In many cases, research that was conducted ignoring the main ethical principles was based on subjects’ exploitation. In the more recent situations, a similar picture can be observed. In 2014, a bioethicist noticed a common problem of homeless people being recruited as participants in clinical drug trials across America (Perry, 2014). While these cases were not brought to court, their failure to address research ethics continues to endanger people. Some people whom the bioethicist interviewed stated that these trials were nothing but beneficial for them. However, they often exhibited adverse effects of the drugs they were taking. These individuals did not receive any medical health and were not supported by the companies initiating these trials apart from a small financial compensation. This paper aims to discuss the clinical trials recruiting homeless people and whether they breach such ethical principles as informed consent, beneficence, and people’s vulnerability.
Breached Ethical Principles
While analyzing this case, a number of ethical principles can be regarded. First of all, homeless people may be deemed a vulnerable population, especially noting the fact that all participants had a mental illness (Fouka & Mantzorou, 2011; Perry, 2014). This also relates to the first principle of ethical research – informed consent. According to Fouka and Mantzorou (2011), people with mental illnesses may not be considered able to consent to certain activities fully. Therefore, their agreement to these trials can be viewed as invalid. This is also supported by the fact that their living environment increased the possibility of them being used because of their financial situation. As Lamkin and Elliott (2018) note, even if the compensation for such trials is substantial, they are still exploitive. While it is not clear how much money the discussed researchers paid their participants, ethical considerations of such actions remain debatable.
Participants’ health after the trials is also subject to analysis. It is clear that the individuals were not made aware of the consequences of these experiments. Their condition after taking drugs was unstable, according to the bioethicist. Many of them acquired side effects that could potentially be permanent (Perry, 2014). It is possible that these persons were not aware of the results. It is also unclear whether they were allowed to withdraw from research. Finally, one can argue that the intent of researchers was not benevolent, as they did not ensure to minimize harm (Polit & Beck, 2017). The health outcomes mentioned before were not treated by the researchers who did not provide participants with additional medical assistance to relieve symptoms and side effects (Perry, 2014). This inaction reveals a lack of social responsibility in this research (Resnik, 2015). Human subject protection was not enforced.
Suggestions
To avoid these ethical problems, researchers would have to recruit people who do not have such apparent financial problems. While this study may be necessary to conduct on individuals with mental illnesses, the participants should have legal guardians or responsible persons who can confirm the their consent and can assist them to withdraw from the trials. Furthermore, the consequences of the used medications must be avoided or mitigated. Medical assistance and healthcare coverage should be provided. These actions could protect people’s rights, while still being beneficial to the study. Mental illness is a sensitive issue that needs more attention being devoted to persons’ mental and physical health.
Conclusion
The discussed case of recruiting homeless people with mental illnesses for clinical trials is unethical for many reasons, including their vulnerable position, inability to fully consent, and the failure to minimize harm. Such research can be made ethical if researchers devote more attention to people’s health during and after the trials’ duration. Such processes need to be transparent and benevolent to protect human rights while contributing to current research.
References
Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1), 3-14.
Lamkin, M., & Elliott, C. (2018). Avoiding exploitation in Phase I clinical trials: More than (un)just compensation. The Journal of Law, Medicine & Ethics, 46(1), 52-63.
Perry, S. (2014). Recruitment of homeless people for drug trials raises serious ethical issues, U bioethicist says.MinnPost. Web.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
Resnik, D. B. (2015). What is ethics in research & why is it important. Web.