Medical Experimentation: Another Tuskegee Study or Beneficial Research

Penal institutions around the world have gross disproportionate rates of HIV infections as well as confirmed AIDS cases. As early as 1994, five point two cases of AIDS infection were reported per one thousand prisoners in the US penal institutions. It has also been validated that there is five times higher HIV infection rate in prisons compared to infection rates recorded among the general population. Some scientists have suggested that a controlled experimentation on inmates to test drugs aimed at controlling such infections should be carried out. This essay discusses a personal position on Dr. Albert M. Kligman theory that prisoners should be involved in medical trials. This essay also addresses both sides of the issue and provides a historical overview of the significant benefits and detriments involving medical testing of prisoners.

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Dr. Albert M. Kligman Theory on Using Inmates for Medical Trials

Kligman is well known for his contribution in conducting various human experiments amongst prisoners at Holmesburg Prison, which is situated in Philadelphia. Before the start of his experiments, Kligman had been invited by the prison officials to conduct tests meant to treat the athletes foot disease. However, later he started carrying out tests for pharmaceutical companies and various government agencies using prisoners as test subjects for different drugs. Between 1965 and 1966, Kligman had exposed about seventy-five inmates at the Holmesburg prison to high doses of the dioxin compounds.

All his efforts were faced with vast critic by both the prisoners and human welfare organizations around the world. It was ascertained that even though the prisoners were paid to participate in the drug trials, little was done to protect them from the negative effects of the drug used. In addition, some of the prisoners were intentionally exposed to various pathogens that caused infections such as the staphylococcus, athletes foot disease, and herpes. Also, the payments attained by inmates who participated in the tests was used for undesirable purposes in prison. The compensated prisoners used the funds to coerce sexual favors from other inmates in the prison. This increased the transmission of sexually transmitted diseases.

The Nuremberg Code

After these occurrences, Kligman still maintained that all his tests were consistent with both the scientific and ethical norms of that era. Nevertheless, approximately three hundred subjects that were tested while in prison sued him for the negative effects of the test drugs. According to the lawsuits, Kligmans tests were in violation of the Nuremberg Code. The code was introduced in 1947 after the Nuremberg trials (Mielke & Mitscherlich, 2002). This is after several Nazi doctors were convicted of crimes committed after drugs human experimentation on prisoners in concentration camps. The codes offer clear legal guidelines that should be followed when conducting various human experiments. Today, there are still several debates as to whether Kligmans strategy of using prisoners for drug experimentation should be upheld. This is in an effort to curb the increasing levels of HIV and viral hepatitis infections in prisons.

Statistical Link Between People Living with HIV and Prison

The HIV and viral hepatitis infection epidemic have affected numerous jails, prisons and other detention centers with an aggressive severity. Numerous persons in incarceration centers across the United States are adversely affected by various health conditions including HIV, STIs, TB and viral hepatitis. According to past research on this issue, an estimated one in every seven persons living with HIV passed through a jail or prison. The increased rate of HIV infections in prisons is attributed to the high-risk factors facing the inmates they are jailed to serve their prison sentence. Such risk factors include the use of injection drugs, other drugs abuse, untreated mental illness, rape, gang violence in prisons, commercial sex work, and low socioeconomic status.

Different Sides of Using Prisoners for Pharmaceutical Drug Experimentation

Positive Effects

In the medical arena, there is a dire need to develop curative pharmaceutical drugs that can treat numerous diseases and infections such as HIV/AIDs in the society. In the event that such drugs are invented, they can averse the high rates of deaths evidenced in numerous regions of the world. HIV/AIDs is among the highest causes of deaths in Africa among other nations of the world. Current clinical research on prototype drugs is performed using wild animals, such as monkeys, which are not as effective as using humans for clinical trials. For this reason, the use of inmates as subjects for clinical trials on pharmaceutical drugs should be considered. Nevertheless, comprehensive guidelines pertaining this approach must be put in place to ensure that all prisoners willing to partake in such experiments are well represented. They should have a complete knowledge of the probable side effects that might occur in their bodies due to their exposure to such drugs.

Negative Effects

Using prisoners to test the effectiveness of pharmaceutical drugs poses numerous health related challenges to the inmates. First, the prisoners are poorly represented when making a consent to be used for the drug trials while still in prison. In most cases, there is no complete transparency on the negative effects of such trials on their long-term health position. There are often offered funds as incentives for them to agree to partake in the medical trials. In such events, emergent conditions following the tests such as viral hepatitis and HIV among other diseases may arise. Such diseases are easily transmitted among prisoners in the incarceration centers increasing the burden of health expenditure on a nations economy. This could also result in an increased mortality rate among prisoners in the penal institutions.

Personal Position on the Issue

Personally, I do not agree with Kligmans approach to using prisoners for medical trials. This is because, in most penal institutions, the risk factors for transmission of diseases are very high. Sharing of injection drugs and sexual activities are among the primary factors resulting in the widespread of various diseases such as HIV/AIDs and viral hepatitis among others. Also, past drug experiments conducted on prisoners yielded catastrophic results. For instance, approximately seventy-five prisoners who consented to Kligmans drug trials suffered from high doses of dioxin. Dioxin is the primary poisonous ingredient of the Agent Orange (Reiter, 2009). Also, in 1946, hundreds of prisoners in the Guatemalan prison got infected with syphilis through clinical drug experimentation CITATION Mar14 \l 1033 (Maron, 2014). In this context, none of the prisoners were asked for their consent to partake in the drug experimentation exercise.

Conclusion

In conclusion, the levels of diseases and infections such as HIV/AIDS and viral hepatitis has increased tremendously in the prison systems. This is attributed to the high-risk factors such as drug abuse and sexual activities amongst inmates. Kligmans methodology to use inmates for clinical drug trials can have adverse negative effects on the health status of the tests participants. It could also affect the ability to control the spread of some of the emergent diseases attained from conducting such trials in prison. Some of the negative effects were seen in 1947 when seventy-five of Kligmans tests participants were exposed to high levels of dioxin. In 1946, hundreds of inmates at the Guatemalan prison were also infected with syphilis following clinical drug trials. For these reasons, inmates should not be used as participants for pharmaceutical drug experiments.

References

BIBLIOGRAPHY F, M. A. (2002, June 09). The Nuremberg Code (1947). British Medical Journal, Vol. 313, Pp. 1448. Retrieved March 20, 2016, from http://www.cirp.org/library/ethics/nuremberg/

Maron, D. F. (2014, July 02). Should Prisoners Be Used in Medical Experiments? Retrieved March 20, 2016, from Scientific American: http://www.scientificamerican.com/article/should-prisoners-be-used-in-medical-experiments/

Reiter, K. (2009, April ). Experimentation on Prisoners: Persist Dilemmas in Rights and Regulations. California Law Review.pdf, Vol. 97(No. 2). Retrieved March 20, 2016, from http://scholarship.law.berkeley.edu/californialawreview/vol97/iss2