The Use of Prisoners as a Research Subject - Ethical Issues of Research with Human Subject

Prisoners face problems in their day in day out lives behind the bars. It is in this light that scientists get interested in studying the medical or social problems faced by the prisoners. It is however very difficult to conduct the research without the direct involvement of the prisoners as research subjects. This paper aims to explore the background of exploitative research involving prisoners, the exploitative research involving prisoners, the codes of ethics on research, measures put in place to safeguard the prisoners from exploitation by the researchers, the access of prisoners to research, and the recommendations that can make research on vulnerable groups fair.

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The background of exploitative research involving prisoners.

In the past century, research on prisoners went terribly wrong and almost sixty percent of the research conducted in the prisons brought serious side effects including the death of the prisoners. The exploitation and abuse reached its peak during the World War II inside the Nazi camps. The scientist conducted experiments on diseases like malaria, sand-fly fever and sleeping sickness (Brody, B. A. (1998). Most of these experiments were aimed at acquiring knowledge for military purposes. The injustices that happened then propelled the advocates of human rights to come up with codes of ethics in research involving humans. The regulations provide strong protection for prisoners. The regulations however faced a lot of critics for being too restrictive and prohibitive for access of prisoners research. This endangered the life of prisoners in terms of health and other problems facing them behind bars. It is not until 1978 when there was the revision of the Common Rule. The revised rule aimed at addressing the legal protection of prisoners under research, the consent issues of prisoners and protection against non-consensual treatment (Cislo, A. M., & Trestman, R. (2013). This made a breakthrough in the protection of research on prisoners and until today the treatment towards prisoners in conducting research is better and keeps improving.

Why prisoners are a vulnerable group of research

The vulnerability of research subjects is inextricably tied to the efficacy of their consent prior to and when a person serves as a subject to a research, his or her consent should be individualized. Some groups of persons are considered vulnerable, for example people who are institutionalized i.e. the prisoners (Coughlin, S. S. (2006). Vulnerability in human subjects research is mainly brought about by two factors: mental limitations that impair an individual's ability to weigh the pros and cons of research, and pressures and coercion either internally or externally that make the person participate in the research. In the case of prisoners, their environment makes them prone to coercion. (Denscombe, M. (2014). . The vulnerability of prisoners is more rampant since: (1) prisoners constitute a readily available and relatively easily managed study population. (2) Research involving prisoners is very cheap as compared to other human subjects. (3) They are steady research subjects since they live in closed habitats and therefore the continuity of a follow-up is guaranteed. (4) They have no liberty. (5) They are impecunious and the general conditions of most prisons are bad.

The codes and ethics governing research on prisoners

Prisoners, as a vulnerable population, are in jeopardy of receiving a disproportionate share of the risk associated with human subjects research (Kipnis, K. (2001). As stated by the National Bioethics Advisory Commission (NBAC), In research involving human subjects, risk is a central organizing principle, a filter through which protocols must pass (NBAC, 1998).

The Common Rule came in to aid in protecting the rights of prisoners (Kipnis, K. (2001). It contains the requirements for informed consent, the risk or benefit analysis, the review of institutional review boards (IRB) and goes an extra mile to provide extra protection for particularly vulnerable research subjects including detailed restrictions for research involving prisoners in sub-section C of the Common Rule document (Kimmel, A. J. (2009). Research on prisoners must present no more than minimal risk, defined as the probability and magnitude of physical or psychological harm normally encountered in the daily lives or in routine medical or psychological examination of healthy persons. Research is permitted only if it is related to (1) Causes, effects and processes of incarceration, (2) Prisons as institutional structures or prisoners as incarcerated persons, (3) Conditions particularly affecting prisoners as a class, and (4) Practices that have the intent and reasonable probability of improving the health or well-being of research participants.

Further conditions in subpart C stipulate that any incentives for participation in research must be of such a magnitude that the freedom of choice for participation are not impaired in the limited choice environment of a prison and that the selection of participants are fair and random (Israel, M. (2014). Prisoners can be recruited for research only under certain conditions, and usually not at all. When considering designing a study that would enrol prisoners, the investigator and IRB must determine if it is even permissible to study prisoners. Generally, only research that has potential to be of benefit to the prisoner is permitted (Meierhenrich, J. (2014). Recruitment practices are closely scrutinized by the IRB and must be fair to all prisoners. Prisoners must be informed that parole boards and other prison officials will not take into account any prisoners participation in the research. It is recognized that prisoners may not feel free to refuse to participate because of undue influence by prison officials and clinical investigators (Seidman, I. (2013).

Measures that have been taken to prevent the exploitation of prisoners used as research subjects:

Prisoners are being integrated in the planning of the research projects that are direct benefit to the prisoners themselves.

There is also increased participation in the consent process of the prisoners, the ones that have reading disabilities and those with problems in language barrier are helped. The confidentiality of the consent process is also advanced nowadays (Zimbardo, P. G. (2007). Prisoners without the ability to make their own consent do not participate in the research process unless their guardians or parents do consent.

The coming in place of the laws safeguarding the research process has played a very important role in the protection of the prisoners used as research subjects (Schwenzer, K. J. (2008).

Recommendations

There is need to guide the people who conduct the researches on how to do so in an ethical manner

The independence of IRBs is a significant issue in evaluating enhancement research, because the institutions themselves i.e. the prisoners may benefit from the enhancement of their constituents.

Certain protections provided for prisoners, such as representatives on the IRB and restrictions on inducements or penalties for participation, should not be provided for in writing but also should be practised and implemented.

The rules, laws and code of ethics governing the research processes should be made available to the prisoners and also interpreted to them in a manner that is easily understandable.

References

Brody, B. A. (1998). The ethics of biomedical research: an international perspective. Oxford University Press, USA.

Cislo, A. M., & Trestman, R. (2013). Challenges and solutions for conducting research in correctional settings: The US experience. International Journal of Law and Psychiatry, 36(3), 304-310.

Coughlin, S. S. (2006). Ethical issues in epidemiologic research and public health practice. Emerging themes in epidemiology, 3(1), 16.Denscombe, M. (2014). The good research guide: for small-scale social research projects. McGraw-Hill Education (UK).

Israel, M. (2014). Research ethics and integrity for social scientists: Beyond regulatory compliance. Sage.

Kipnis, K. (2001). Vulnerability in research subjects: A bioethical taxonomy. Ethical and policy issues in research involving human participants, 2.Kimmel, A. J. (2009). Ethical issues in behavioral research: Basic and applied perspectives. John Wiley & Sons.Levine, C., Faden, R., Grady, C., Hammerschmidt, D., Eckenwiler, L., & Sugarman, J. (2004). The limitations of vulnerability as a protection for human research participants. The American Journal of Bioethics, 4(3), 44-49.

Meierhenrich, J. (2014). Genocide: a reader. Oxford University Press USA.

Seidman, I. (2013). Interviewing as qualitative research: A guide for researchers in education and the social sciences. Teachers college press.Sieber, J. E., & Tolich, M. B. (2013). Planning ethically responsible research (Vol. 31). Sage.Sparks, R., Bottoms, A. E., & Hay, W. (1996). Prisons and the Problem of Order (p. 2). Oxford: Clarendon Press.

Schwenzer, K. J. (2008). Protecting vulnerable subjects in clinical research: children, pregnant women, prisoners, and employees. Respiratory care, 53(10), 1342-1349.Zimbardo, P. G. (2007). Lucifer Effect. Blackwell Publishing Ltd.