According to New York Times writer Andrew E. Kramer, “patients…are eager to join trials because often it is the only way to receive modern medical care.” As his article suggests, this kind of access to modern medicine “creates a pool of willing test subjects.” The Russian government is welcoming foreign investment as a way to boost the economy and has facilitated foreign drug companies’ access to its citizens. Kramer has definitely pointed out the positives of this surge in drug experimentation; “testing in Russia is a net benefit to public health, pouring hundreds of millions of dollars into diagnostic work and doctor care that would not have been here otherwise.”
But the advantages are easy to see; greater willingness to try experimental drugs will enable the placement of these drugs, if effective, on the market, ensuring access to consumers and a diversified selection of medicine for us all. With that said, I feel like it is only fair to point out the ethical dilemmas of experimental drug testing. The medical field, at least in the United States, is already well aware of the dangers associated with “guinea-pigging.” Experimental drugs, before being approved for sales and market distribution, must be tested. Many drug companies are insisting that testing be done on humans.
While the resulting causal relationship is one we can accept -the more invasive or risky the procedure or drug, the higher the pay for participating in the study- I’m not so sure we should accept the fact that people are making a living this way. The best-paying studies tend to be long and restrictive. They are likely to be in-patient trials where subjects are required to remain at the research facility for days or weeks so that diets can be controlled and vitals can be monitored constantly. The problem is this: “because such studies require a fair amount of time in a research unit, the subjects are usually people who need money and have a lot of time to spare: the unemployed, college students, contract workers, ex-cons, or young people living on the margins who have decided that testing drugs is better than punching a clock…” The New Yorker
Some of these subjects become dependent on the monetary incentives or the modern medical care, as in Russia, enrolling in one study after the other and exposing themselves to harmful risks. While society at large benefits from the subjects’ aptitude for risk and willingness to participate, do we really want the emergence of a class of people shouldering this burden? If we consider who might be at risk of becoming a repeat test subject, a guinea-pig for the rest of us, a number of racial and socioeconomic issues arise. Those who can afford adequate health care have no incentive to repeatedly participate in medical experiments. Unfortunately, the same cannot be said for the millions of people around the world who want for a steady pay-check and health care.
SOURCE: The New York Times
PHOTOGRAPH: Olga Krevits for the New York Times
“Guinea-Pigging” poses ethical and moral dilemmas for people all over the world. We must ask ourselves, “Is it always better to kill one to save a thousand?” Is it better to sacrifice a few people’s health for the advances in medical technology to save millions of others? After all, no one is forcing these people to participate in these studies. A strong argument can be made that people are forced to participate in these trials for the monetary incentives and modern medical care. This results in certain socioeconomic groups and races, such as the unemployed, college students, contract workers, ex-cons, or young people living on the margins to be the majority of the “Guinea Pigs”. Should society have a major problem with this? I do not believe so. Drug companies are now insisting that testing be done on humans. There is no way around this. Test your drug or procedure out on humans or say goodbye to its approval. Should advances in medical technology now come to a halt simply because we find human testing unethical? Human testing is absolutely necessary in the medical field. These people have a choice to participate in these trials, and I am confident that they are told all of the risks before the testing starts. If these people choose to remain at the research facility for days or weeks or to inject themselves in the stomach daily and endure weeks of vomiting, instead of getting a nine to five job, then so be it. There are worse ways to make money. We can try taking away the monetary incentive, but then there is the danger that no one will participate. Although there are some genuinely good people in the world, the harsh reality is that incentives will make people more willing to sacrifice their time and health for the “common good”.
Obviously human testing is a controversial issue. On one side it helps scientific research and advancement in the medical field while on the other side some believe it to be unethical. I believe that if people sign up for it and are informed about every aspect of the test, then testing should be allowed. It gives people a way to make money and get healthcare. I am sorry if people feel as if the only way to make money or get healthcare is to be subjects in human testing but in reality there are other ways to make money and get healthcare, but these other means may not be as quick as filling out a form and showing up to the testing site. Although I will mention that after reading this blog, I could not help think about those movies and books that involve testing on humans and they turn into monsters or some type of apocalyptic nightmare. If a type of drug in the near future could possibly do that to human subjects, I suggest we avoid human testing with that drug in order to preserve mankind.
I mostly agree with Cali, however, if there is a drug out there that may “accidentally” lead to a zombie apocalypse, I want to see it. It could solve a lot of problems. For instance, no one would care about unemployment anymore, and if Iran actually is developing a nuclear weapon, we can use it to blow up all the zombies. I’m sure Prime Minister Netanyahu would be alright with that. Furthermore, there are people in this world who have been preparing for this sort of thing for years. Converting underground missile silos into homes, and stockpiling enough food and ammunition to survive indefinitely, it would be a shame to see all their hard work go to waste.
On a serious note, human testing is vital to proving the safety and effectiveness of new drugs. “Sacrificing one to save a thousand” may seem immoral at first glance, but if the one to be “sacrificed” is truly willing to do it, I believe that can negate the immorality. Moreover, who is to say these human guinea pigs are actually being sacrificed? By the time experimental drugs make it to the human testing stage much of the kinks have generally be worked out, and the test subjects stand to gain a lot if the drugs actually work. If they do not work, then the person is no worse off than he or she was to begin with. I would have to imagine that it is rare for any of these experimental drugs to actually make the patients worse off than they were when they signed up for the trials; although, I do not know for sure.
While human clinical testing, also known as “guinea-pigging”, can be controversial, I think that the benefits outweigh the negatives. As long as a patient is adequately informed, explicitly consents, and understands what they are getting into, there is not much of a problem. Testing absolutely needs to be regulated, in that, I think the higher the risk of the treatment the more instruction and information the patient should be given. As the New York Times article states, “Much of the business swirls around lower-risk testing of generic replacements for brand-name drugs.” In these situations, the risks are relatively low; however, in the less frequent instances of high-risk testing, the burden should be on the administrators of the drug to make sure the patient has comprehended the risks of the clinical trial before undergoing treatment.
The fact that Russia’s economy is benefiting from the increase in subjects for testing is an obvious benefit of Russian citizens’ willingness to go forth with such studies. The New York Times article points out as well that the United States is way ahead of countries such as Russia in the total amount of testing being done. As long as there is not an overwhelming majority of citizens seeking such treatment, it seems that these tests are a way for patients who can’t afford care to get it, and for a struggling economy to receive enormous investments from the healthcare industry.