Unethical medical experimentation on prisoners

When drug or other therapeutic research reaches the stage when it is ready for human trial on a controlled, scientifically-observed experimental basis, particularly under conditions of segregation, the prison population is often turned to. Experimentation in jails and penitentiaries may be done without the prisoners knowledge and consent, or with consent but with little or no understanding of the risks involved. In some cases the experiments are dangerous, the risks being surgical mutilation, pharmaceutically or chemically induced organ impairment, or personality disorders.
The idea of medical experiments on volunteer prisoners is by no means new, for as long ago as 1721 King George I of England offered a free pardon to such inmates of a London prison as would offer to submit themselves to smallpox inoculation (vaccination came over 70 years later). Six prisoners volunteered. These prisoners, by volunteering, saved their necks and won their freedom, and also acquired a new immunity to a highly dangerous disease that was then a universal threat. Unfortunately in the next two centuries there were few such happy endings and ethical problems still remain.

Although the use of prisoners for biomedical research is not explicitly debarred by any of the international declarations when all appropriate safeguards are followed, arguments on both sides are persuasive and such contradictory ethical evaluations provide no basis for an international recommendation. The Nuremberg Code is a set of principles especially applicable to controlling but also to authorizing ethical research on prisoners. Nevertheless, the tradition in Europe since World War II has been to avoid all medical research on prisoners. This strong position has been a reaction to the Nazi atrocities. Also, it is generally believed that prisoners cannot be expected to give a free consent to experimental projects. This position is contrary to the whole purpose of the Nuremberg Code.

Up to recent years, the USA was in clear disagreement with the European position. Now, however, there has been a rapid reversal, due to law suits and adverse publicity engendered by civil rights activist groups. Approximately two-thirds of the American states now ban research on prisoners and the ban has been extended to federal penitentiaries. The recommendations of the National Commission on Protection of Human Subjects would virtually end all research in the USA using prison inmates.

During World War II, the Nazis experimented on prisoners in concentrations camps and the Japanese experimented on prisoners of war. Prisoners have been used in widespread fashion all over the USA in therapeutic drug trials and other medical and behaviour experiments.

In the 1960s, the USA treated prisoners' skin with chemical agents in the hope they would cause significant inflammation and crusting. The experimentation was to discover if skin could be toughened sufficiently to provide natural body armour for soldiers.

The consent of members of a captive population cannot be valid in that it is influenced by the hope of advantageous benefits such as earlier parole, and that it is purchased by this and other expectations rather than given freely.
Prisoners are particularly suitable subjects for medical experimentation in that they are living in a standard physical - and, indeed, psychological - environment; that they have the time to participate in long-term experiments that is not available to socially active populations; and that the prisoners themselves regard such participation as a means of escaping from the tedium of prison life, or demonstrating their social worth, and of earning a small income.
(E) Emanations of other problems