Introduction
The history of conducting clinical trials on inmates in the United States has long been marred with cases of prisoner abuse and exploitation. Nevertheless, the Nuremberg Code and Belmont Report led to the development of research ethics, which highlighted the oppressive practices of the researchers. This led to the establishment of 45 C.F.R. part 46, subpart C, which categorizes inmates as vulnerable populations, limiting the circumstances under which they would be used for clinical research (Huang et al., 2017). Under this regulation, prisoners can only be used as subjects in research studies involving criminal behavior, inmates’ conditions, or experiments that aim to enhance their well-being (Christopher et al., 2017). In addition, convicts may participate in clinical trials aimed to determine an illness’s prevalence or its probable risk factors. However, the issue of experimenting on prisoners continues to elicit mixed reactions among the public. The supporters of both sides argue that the principles of justice, respect for persons, and beneficence are in their favor. Inmates should not be involved in medical experiments because they lack free, informed consent and barely benefit from the research.
Arguments Supporting Clinical Trials on Inmates
The prison population may benefit from the discoveries made in clinical trials. Research indicates that compared to the general public, most inmates suffer from chronic diseases such as HIV/AIDS, hepatitis, tuberculosis, and diabetes (Huang et al., 2017). Therefore, denying this population the chance to participate in medical experiments may deprive them of life-saving treatment approaches. Some prisoners may view medical experiments as an opportunity to receive high-quality healthcare services that are almost inaccessible to the incarcerated population. Similarly, based on respect for persons, prisoners should be regarded as autonomous beings with the freedom to choose whether or not to be involved in medical trials (Christopher et al., 2017). In this case, some inmates may participate in medical experiments to benefit society. Not to mention, the main limitation linked with experimenting on convicts is the scientists’ unethical practices. Hence, if stringent regulations are implemented to further protect the inmates, such research studies may yield positive results that benefit the prisoners and the general public (Huang et al., 2017). Thus, clinical trials can profoundly enhance the welfare of convicts by developing diverse treatment plans to manage or cure their ailments
Arguments Opposing Clinical Trials on Prisoners
Most of the inmates are unable to give free and informed consent. Due to the oppressive nature of prison facilities, convicts hardly have the right to self-determination. This implies that the incarceration conditions encourage prisoners to participate in studies they would not consent to if they were free. Additionally, some inmates’ involvement in clinical trials may not be due to free consent but to various motivating factors, such as rewards and better treatment. Many prisoners participate in research to obtain reduced sentences, finances, better living conditions, and medical aid (Christopher et al., 2017). For example, most inmates who participated in the Holmesburg prison experimentation were attracted by the monetary incentives, promises of reduced sentences, and Dr. Albert Kligman’s assurance of the study’s safety (Tanenbaum, 2022). Such motivations encouraged the prisoners to test different skin creams and be exposed to toxic chemicals such as dioxin resulting in long-term illnesses. This rules out the idea of informed consent because the inmates did not know they were testing on chemicals that would adversely affect their health. Therefore, prisoners cannot give free and informed consent due to the constraints involved in the prison system.
Most research studies do not aim solely to benefit the inmate population. The push for inmates’ experimentation is mainly influenced by the drive for scientific discoveries and business priorities, including profits and expediency but has no regard for the convicts’ well-being. For instance, in the Tuskegee study, the experiment intended to monitor the full progression of syphilis and disregarded the prisoners’ welfare. Even though penicillin became the recommended drug for treating syphilis in 1947, the researchers continued administering supplements to the prisoners until 1972, when the study was ended (McVean, 2019). Consequently, some inmates suffered insanity and blindness; by the end of the Tuskegee experiment, 128 prisoners had died from syphilis or related complications, with some having infected their spouses (McVean, 2019). In addition, the ailment had been transmitted to at least 19 children during birth. In another case, the Holmesburg experiments on skin chemicals resulted in huge research breakthroughs which profited pharmaceutical companies such as Dow Chemicals and Johnson & Johnson (Tanenbaum, 2022). Therefore, the trials benefited big organizations while predisposing the inmates to various health complications, proving that experimenting on prisoners defies beneficence and justice principles.
Position
Clinical trials should not be performed on inmates due to the lack of free and informed consent. Prisons or correctional facilities are coercive environments where a convict’s free choice has been heavily compromised (Christopher et al., 2017). Therefore, the decision on whether or not to participate in medical research is influenced by motivating factors such as cash rewards or fear of disciplinary actions by correctional officers but not by consent. With such limited choices, it is challenging for prisoners to opt out of clinical trials. Some critics may argue that with proper government oversight, medical experiments may be conducted safely to safeguard prisoners’ rights (Huang et al., 2017). However, current laws present a lot of loopholes for scientists to continue exploiting the incarcerated population. Therefore, medical experimentation should not be conducted on inmates because they have limited rights, which deter them from withdrawing from research if it adversely affects them.
Although some researchers suggest that medical experiments may significantly benefit the prisoners by availing various treatment plans, evidence indicates that inmates’ welfare is the least priority in research. For instance, the Tuskegee, Guatemala, and Holmesburg experiments are characterized by immense suffering of the inmates resulting in high fatalities and adverse health conditions. In addition, Dr. Kligman’s description of inmates as “acres of skin” shows that researchers are only interested in making medical discoveries to benefit themselves but not the inmates (Tanenbaum, 2022). Furthermore, studies conducted on prison subjects take a prolonged period, implying that some inmates may die in the process and thus fail to benefit from the medical experiment that led to their demise. Therefore, medical experimentation on convicts should be banned because it does prioritize their welfare.
Conclusion
In conclusion, the issue of inmates’ involvement in clinical trials continues to elicit public debates due to its long history of prisoners’ exploitation. On one side, proponents maintain that experimenting on convicts may result in significant scientific discoveries that may benefit both criminals and society. The respect for person principle also safeguards a prisoner’s right to participate in medical research. Alternatively, the opponents argue that inmates should not participate in research studies because they are coerced or motivated by different constraints in the prison environment. Similarly, most research studies are driven by the need for scientific breakthroughs or company profits and hence are not aimed at solely benefiting the incarcerated populations. Although there is a possibility that clinical research on inmates may provide high-quality treatment approaches to help manage their conditions, scientists may exploit the loopholes in existing laws to continue abusing prisoners. Therefore, clinical trials should not be performed on prisoners because they lack free, informed consent that allows them to withdraw from research if necessary.
References
Christopher, P. P., Garcia-Sampson, L.G., Stein, M. D., Johnson, J. E., Clarke, J., Rich, J. D., & Lidz, C. W. (2017). Enrolling in clinical research while incarcerated: What influences participants’ decisions? Hastings Center Report, 47(2), 21–29.
Huang, E., Cauley, J. & Wagner, J.K. (2017). Barred from better medicine? Reexamining regulatory barriers to the inclusion of prisoners in research, Journal of Law and the Biosciences, 4(1), 159-174.
McVean, A. (2019). 40 years of human experimentation in America: The Tuskegee study. McGill. Web.
Tanenbaum, M. (2022). Philadelphia apologizes for ‘deplorable’ history of medical experiments on Holmesburg prison inmates. PhillyVoice. Web.