Institute of Medicine recently released a report recommending that regulations limiting federal biomedical research on prisoners be relaxed so that inmates can participate in higher risk studies.

Current regulations allow prisoners to participate in federally financed biomedical research only if the experiment poses “minimal” risks to the subjects.

To support the recommendation to relax this rule, the report also suggested that greater precautions be taken. The report brief states: “Prisoners face restrictions on liberty and autonomy, limited privacy, and potentially inadequate health care services. These factors can be barriers to the prerequisites of ethical research, namely the acquisition of voluntary informed consent, protection of privacy, and access to adequate health care such that a choice between research participation and nonparticipation is not simply a desperate action to obtain treatment.

“All of these factors point to a population that is more vulnerable and requires stronger protections than those inspired by the national commission in the 1970s.” Recommended protections include enhancing the systematic oversight of research involving prisoners, and universal regulations and oversight of all testing, regardless of funding. Currently, all private and state testing on prisoners is unregulated. (www.iom.edu)

Yet many find it hard to believe that even with new protections, prisoners’ best interests and desires will be considered if more risky testing is allowed. For example, despite the IOM’s stated concerns about prisoner well-being, it failed to recommend full medical coverage and services for all prisoners.

Instead it suggests relaxing the minimal risk provision if the “potential benefits ... outweigh the risks.”

A New York Times report pointed out that the current incarcerated population suffers disproportionately from HIV and hepatitis C, which some researchers say “could be better controlled if new research were permitted in prisons.”

Paul Wright of Prison Legal News told the Times, “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.”

Daniel S. Murphy, professor of criminal justice at Appalachian State University, said, “Free and informed consent becomes pretty questionable when prisoners don’t hold the keys to their own cells, and in many cases they can’t read, yet they are signing a document that it practically takes a law degree to understand.”

Murphy said the recommended precautions were “also the parts of the report that faced the strongest resistance from federal officials, and I fear they’re most likely the parts that will end up getting cut as these recommendations become new regulations.” (New York Times, Aug. 13)

Poor & oppressed as guinea pigs The use of poor people, particularly people of color, as guinea pigs for pharmaceutical tests is nothing new.

For 40 years, the U.S. government conducted an experiment called the “Tuskegee Study of Untreated Syphilis in the Negro Male,” ending in 1972. More than 400 mostly illiterate Black sharecroppers with syphilis were experimented on without any treatment for the disease, even after a cure was discovered. Most had never seen a doctor before, and all were lied to and told that they were receiving treatment from the researchers.

At the end of the experiment, 28 of the men had died from the disease, 100 had died of related complications, 40 of their spouses had been infected, and 19 of their children were born with congenital syphilis. The experiment was conducted under the auspices of the U.S. Public Health Service, with the U.S. Surgeon General assisting the lie by sending the men certificates of appreciation. (www.infoplease.com)

Current regulations on prisoner testing were created only after widespread abuse was found in several prisons across the country. By 1972, the Food and Drug Administration estimated that more than 90 percent of new drugs were tested on prisoners first. (www.eh.doe.gov) Inmates were sometimes offered fees that were coercive given their inability to earn any real income otherwise.

In 1974 allegations of abuse were exposed to the public—such as testing at the Holmesburg Prison in Philadelphia, where studies were conducted on inmates with Agent Orange, psychotropic drugs, chemical warfare trials, and radioactive isotopes from the U.S. Atomic Energy Commission. (New York Times)A report by the Advisory Committee on Human Radiation Experiments of the Department of Energy points out: “The use of prisoners as research subjects seems to have been a uniquely American practice in the years following World War II. ... In other countries it seems that the first clause of the Nuremberg Code was interpreted to preclude the use of prisoners in experimentation. This clause begins with the assertion that the only acceptable experimental subjects are those who are ‘so situated as to be able to exercise free power of choice.’”

More recently, the pharmaceutical industry has taken to exporting its tests to the poor and oppressed outside the United States. In an Aug.30, 2005, article, The Nation magazine reported that U.S. drug producer Merck was at the time conducting 50 percent of its trials outside the United States, and Wyeth Pharmaceuticals was expected to have 70 percent of its trials overseas by 2006.

The Nation reported that “ethical lapses are strikingly common.” One example was the case of subjects of an HIV vaccine test in Thailand who apparently were misinformed that the test would protect them from the virus. The Nation reported that “placebo trials among ailing AIDS patients,” similar to the Tuskegee tests, “are frequently described in the medical press; when the subjects are poor Africans or Asians, nary an eye is batted.”

The use of prisoners as human guinea pigs is consistent with the overall treatment of working and poor people in the prison-industrial complex. Rather than subjects of rehabilitation, prisoners are considered dispensable, good only for work at slavery wages and subject to torture, brutality and racism at the hands of the prison guards.

Almost 7 million people are in U.S. prisons, jails, or on probation or parole. The United States has the highest prison population rate in the world, according to the International Center for Prison Studies at King’s College London. (www.kcl.ac.uk)

Email: ldowell@workers.org