The image above may seem like an innocent photo of a vaccination or a medicine being administered but this is really a photo of the infamous Tuskegee Study where 399 black men were denied treatment to syphilis treatment. Initially there was no cure for syphilis when the study first began but by 1943, antibiotic treatments were becoming widely available and the antibiotic treatment was not offered to the infected men of this study. This is a serious breach of ethics because syphilis may appear benign initially but in later stages it can wreak havoc on your body. If it is not dealt with in it's initial stages, the bacteria in it's late stage can cross the blood brain barrier causing blindness and damage to the brain. It can also infect your nerves and many organs lead to death. A review of the study years after found similar results that the study was not "ethically unjustified" and the results of the study were small compared to the cost of the disease to the men ("Tuskegee Study", 2022)
While this study was a long time ago, have we learned from our mistakes? Are the costs to participants worth the benefits of new scientific knowledge? Are test subjects being treated like Guinea pigs or people?
Studies like the Tuskegee study are no longer acceptable and boards of ethicists must approve studies. Additionally informed consent is now a pivotal feature of studies where the participant knows of the risks and benefits of a given study. While the researchers in the past had to swear by hypocritic oath to do no harm, it is now enforced by governmental bodies such as the FDA. Having an approval process is essential for human clinicals trials, so that the ethics of the study are not up to the discretion of the researcher. Another ethical consideration is the deception associated with having placebos tests. Placebos are necessary because the knowledge of whether you are taking a fake or real medicine affects the study results. Using a placebo accounts for the effect of this phenomenon but it does deceive those taking placebo rather than the actual medication (Nardini, 2014)
Overall there are always going to be at least a few costs to those participating in clinical studies. Researcher have come a long way since the Tuskegee study. As long as those who are participating understand and consent to the study and there is no harm being done to them and there is a greater benefit to man kind than a cost to the individuals in the study, then human clinicals trials are ethical.
Centers for Disease Control and Prevention. (2022, December 5). Tuskegee Study - Timeline - cdc - os. Centers for Disease Control and Prevention. https://www.cdc.gov/tuskegee/timeline.htm
Nardini, C. (2014, January 16). The Ethics of Clinical Trials. Ecancermedicalscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894239/
I agree that the Tuskegee study was one of the most inhumane acts done in order for research. It's disheartening how the men were treated and weren't given the antibiotics. Now that we have the Institutional Review Board (IRB) in place, I feel more confident that research with humans and animals is done ethically. There are still ethical concerns with using lab animals and humans in studies, but I think if it benefits more patients, it's worth it. Informed consent is especially important for human clinical trials, so they understand the risks and benefits. I found an article about the ethics and productiveness of the IRB below. It's also good to know that the IRB is continually being audited in order to make sure ethical research is being done.
ReplyDeleteAsif, F., & Baig, S. (2023). Is Institutional Review Board (IRB) doing its job right? how to assess this. Journal of the Pakistan Medical Association, 73(7), 1416–1435. https://doi.org/10.47391/jpma.7157