The ethics of drug testing

As we prepare for Paul Farmer’s lecture today, you may recall how the reading by Farmer that we read last semester began: a comparison of AIDS research on sub-Saharan Africans to the infamous Tuskegee experiments.  Drug tests have always been conducted on the most marginalized sections of our population- which raises the question, over and over, of the degree to which informed consent and acceptance of risk are really possible or ethical in these contexts.

Since Phase I drug testing on prisoners was made illegal in 1980, America has depended on volunteers to test drug safety and efficacy. A recent ethnography by Roberto Abadie, The Professional Guinea Pig, has been a big contribution to the surprisingly small body of anthropological work on who these people are (he spends time with transients, anarchists (!) and the HIV-positive), although it does not really tackle the ethical context.  The Chronicle of Higher Education has a nice write-up of his work, and this article is a pretty great overview of the subject in all of its ethical murkiness.

But as with so many things in our globalized economy (think of the work we read by Scheper-Hughes on organ trafficking), drug research often moves to places with even fewer protections than the most marginalized Americans enjoy.  This week’s NYT has an excellent article about Russians eagerly signing up for drug trials because it offers their only chance to access modern medical care.  Pharmaceutical companies take advantage, using the results of Russian trials to win approval for the drugs from the FDA.