Ethics: Use of prisoners as medical research subjects

[Broomstick]

What makes you think the prison demographic is different from the rest of the population biologically?

Among other things, the rate of HIV, hepatitis, veneral infections, and several other nasty disorders are MUCH higher in the incarcerated population than the population at large. And all of the above would be extremely unsuitable for organ or tissue donation.

Drug addiction, with its attendance side effects, is also much more prevelant. Organs injured by addictions - kidneys, livers, hearts, etc. - would be unsuitable for donation.

[Broomstick]

Death row inmates should be forced organ donors. Face it; they're going to die anyway, so you might as well save the body.

Now this I understand, assuming the execution itself doesn't damage organs.

Lethal injections renders organs unfit for transplant. So does the gas chamber. (Both techniques leave the body tissues saturated with poisons). Some organs might remain viable after hanging or beheading, but you'd need surgical team right there. Firing squad risks damaging vital structures.

No, if we're going to use death row inmates for organs (assuming they even make suitable donors) the only viable way to do it is to put them under regular anesthetic, dig out what's to be used, THEN administer lethal doses of drugs or, or if the heart is removed, simply let the person die under anesthetic.

But good luck finding doctors willing to participate in all this - most Western doctors, and quite a few non-western, would find it a violation of both professional and personal ethics.

[Lagmonster]

Among other things, the rate of HIV, hepatitis, veneral infections, and several other nasty disorders are MUCH higher in the incarcerated population than the population at large. And all of the above would be extremely unsuitable for organ or tissue donation.

Drug addiction, with its attendance side effects, is also much more prevelant. Organs injured by addictions - kidneys, livers, hearts, etc. - would be unsuitable for donation.

Now you've struck oil. Ineligibility would be a huge factor for most prisoners, but in all fairness I don't know that there is enough demand to pick the prisons clean, at which point it becomes interesting to debate just how many rights a prisoner gives up when they break the law.

As an aside, the option that most people I've spoken with find the most acceptable is forced blood donations among eligible candidates. Especially when there's things like Katrina going on and the demand versus supply problems are amplified and posted on every television screen; all of a sudden, people say, "Hey, if I got pressured to give at the office, they can tap a few pints out of Martha Stewart".

[Nova Andromeda]

I'm offering you more than one option, varying from non-consentual non-invasive product testing and experimentation to consenting (or not, you choose) invasive research or even forced organ and blood donation.

--The first problem I have with any variation of this idea is that you build a conflict of interest into the criminal justice system (i.e., you give society a non-trivial reason to make more prisoners irrespective of whether they committed an offense or the magnitude of any offense they did commit). The criminal justice system in the U.S. is pathetic enough without this conflict of interest.
-The second problem I have is that criminals are not recompensed for criminal justice errors that harm them (in the U.S.).
-Third, medical testing generally involves a serious risk of permanent damage to the subject. However, even for those things that don't involve such a risk (such as blood donation), there is still a conflict of interest problem.
-Fourth, scientific ethics doesn't not allow for non-consensual/coercive experimentation.
-Fifth, the death penalty in the U.S. has been shown to be entirely broken with innocent people pardoned just before execution and undoubtedly innocent people actually executed. It is hard to believe the rest of the criminal justice system is any better. In fact, it is probably much much worse.
-Sixth, there is no independent verification (that I know of) to ensure that the criminal justice system is actually doing a reasonable job of finding criminals in an unbiased manner.

[Nova Andromeda]

--I forgot to mention. If we had a good criminal justice system that wasn't unfairly biased, etc. I would support using the prisoners in any way society deemed fit so long as the "use" caused less harm to the prisoner than they owe to society. I would only support "uses" of the prisoners that have an unreasonable risk of permenant harm if there were well nigh absolute certainty of the guilt of the prisoner.

[Lagmonster]

Bear in mind that medical research does not necessitate strapping someone to a table and slicing them open to dip their liver in a vat of chemicals.

How disappointing. You just live to dash dreams, don't you?

Well, *cough*, I suppose you could make a case that a lot more scientific progress would be achieved if we employed such a punishment for, say, convicted mass-spammers. If by no other means than saving researchers a lot of time they'd waste sorting through piles of e-mails for sex drugs and cash payoffs from Nigeria.

[SirNitram]

Has anyone in this thread talking about how it shouldn't happen been in a medical test? Where they give you a new type of pill, or a sugar pill? Or are they basing their opinions on mad scientist movies?

I have not. What I know about medical tests comes from Psychology class and what my dad's biotech company is doing.

I am not familiar with "mad scientist movies" in general, though I doubt they can be much more horrific than German and Japanese medical tests on unwilling subjects during World War II.

That's the gist. That's also completely off from what's being discussed.

"A new type of pill" could easily be dangerous. THAT'S WHY THEY TEST THEM. Forcing someone to risk their own health crosses my threshold of "cruel and unusual punishment."

You are aware that there are rigorous tests to pass before you can test on humans? And that people regularly partake for money? And this is 'cruel and unusual'?

No reputable scientist will agree that testing should be done on unwilling humans. There isn't a serious shortage of volunteers for medical tests in this country anyway, so the only reason you'd need or want prisoners is because they would be easier to coerce or force into more dangerous experiments.

Why would no reputable scientist agree to this?

[Nova Andromeda]

"A new type of pill" could easily be dangerous. THAT'S WHY THEY TEST THEM. Forcing someone to risk their own health crosses my threshold of "cruel and unusual punishment."

You are aware that there are rigorous tests to pass before you can test on humans? And that people regularly partake for money? And this is 'cruel and unusual'?

--Many new drugs are for serious illnesses that are leading to death already. Testing on a health criminal is an entirely different matter. Effectiveness testing generally needs to be done on people who actually need the procedure/drug. This means the testing will probably be done outside of prison populations since the prison population is small compared to everyone else. If one is testing for side effects then any healthy prisoner will do, but this implies that there is a real and significant risk to the new drug/procedure.

[wolveraptor]

Among other things, the rate of HIV, hepatitis, veneral infections, and several other nasty disorders are MUCH higher in the incarcerated population than the population at large. And all of the above would be extremely unsuitable for organ or tissue donation.

Drug addiction, with its attendance side effects, is also much more prevelant. Organs injured by addictions - kidneys, livers, hearts, etc. - would be unsuitable for donation.

Then they're all the more effective for drug testing.

[SirNitram]

"A new type of pill" could easily be dangerous. THAT'S WHY THEY TEST THEM. Forcing someone to risk their own health crosses my threshold of "cruel and unusual punishment."

You are aware that there are rigorous tests to pass before you can test on humans? And that people regularly partake for money? And this is 'cruel and unusual'?

--Many new drugs are for serious illnesses that are leading to death already. Testing on a health criminal is an entirely different matter. Effectiveness testing generally needs to be done on people who actually need the procedure/drug. This means the testing will probably be done outside of prison populations since the prison population is small compared to everyone else. If one is testing for side effects then any healthy prisoner will do, but this implies that there is a real and significant risk to the new drug/procedure.

This is a fairly ridiculous set of strawmen. We're simply adding to the potential test subjects.

[wolveraptor]

Besides, it's already been indicated that the prison population is a great demographic for disease and psychological problems.

[Nova Andromeda]

--Many new drugs are for serious illnesses that are leading to death already. Testing on a health criminal is an entirely different matter. Effectiveness testing generally needs to be done on people who actually need the procedure/drug. This means the testing will probably be done outside of prison populations since the prison population is small compared to everyone else. If one is testing for side effects then any healthy prisoner will do, but this implies that there is a real and significant risk to the new drug/procedure.

This is a fairly ridiculous set of strawmen. We're simply adding to the potential test subjects.

--What strawmen exactly? My point is that forcing medical testing on prisoners isn't useful unless it is testing for significant side effects that the general population isn't willing to endure. I don't see where you are adding to potential test subjects since prisoners can opt to be part of medical testing already as part of their normal health care (at least I think this is true) and they are small in number compared to the general population.
-Am I still missing your point?

[brianeyci]

The op mentions that as an alternative to their death sentence they can take medical experiments.

No, not because it's unethical to do it (it's voluntary according to the op) but because I don't think somebody should just be able to donate a body part to live out part of their sentence. Justice is vengeance and rehabilitation, and if someone gets the death sentence it follows (if the system didn't fuck up) that he deserves the death sentence and shouldn't be able to escape no matter what.

For example, murder donating eyes, kidney, lung... honestly I can't think of anything that's worse than death other than torture and torture is inhumane.

As for the mad scientist brainbug, it's not true... my friend did medical testing, they pay you, give you a place to stay for the weekend. You hang out with a group of adults, eat pizza, watch movies and stay for observation then you're let go. They also do a lot of blood tests on you. No big deal. The risk is probably minimal. My friend mentioned that the blood tests were the worst part, because there's sub-par nurses trying to stick a needle in you and they can't find the vein and fuck around moving the needle around after they jab it in. Lol.

Brian

[Broomstick]

Among other things, the rate of HIV, hepatitis, veneral infections, and several other nasty disorders are MUCH higher in the incarcerated population than the population at large. And all of the above would be extremely unsuitable for organ or tissue donation.

Drug addiction, with its attendance side effects, is also much more prevelant. Organs injured by addictions - kidneys, livers, hearts, etc. - would be unsuitable for donation.

Now you've struck oil. Ineligibility would be a huge factor for most prisoners, but in all fairness I don't know that there is enough demand to pick the prisons clean, at which point it becomes interesting to debate just how many rights a prisoner gives up when they break the law.

Given that an organ donation needs to be more than just a healthy organ, that you need to match the tissues immunologically so can't just put any random liver into any random recipient -- you're going to find instances where an organ is a match no one who needs it.

The flip side is that organs and tissues are so useful, and so much in demand, that if you could match every available organ to a recipient most certainly, yes, you could "pick the prisoners clean" and still have demand for organs.

[Broomstick]

Among other things, the rate of HIV, hepatitis, veneral infections, and several other nasty disorders are MUCH higher in the incarcerated population than the population at large. And all of the above would be extremely unsuitable for organ or tissue donation.

Drug addiction, with its attendance side effects, is also much more prevelant. Organs injured by addictions - kidneys, livers, hearts, etc. - would be unsuitable for donation.

Then they're all the more effective for drug testing.

Untrue - with malfunctioning organs they will not give reactions/results in the same manner a healthy, undamaged person would. Garbage in, garbage out.

Unless you're talking about disease-specific testing - say, for new HIV drugs - you need test subjects as close to normal and average as possible. The more they deviate, the less suitable they are.

Even for some disease-specific testing they would be unsuitable. Diabetes control, for instance - because their movements are restricted and they are fed by an institution making food choices for them their exercise and diet opportunities are completely different than in the outside world. A strategy for diabetes control might work in the artificial environment of prison but be totally useless outside where people are free to gorge on donuts 24/7, or, conversely, eat a macrobiotic diet and run marathons.

[Broomstick]

--Many new drugs are for serious illnesses that are leading to death already. Testing on a health criminal is an entirely different matter. Effectiveness testing generally needs to be done on people who actually need the procedure/drug. This means the testing will probably be done outside of prison populations since the prison population is small compared to everyone else. If one is testing for side effects then any healthy prisoner will do, but this implies that there is a real and significant risk to the new drug/procedure.

Let's clarify something.

There are two kinds of testing on humans - the first is done on healthy subjects that are a good representation of a cross section of the population (ideally - if you can't get a cross section you settle for "healthy"). Typically, young adults, such as college students. This testing would exclude people who are old, children, and anyone
chronically ill. With screening, you could probably pull a group of suitable candidates out of a prison, but it would be a subset of that population given that prisoners are of many different ages, including middle-age and elderly, and a significant number have chronic conditions.

The final human testing is on subjects who are actually suffering from the condition(s) the drug is meant to treat. In this case, you might well seek out someone with chronic illness, but elminate anyone with multiple such illnesses. Again, a subset of the prison population. Someone suffering from HIV alone might be a suitable test subject - someone with both HIV and hepatitis C, or HIV and some inherited condition - would not be.

One more clarification - there ARE risks to medical testing. The risk to volunteers is minimized as much as possible, but every year a certain number of such volunteers suffer side effects, sometimes even permanent, and occasionaly there is a death during such testing. If testing was done on prisoners, would there be the same motivations to reduce risk as much as possible? And how do you avoid coercive elements to prisoners "volunteering" under such a system? Or do you do away with the voluntary part when it comes to testing on prisoners?

The idea of medical experimentation or organ donation using prisioners has some appeal, until you understand that this isn't at all like ditch digging. Most prisoners are fully capable and qualified for ditch digging, just give them a shovel and point to where to start. This medical testing isn't so straightforward, and neither is the organ donation. You have to be a LOT more choosey in who you pick, random selection will just no give you good results.

[Anguirus]

You are aware that there are rigorous tests to pass before you can test on humans? And that people regularly partake for money? And this is 'cruel and unusual'?

Yes, I am fully aware of this. You are aware that that doesn't mean there's no risk to the test subjects, right? You are aware that people who partake for moeny are obviously willing and accept the risks, right?

Why would no reputable scientist agree to this?

Because testing on unwilling humans is a violation of scientific ethics!

[Durandal]

Actually, I'd say that a volunteer-based program for prisoners would be a good idea. In return for donating their bodies to medical science, they would get reduced sentences, early parole or privileges while on the inside. They would be giving something back to society.

[Lord of the Abyss]

There are two kinds of testing on humans - the first is done on healthy subjects that are a good representation of a cross section of the population (ideally - if you can't get a cross section you settle for "healthy"). Typically, young adults, such as college students. This testing would exclude people who are old, children, and anyone chronically ill. With screening, you could probably pull a group of suitable candidates out of a prison, but it would be a subset of that population given that prisoners are of many different ages, including middle-age and elderly, and a significant number have chronic conditions.

Another problem; anyone in prison is likely under great stress, and stress screws up the body in a number of ways. It would skew the results.

I oppose this idea for the same reason I oppose the death penalty : I don't trust the system that much.

I'd also like to point out that this creates a situation when criminals ( or even innocent people the cops think are criminals ) are much more likley to fight to the death, instead of submitting to arrest. That'll put the cops in more danger; if they are trying to take alive someone who prefers death, they're at a disadvantage. For that matter, some crooks might start wearing explosive clothes like terrorists; if they do get caught, they can take a few cops with them.

[wolveraptor]

Unless you're talking about disease-specific testing - say, for new HIV drugs - you need test subjects as close to normal and average as possible. The more they deviate, the less suitable they are.

And how would they be deviating from the norm, beyond their criminal records? There are likely to be at least some prisoners who have HIV and HIV only.

Even for some disease-specific testing they would be unsuitable. Diabetes control, for instance - because their movements are restricted and they are fed by an institution making food choices for them their exercise and diet opportunities are completely different than in the outside world. A strategy for diabetes control might work in the artificial environment of prison but be totally useless outside where people are free to gorge on donuts 24/7, or, conversely, eat a macrobiotic diet and run marathons.

I never claimed that all drug tests would be suitable for the prisoner population.

[Gil Hamilton]

Bear in mind that medical research does not necessitate strapping someone to a table and slicing them open to dip their liver in a vat of chemicals.

An individual would have to be eligible for testing, and even in the case of forcing prisoners to give blood, they'd have to be tested as eligible for that too (and I'm willing to bet more people would okay forcing eligible prisoners to donate blood or plasma by the pint, given the demand and the relatively non-threatening nature of blood donation).

You can't do that. Prisoners aren't allowed to give blood according to Federal Guidelines, for much the same reason they don't let you give blood if you are from Africa. The blood is considered "high risk" of fluid borne diseases.


To the OP:
Further, no one should be subjected to non-consensual medical experiments. We aren't fucking Nazis, for pete's sake, and yes, prisoners do still maintain some rights. I almost guarentee it would be cruel and unusual punishment and therefore unconstitutional.

[Evil Bob]

I too am against such treatment, especially in the case of nonconsensual testing. What is there to say that it won't spread on to people who have commited petty crimes or that it is not possible for corruption to lead to the government picking people up off the streets just because they need more people for testing? Furthmore it goes against the The Oath of Hippocrates, both the original and the modernized, that most (if not all) doctors take when they become doctors.

Modern Oath Classical Oath

[wolveraptor]

Do you have any evidence that it will automatically lead to widespread corruption of the original process?

[Broomstick]

Unless you're talking about disease-specific testing - say, for new HIV drugs - you need test subjects as close to normal and average as possible. The more they deviate, the less suitable they are.

And how would they be deviating from the norm, beyond their criminal records? There are likely to be at least some prisoners who have HIV and HIV only.

I see my point sailed completely over your head.

For general medical testing the prison population is unsuitable for medical reasons - they tend to be sicker than the non-incarcerated population.

The "pure HIV" prison population is a small subset of prison population as a whole, perhaps not enough to conduct a sound clinical trial with unless you transported most or all of them to same location. Then you have the problem of keeping them "pure HIV" - prisons are breeding grounds for everything from toenail fungus to tuberculosis. It's not just a matter of keeping them in separate cells - you'd have to prevent all contact, install separate ventilation to avoid airborne contagions, and so on.

It's LOT easier and cheaper to recuit test subjects from the free population.

Leaving aside the moral issues, utilizing prisoners for medical research is bad science, for reasons listed by others as well as myself.

[Evil Bob]

I'm not saying that it will automatically lead to automatic widespread corruption, but if history shows us, it is a defenite possibility. When you start to take away the rights of the 'undesirable' people there is nothing to prevent it from moving on to others. I feel the following would apply here,

First they came for the Jews
and I did not speak out
because I was not a Jew.
Then they came for the Communists
and I did not speak out
because I was not a Communist.
Then they came for the trade unionists
and I did not speak out
because I was not a trade unionist.
Then they came for me
and there was no one left
to speak out for me.

There are constant allegations in the amrican penal system(and those in other countries) of corruption. For example there have been instances were prisoners live in poor conditions and get low quality food just for the sake of cost cutting. You can look at Sheriff Joe Arpaio in Arizona where he has inmates living in tents. Phoenix New Times