We keep hearing that President Barack Obama is intent on correcting the excesses of the previous administration, whether it's waterboarding or dirty air or international relations. But how about this: There exists the possibility that prisoners in American jails could be used for "voluntary" experiments - clinical trials for drugs, new surgical procedures and the like. It's a troubling piece of Bush-era business that the president could correct with the stroke of a pen.
For more than two years, we, as members of a liaison panel advising the Institute of Medicine, have been waiting for an answer from the secretary of health and human services concerning the troubling potential for inmates in American prisons to be used for experiments. In 2006, the formal IOM committee recommended that convicts be made available for human subject research - a possible return to the mindset that gave us horrors such as the Tuskegee Syphilis Study. Fortunately, the Bush administration did not act on the recommendation, but the lack of a decision has not given us any comfort. This country's leaders should firmly reject the proposal.
Our panel, focused on former prisoners and prisoner advocates, tried to convince the IOM committee that loosening restrictions on the already weakened protections for incarcerated Americans would take us back to a time when vulnerable populations were grist for the research mill and ethical abuses were tolerated. Prisoners were used as the guinea pigs of choice for researchers and pharmaceutical companies well into postwar America, and prisons have been a convenient storehouse of cheap and available research subjects. Physicians with pet medical theories and budding careers, or drug companies in the financial straits of product development, aggressively sought access to walled institutions as perfect places for testing.
Incorporated in everything from testicular transplant and irradiation experiments to studies subjecting them to radioactive isotopes, dioxin and chemical warfare agents, prisoners were a key pillar of American medical and pharmaceutical research.
This, from the same country that led the prosecution of Nazi doctors for their barbaric medical experiments on concentration camp prisoners. And this, from the country that served as a principal author of the Nuremberg Code, which ardently proclaimed that people "unable to exercise free power of choice" or subject to "constraint or coercion" should not be included as subjects in medical experimentation. Regrettably, the research community back at home continued to mine our mental institutions, orphanages and prisons for research subjects. Only during the great ethical enlightenment of the 1970s and the aftermath of the Tuskegee "studies" did American researchers condemn this practice.
The IOM's 2006 report, "Ethical Considerations for Research Involving Prisoners," called prisoners "an especially vulnerable class ... who historically have been exploited by physicians and researchers." This turned out to be lip service, though: The group decided that the use of prisoners for experiments could be rationalized because this population is also vulnerable to diseases such as AIDS, hepatitis C and tuberculosis, and therefore could benefit from new treatments, even if they are experimental in nature. Develop an "ethical framework" for research, the committee urged, and the potential for abuse would be eliminated.
We're skeptical, given the lack of choice that convicts have in their daily lives. Couple that with the notoriously poor health care available in American cellblocks, and you have a potential disaster.
President Obama and his nominee for secretary of health and human services, Tom Daschle, have an opportunity to clarify our nation's stance toward those whom we have declared unfit to live free among us. They can demonstrate, by rejecting the IOM's recommendation, that the prison abuses condoned or ignored by previous administrations will stop. While steps are being taken to close the notorious prison at Guantanamo, let's do what we can closer to home to ensure civil treatment for the incarcerated.
Allen M. Hornblum, author of "Acres of Skin" and "Sentenced to Science," frequently lectures on medical ethics. Jeffrey Ian Ross, a University of Baltimore professor and a fellow in UB's Center for International and Comparative Law, is author of "Special Problems in Corrections" and co-editor of "Convict Criminology."