Clinical Trials Response

Adriana Petryna’s book When Experiments Travel: Clinical Trials and the Global Search for Human Subjects poses a big question about clinical trials: are they inherently exploitative or is it beneficial to its recipients?

In today’s modern day context, there is a dramatic increase in the outsourcing of clinical trials, especially the most dangerous phase 1 trials to the world’s middle to low-income countries where serious health risks can occur. With much of the progress of medicine nowadays dependent on the participation of the poor or marginalized populations (citizens of low/middle income countries, etc.) in the most risky parts of the clinical trials, the world is faced with an ethical dilemma. One of the claims that were explored in the book was that these outsourced clinical trials were good because populations who would not be able to normally afford treatment or medication are able to get access to some of the breakthrough drugs happening in the market. However, some questions to be thought about are whether or not these people will have access to the medicine after the clinical trials are over and the drugs are released into the market, and the use of placebo if the marketing of the clinical trials to potential participants were suggestive that participants would be receiving drugs to help manage their disease. Also, can informed consent of the clinical trials be true consent when the participants may be desperate for any kind of treatment they can get for their particular disease?

The ethical dilemma of the clinical trials is an excellent example of socioeconomic stratification manifesting itself in the pharmaceutical world. Medicine research is highly corporatized. From what kinds of drugs and diseases are investigated to the distribution of funds to research and develop drugs throughout the world, the process highly favors those in a position of power and wealth. Corporations are more incentivized to create boutique lifestyle drugs for its affluent customer base, or oftentimes, the high cost of brand name drugs and monopoly status frequently leave many people who need the treatment unable to access it.

The topic of drug development and the resulting clinical trials is a complex issue that has many dimensions that contribute to it. I personally believe that exploiting populations that are in need (i.e. treatment for their illness, financially, etc.) is incredibly dehumanizing and that global clinical trials need to be subjected to more thorough reviews and processes to prevent these unfair circumstances. Yet, as someone wanting to go into the medical field, I also understand the need for medical progress and the usefulness of human-test subjects in clinical trials. I do not know the solution in how to incorporate these two ideas, but there certainly needs to be some type of process overhaul.