LABORATORY
IN CUSTODY
The ethical, legal and practical aspects of clinical trials on
prisoners
Anurag Kumar, Batch of 2014
C
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onducting clinical trials is a complicated job in
present times. With several human rights groups
mushrooming up, it is difficult to conduct a trial
even in healthy volunteers. And when comes the issue
of prisoners, it is almost impossible to conduct a clinical
trial on them due to a plethora of restrictions, bundles
of paperwork and a lot more reasons. In the past, many
atrocities were committed on prisoners, especially pris-
oners of war. Herophilos of Chalcedon vivisected prison-
ers received from Ptolemaic kings. During Second World
War, prisoner abuse reached its peak, ranging from Nazi
experiments on chemical warfare to Japanese experi-
ments on Chinese prisoners. Even after World War, the
Guatemala syphilis experiment was performed by the US
from 1946-1948, involving prisoners, prostitutes, soldiers
and mentally ill patients.
After the Nuremberg trial, German experimenters
were punished and the Nuremberg code was established
to introduce informed consent and to avoid coercion.
Later, many countries developed their own sets of regu-
lations to protect prisoners from such atrocities.
Hence, researchers prefer general population over
prisoners due to the involved legalities, especially in Eu-
rope and America, which have clear guidelines regarding
experimentation on prisoners. In England and Wales, only
0.049% of proposed clinical trials between April 2010
and March 2012 involved prisoners.
There are many disadvantages of experimenting on
prisoners including medical, ethical and logistical reasons.
Prisoners tend to have a higher prevalence of psychiat-
ric illness as compared to general population. Psychiatric
problems can act as confounding factors and influence
results of trials not pertaining to mental health. Substance
abuse can lead to dependence and affect physiological