Written By - Marium Ghobriel, Edited By - Pooja Suganthan
Prisons are no longer used for the purpose of rehabilitation and character growth. They are now places that instill fear and punishments that tiptoe the line of legal intervention. Although the incarcerated are usually there for a reason, does committing a crime warrant a punishment as severe as subpar healthcare? If the foundation of medicine is to heal and prevent adverse effects on health, where should physicians and scientists lie on this moral compass, if at all?
Prisoners and medical research have had a rough past, and unfortunately, a present that isn’t much better. In 1946, the United States spent several years purposefully infecting Guatemalan prisoners with syphilis and other sexually related diseases without asking for consent. The experiments were funded by the National Institutes of Health, meaning that this was not the work of a few scientists with poor morals- this was a study approved at the highest level of medicinal research, with direct ties to the government and some of the largest facilities for public health research. Approximately 1,300 people were infected and 83 of them died. Only about half of the subjects were reported to have received any treatment. It is clear from the events in Guatemala that prisoners were seen as less than human by physicians and researchers, and there were no laws protecting their human rights from being grossly violated.
It’s easy to think that because this happened 75 years ago, nothing like it exists today — this is sadly not the case. In 2018, the New York Times discussed a proposed study regarding salt intake and its connection to hypertension. A large-scale study on the appropriate amount of daily salt intake would provide many answers to one of the most prevalent conditions in America. Studies rarely include a large number of participants because it is difficult to find a monitorable, diverse population that meets a standard set of criteria. However, using prisoners as participants would be the perfect solution: this population would be easy to monitor and control their diet, allowing researchers to adjust the levels of salt intake and thus manipulate the conditions to study the effects of salt on hypertension. Moreover, using prisoners would allow researchers to conduct long-term studies, as many prisoners serve sentences that last over half a decade. According to the NYT, the study planned to include 10,000 to 20,000 prisoners over the course of 5 years, all of which would be funded by the NIH. The study is still pending approval, but if the scientists are granted the green light, the prisoners will not have autonomy except for the choice to decide whether their health data would be public information.
Although minimal, prisoners are somewhat protected by the law when it comes to healthcare and human experimentation. The Code of Federal Regulations states that prisoners may only be subjects for studying criminal behavior, prisons, prison conditions, and practices that intend to improve the participants’ wellbeing. A new addition to the law allows prisoners to be subjects for epidemiological research regarding the prevalence of risk factors for a particular disease; this means that this hypertension study would most likely be approved. Some arguments in support of the exploitation of prisoners are that because they are imprisoned due to actions that negatively impacted the public, they should use their time in jail to contribute to health research and thus serve the general population. Scientists have also brought up the point that health studies have a higher chance of improving a prisoner’s quality of life, as the results of the experiment could lead to developments that directly benefit them. While seemingly promising, autonomy remains a major issue because these prisoners are being forced to participate.
It is no surprise that the food served in prison is not luxurious. In order to save money, prison meals often contain low-quality ingredients and small portions. Further alterations to prisoners’ meals would have a negative impact on the participants because the little they receive already holds great value to them. To get some satisfaction from their meals, prisoners will often turn to salty snacks, such as chips and jerky, which would likely be limited while the study occurs. Many would consider controlling one’s intake in this manner as punishment. So far, the scientists that proposed this study are optimistic that their idea will be approved. The lingering question is, should prisoners’ voices be silenced due to their past actions, or do they deserve the right to make decisions about their own health and wellbeing?
Kolata, Gina. “The Ideal Subjects for a Salt Study? Maybe Prisoners.” The New York Times, The New York Times, 4 June 2018, www.nytimes.com/2018/06/04/health/prisoners-salt-study.html?smid=url-share.
“Shackled by Science: The Exploitative Use of Prisoners in Scientific Experiments” Civil Liberties Law Review, Harvard Civil Rights, 14 November 2018, https://harvardcrcl.org/the-shackles-of-science-the-exploitative-use-of-prisoners-in-scientific-studies/