The Ethics of Clinical Trials

            I was first introduced to the ethical issues that crop up when considering conducting clinical trials in foreign countries in Carolyn Sargent’s class Health Healing and Ethics. One article that stands out in my mind discussed the ethics of conducting clinical trials in the Ugandan context. In these Ugandan trials, the participants had no other access to health care outside of the clinical trials and so it was questionable whether informed consent could really be given in this case. Reading Petryna’s article, Clinical Trials Offshored, has only further led to my confusion as to what extent it is ethical to conduct clinical trials in places where access to healthcare is severely limited.

            Petryna effectively outlined the appeal of third world countries to pharmaceutical companies looking to provide clear evidence on the efficacy and risks of a drug. One major factor that she emphasized is the fact that people in these areas have been exposed to fewer treatments, which introduces less confounding factors when compared to Westerners who have used multiple other drugs to treat illnesses. Nevertheless, it is unsettling that the main impetus of researchers choosing sites where people have limited access to pharmaceuticals is not to help bridge health disparities between the first and third world or even to simply save the lives of the people in the trials, but rather to exploit people who have no other means of obtaining healthcare solely for the profit of the industry. Petryna argues that “we need to look at the value patients bring to these regimes and what is owed to them, such as continued treatment once a trial is over,” demonstrating that currently, the patients are seen more as sources of data, rather that human beings that are suffering from a condition. My personal opinion is that in the case of an acute illness that can be cured during the course of a clinical trial, it seems more like the subjects are being adequately compensated. However, if once the trial is completed, the pharmaceutical company goes on to profit greatly while the participants are left dealing with a chronic condition and are no better off than when they started, then there is definitely a question of ethics. How to solve this issue without completely eliminating one of the few means through which people in the third world have access to health care is where the true dilemma lies.