Good evening, ladies and gentlemen, and
welcome to The Advocates, the PBS Fight of the Week. Tonight's debate is
coming to you from Boston's historic Faneuil Hall.
Ladies and gentlemen, may I have your attention,
Moderator Evan Semerjian has
just called tonight's meeting to order.
Good evening, ladies and gentlemen, and welcome to The Advocates. Tonight we
look at the ethical problems of medical experiments on human subjects and
whether certain groups in our society are, by virtue of their circumstances,
less appropriate than others. Tonight we focus on one of those groups,
prisoners. And our specific question is this: Should all medical experiments
on prisoners be banned? Advocate Tom Bourdeaux says, "yes."
Tonight we'll be discussing a subject that most of
us don't know much about. Medical experimentation is conducted in prisons
with prisoners in programs that are voluntary in name only. My witnesses are
William McCue, a former prison inmate, and Jessica Mitford,
Advocate Crawford Morris says,
The abuses to which prisoners are put
in human experimentation are extremely rare. The real important problem that
we face tonight is whether suffering and disease will ever be cured if we
banned experimentation. My witnesses tonight are Dr. John Arnold, Director
of the Harry S. Truman Laboratory in Kansas City, and Dr. Monroe Trout, Vice
President of the Sterling Drug Company.
Thank you. I'd like to take this opportunity to welcome back Thomas
Bourdeaux for his second appearance on The Advocates. He's an attorney from
Meridian, Mississippi. I'd also like to welcome Crawford Morris, who's
making his first appearance with us tonight. He's an attorney from Cleveland
who has specialized in medicine and the law. We'll be back to these
gentlemen for their cases in a moment, but first a word of background on
The issue of conducting medical
experiments on prisoners arises most often in connection with the legal
requirement that all new drugs be demonstrated both safe and effective
before they're permitted to be sold to the consumer. The Federal Food and
Drug Administration requires that all new drugs must be tested on healthy
human beings to determine possible harmful side effects. This is called
Phase I Testing. At present almost 90% of all such medical testing is done
on prisoners who volunteer for the experiments and who are paid for taking
part in them. Medical students are the main source of volunteers for the
remaining 10% of these experiments. The vast majority of medical testing on
prisoners involves little or no risk to the health or comfort of the
volunteers, but there are experiments which necessarily do carry risks, and
disabilities and in rare instances death have resulted. Elimination of all
risk is not a possibility, and because risk must be present, the issue of
why and under what circumstances prisoners volunteer has become a central
one. Critics of the use of prisoners for such experiments argue that the
concept of prisoner-volunteer is a contradiction in terms. They have called
for an end, therefore, to all medical experiments on prisoners. And now to
the cases. Mr. Bourdeaux, why should all medical experiments on prisoners be
Prisoners tell us that they
have one overriding concern, and that is to get out. We believe that in
considering the prison environment in its totality an inmate can't mentally
or legally give the free and voluntary consent that all agree is essential
to medical experimentation with the human body. The very nature of prison
confinement, the atmosphere of physical and psychological oppression serve
to render the prisoner often incapable of making that value judgment before
submitting his body to the rigors of unknown results of medical testing.
Necessarily, the prisoner is forced to submit to an authority almost
absolute during the period of his sentence, and to gain any relief from this
sorry state, he submits his body to things that he would not even consider
doing if he were on the outside. Therefore all medical experiments in
prisons should be banned. To tell something about life in prison and medical
experimentation, I call as my first witness William McCue.
Mr. McCue, welcome to The Advocates.
McCue served eleven years as a prison inmate, but now he is Drug Treatment
Coordinator for the Massachusetts State Prisons. Mr. McCue, what is the main
concern of a prisoner?
I would say from day
one that it's to get out of prison.
has other concerns. What are some of those?
The other concerns are to try to survive in the prison, to try to live as
comfortably as possible, and to get some of the amenities that he was
accustomed to having on the outside.
Well, what is it about prison life that makes a prisoner willing to let his
body become a test tube, to become a guinea pig?
Well, first of all I would say that the majority of prisoners are
people who come from low income neighborhoods, welfare kinds of children,
people who don't have means to have money in prison. Little known fact is
that there's nothing in prison that's given away except an issue of clothes
and three meals a day and . . .
money paid to prisoners who participate in these drug programs?
After a prisoner is in prison for two or three
months, he's classified, given a job, and can make up to fifty cents a day
in these prisons, and therefore in the meantime, the first three months, he
would do probably anything to get a dollar to buy cigarettes or candy or ice
Well, money is given to
prisoners to participate in the drug programs.
You're talking about drug experimentation?
I'm aware of that fact,
All right. Now, do these testers
offer to the prisoner a chance of parole if they participate?
Not in Massachusetts. There's no direct promise of
parole, hut I think that every inmate—even myself, I can remember hoping for
a hurricane to blow the walls down, so I could get out of there—and if
undergoing, or submitting yourself to an experiment, even to the point of a
terminal disease, there's always the hope that that's going to make you look
good and you're going to get out sooner.
Well, are the experiments conducted in the cell block, or is the
prisoner removed to some other place, and is this a factor?
I think the HEW guidelines require that the persons
who are undergoing research, the subjects have to be kept in an area where
they can be observed, so that they are confined in one area.
Well, is their condition of living better in the
area where the testing is going on than it is in the cell block?
Well, in the case of Norfolk Prison, for example, all
of this is done in a hospital—we have an accredited hospital—and therefore
these people live in the hospital; the conditions are better, they eat
better, they have more amenities, they have a chance to look at a nurse once
in a while.
What does that do to the
space in the hospital for other prisoners that might need it for
It's my observation that it
deprives prisoners around the prison system from getting medical care. We
have a lot of sick and injured people in the other prisons who cannot get to
Norfolk for the proper medical care because the second floor of the hospital
is taken up by this research project.
Is part of your work with the Massachusetts prisons—are you familiar with
the Concord prison?
Is the drug program going on there? Have they one
going on there that you're familiar with?
The Concord prison you're talking about, one in Concord,
Massachusetts, is that right?
We're talking about the Youthful
Offenders Prison in Concord where the age grouping is eighteen to
twenty-four years old. When you say drug program, I'd like to correct that.
We're talking about drug experiment. We have drug programs that are trying
to deal with the fact that we have a very high population of drug
We're talking about testing,
experimenting with drugs, at the instance of drug companies and so
At the present time there is no drug
experiment going and only because some observant people caught a private
brokerage firm going into—and I feel that somebody got paid off, I'll say
this straight out—to go by all of the different committees, the Shattuck
Committee and the Protocol Committees, and almost got this study on Clobizan
going there. I'd like to mention that 77% of the inmates at the Concord
Reformatory are there either as a direct or indirect result of drug abuse.
They are there, they were convicted for using drugs illegally for no
medicinal reason, and yet we were prepared to use the same kind of drug, a
psychotropic drug, on these inmates for money, and I think that's very
All right, let's go to
Mr. Morris for cross-examination.
McCue, when we develop drugs that really do help, like vaccines for
poliomyelitis and some day a cure for cancer, that benefits everybody that
possibly can come within the range of that disease, isn't that so?
And if prisoners come in the range of this disease,
it benefits the prisoners too.
And why is it that you don't want the
prisoners to volunteer to help us to develop these drugs which will benefit
them eventually if they should come into the range?
First of all, I don't think it's volunteerism. There
is always the onus of force and coercion. There is no free consent in
prison, and I'm talking about the prisons within walls. We have other
prisons without walls, and I think people have freer choice there, but we
don't do experiments there.
Do you think
it's fair that a prisoner should not have to take some of the
experimentation trials and yet be able to get the benefits of that, whereas
everybody out in society who's going to have to fill that gap and go through
the experimentation, they have to do that if they want the
The last word that I have from
the inmates, as far as speaking for them, is that they would much rather
that some research be done on why they're there, not on things that are not
relevant to them at the present time.
You're familiar, are you not, with some of the drugs that have been
developed? Are you familiar with the fact that the drug company—one of the
drug companies—developed a drug called Chloroquisine, an anti-malaria drug,
and they developed this by testing on prisoners.
Yes, prisoners and conscientious objectors during the Second World
War. I don't approve of that.
and are you familiar with the fact that this drug company, every time it
makes it, does so at a financial loss to itself, and it has flown it free
out to drug addicts who got malaria from dirty needles in California and
flew it free down to the South where a Viet Nam veteran was dying of
cerebral malaria and this drug saved his life?
Let me say that there are roughly 400,000 prisoners . . .
Answer my question: are you aware of that?
I'm not aware of that, no.
All right. How about the—your particular sphere is the drug abuse
part of it, is it? You deal with the people with drug abuse?
I represent all . . .
Drug addicts that are trying to get cured?
I represent all the prisoners.
All right. Now, how about the heroine-blocking drugs
that have been developed—Methadone and Cyclizine? They were developed by
experimentation on prisoners, and they are used to try and help prisoners to
try and get over their habit, isn't this so?
That's not so. That's a medical opinion that's widely disagreed
with. I don't see that Methadone is any better or different than
Mr. McCue, let me ask you this
to clarify it. Let me ask you this to clarify something. Are you saying that
there aren't any prisoners who would volunteer for, or would make it a free
choice in these experiments?
people in prisons who volunteer are people who have no means. We have Mafia
types in prison who don't need to submit to this. They have plenty of bread.
We have other prisoners who come from wealthy families who don't volunteer.
It's always the Spanish, the black and the low income prisoner who has no
means to buy toothpaste, candy and cigarettes. We have prisoners who submit
to homosexuality merely to get a candy bar or a sandwich or a pack of
What if you put it to a
vote tonight with all prisoners in the country as to whether or not
prisoners should be permitted to participate in experiments? What do you
think the vote would be?
I would say that
the vote, being honest, I think it would be split in half.
would say, approximately.
Go ahead, Mr.
Yes. In that regard, the prisoners
themselves really do want this right to experiment.
I did not say that. I'd like to also say that only 8%
of prison populations have a high school education, and that only .14 have a
Are you familiar with, Mr.
McCue, with the Lancaster experiment down in the Lancaster County Prison,
where they temporarily suspended all medical experimentation, and 60% of the
prisoners wrote in and said that—wrote letters to the prison officials and
said that—they wanted it, and nobody said they didn't want it? Are you
familiar with that?
I'm not familiar with
that, but in response to that, let me say that I know a lot of prisoners who
would like to have Dr. Leary come back and do that LSD experiment again that
they did at Concord Reformatory.
that's beside the point of my question. How about the Connecticut experiment
where the Connecticut Correctional Department temporarily suspended it and
they had hundreds of prisoners write in and say, "Please start up the
experimentation again," and no one wrote in and said no?
Probably because Connecticut also pays $25 a day for
a man's labor.
All right, let's go back
to Mr. Bourdeaux.
Mr. McCue, you know,
of course, that 90% of all drug testing is done in prison, do you
I just learned that now, and it seemed
awful high to me.
Yes, sir. But this
cancer cure that Mr. Morris is going to find one of these days is going to
be to the benefit of everybody, isn't it?
Hopefully, it would be one for the cervical cancer as a result of the
morning after pill that research came up with.
All right. Would you agree that everybody ought to participate
in testing if they're going to benefit from the cure?
I don't necessarily go along with that. All prisoners
will hit the streets eventually, and if they want to do it then, that's
certainly their choice.
Morris, let's come back to you.
willing to let the prisoners decide whether or not they want to have this
experimentation on their prisoners by a popular vote in your
Based on the knowledge that I have
from the inmates, I'd be willing to do that tomorrow morning.
And you know it's a fact, don't
you, from all of the studies from all over the country that when they do
have that right to choose, the great majority of them want this.
I'm saying that in the Massachusetts prisons tomorrow
I would be willing to take that vote, and I feel confident of what it will
Well, isn't it a fact that more than
half of them do?
I don't think it's a fact.
I don't think that has been substantiated.
You've talked about the coercion among the various prisoners, but we all
have coercion in life, we're all prisoners of life, are we not?
I would say that some of us in a better circumstance
Yes, but nobody's free.
Everybody has a coercive factor: he has dependents if he's working, he has
I'm going to have to
interrupt. Mr. McCue, I want to thank you very much for being with us
tonight. Thank you.
I call as my next
witness Jessica Mitford.
welcome to The Advocates.
Mitford is a noted author. Her latest book is on prisons, and it's entitled
Kind and Usual Punishment. Miss Mitford, you have a chapter in your book on
drug experimentation in prisons called "Cheaper than Chimpanzees." How did
you get interested in drug experimentation programs and other medical
experimentation programs in prisons?
Well, as a matter of fact, I ran onto that very much by accident. These
experiments were carried out in deepest secrecy. They're very much shrouded
from the general public, the fact that this goes on, has been shrouded. I
found, for example, in California, where I did most of the research on this,
that even very knowledgeable people in the State Legislature were unaware of
what was going on in Vacaville Prison right under their nose.
What did you find out was going on in Vacaville
Prison when you went there to do research on your book?
Well, to my astonishment, I discovered that this
organization with a rather high-sounding name of Solano Institute for
Medical and Psychiatric Research, called SIMPR for short and that this
organization is a conduit with headquarters within the prison itself for
research grants from the giant drug companies that go through medical
investigators and work entirely on the bodies of prisoners.
Well, what was SIMPR doing in
That's what I should like to
know. In other words, Vacaville is a state prison, and this is called a
non-profit organization. When you start looking a tiny bit into it, it's so
for profit that you . . .
conducting any experimentation programs in Vacaville?
It exists entirely as a conduit for the drug
company experimentation programs on prisoners in Vacaville.
Did you discover any effects of any of the
experiments in Vacaville on the prisoners?
Well, I was able to discover a few things that went on there.
You've got to understand that it's jolly difficult to learn anything about
what goes on in prison. Prison is a very secret place. But I did find out
one or two things, and these again—you only learn these things more or less
almost by accident. I guess that one of them that struck me came to my
attention as a consequence of a lawsuit that was filed by a prisoner who
almost died as a result of having a drug called Varidase injected into him.
This was an experiment carried out for the Lederle Drug Company.
Well, aren't there supposed to be some
safeguards, somebody that oversees these programs?
Did you look into that?
I did. There is
. . .
And what did you find
I found out that the University of
California, the Chancellor of the University of California some years ago
established a committee which sounds on paper like the perfect idea to
safeguard all subjects, all human subjects, of medical
Did you appear before
I went and had a meeting
with them, yes.
And what did they tell
you about the Varidase program?
told me that none of these Vacaville experiments—that Varidase and dozens of
others that are going on today in Vacaville—none of these have been brought
to their attention in spite of the fact that the experimenters, the doctors
doing it, are on their own staff at the University Medical Center.
And after you found out what was going on at
Vacaville, did you look around for other prisons to see where there was
medical experimentation going on? I have particular reference to the state
of Iowa. What did you find out there?
Well, in the state of Iowa, for example, a few years ago a number of black
convicts were taken out of the prison and into the hospitals on this alleged
informed consent, and we were talking about informed consent and
volunteering: I just wonder if these prisoners were told what was going to
happen to them.
In other words, the
rule is that a prisoner has got to be informed as to what is going to happen
to him, he has got to consent to it freely and voluntarily, is that
That's right. He's supposed to know
what the likely consequences will be.
All right. What were they doing in Iowa?
What they were doing was to deliberately cause these prisoners to have
scurvy by the simple expedient of withdrawing Vitamin C, which I guess
Columbus would probably have known about. I mean, the causes and cure of
scurvy have been known for many, many hundreds of years. However, what
happened to these men predictably was that they got intensely ill,
agonizingly ill. I showed the medical article that was written about this
experiment to the man who's the head of the Department of Nutritional
Science at the University of California, and he said that the likely
consequences to these people would have been that they could have easily
suffered cardiac arrest. In fact, in the experiment itself, in the
description, the doctor who did it described how their hair fell out, their
teeth fell out, one man became unable to walk, they suffered terrible,
agonizing swellings and pains.
after . . .
Okay, I'm going to have to
interrupt. Mr. Morris is eager to ask you some questions.
here he comes.
Miss Mitford, you've told
this audience about these horror stories that I call them, these examples
that you've just gone through, Vacaville and all the rest, and I noticed
that those are also in your article in the Atlantic Monthly and which is a
chapter in your book. But these really are the exceptions to the rule, are
I have no way of knowing that
because I'll tell you why. As I said, it's really extremely hard, since the
experiments are carried on in secrecy, since the—well, there are several
reasons for the secrecy. In the first place, the drug companies . .
Let me interrupt at this point. There's
no secrecy about the medical literature which you have a chance to read, as
we all do, and it's full of all of this. Have you reviewed the medical
Well, I've just told you
some of the articles I read, like the one about the scurvy experiment, for
example. What I wanted to say was, though, that the secrecy has a very great
bearing on it. For example,
Well, wait a
minute, let's go to my question or we'll never get through.
Let me just explain this. Well, if I can explain
Well, make it a very brief
answer, Miss Mitford.
All right, it was
merely this, that in the Varidase case, for example, the case of that
experiment, the only reason it came to light at all was that a lawsuit was
You said that before.
Otherwise nobody would have known.
Yes, you said that before, but let me ask you this.
In the ten year period you studied in your article you only talk about seven
cases, and those seven cases, none of them involve the problem that we're
here with today. Some of them didn't involve prisoners, some of them didn't
involve any testing, and it was only one that involved Phase I testing of
drugs . . .
Excuse me, you're mistaken
about that. You're mistaken in saying that only some of them involve
prisoners. This is all.
I say some did
not involve prisoners. Isn't that right?
No, that's not right.
Now, how about
this? In the ten year period where you found seven of these horror stories,
in that period of time over 120,000 prisoners were tested on Phase I testing
and there weren't any deaths and there weren't any serious side effects,
isn't that so?
Well, wait, it doesn't
really ... Nobody knows that, you see. I don't know whether you could state
that, but, for example, in the sixties . . .
I don't state it, but Mr. Stetler it, and he testified with you
before Senator Kennedy, isn't that a fact?
That's true, but in the sixties, for instance, the late sixties, a
New York Times reporter discovered that—and again, he wasn't able to
determine the number of actual deaths, but—numerous deaths and enormous
amounts of illness in three or four southern states that occurred as the
consequence of this drug testing.
do the mathematics of this, it comes out that your horror stories are about
one-tenth of a whole percent, which is just infinitesimal.
Well, I don't quite agree with this, but I'll tell
you why: because, you see, all I—I only lifted a tiny corner of that rug . .
Well, but let's . . .
I just found out these few little things. I'm
hoping in fact that Senator Kennedy's committee, that large, metropolitan
newspapers and so on with far more resources than I, will start taking up
where I left off.
Yes, but if it is true,
if it is true, that it's just an infinitesimally small amount, these horror
stories, you don't want to throw the baby out with the bath, do you? You
don't want to stop research because there have been one or two
But you're the one who is saying
there are only a tiny few, and I'm saying that I don't believe you
Well, I'm saying . . .
Unless you . . .
... that I only know what the medical literature shows.
know what the medical literature shows, but you admit you don't know at all
because you haven't looked into the medical literature. Let me ask you this:
can you name a single prison where a substantial number of the prisoners
have voted to stop experimentation in their prison?
I don't believe that prisoners are usually called
upon to vote about anything in their conditions of life.
Well. There are two answers to that: one that the
medical literature is just full—and I've got it all here, hut we don't have
the time to go through it—but the medical literature is just full of the
prisoners voting and telling about the results of their votes and how they
do want this. Now, let me go to another source if you don't want to take
that. You're familiar with the Associated Press survey they made recently,
when they went out and studied the prisoners, and you're familiar with that
and what they said, and I'll quote it: "In the overwhelming majority of
cases researchers and the institutions for which they work are reputable and
keenly aware of the need to protect their subjects." Now, that's what they
said after they made the interview.
Well, okay. May I give a little answer to that then? I think it is not
reputable, for example, for the medical researchers to require the prisoners
to sign an illegal and fraudulent waiver of their rights, and this is
routinely done. I found this in every prison where I looked into the thing.
In other words, the prisoner is forced to sign a paper saying that he waives
the right to sue if any injuries should result.
What do you mean he's forced?
Well, in other words, he cannot participate in the experiment
unless he will sign this waiver.
that happens to anyone who is in an experiment, isn't that right?
No, no. In fact, it's against the law. It's
illegal, it's against FDA regulations, having the force of law. It is also
fraudulent because it's invalid. You cannot, you or I or a prisoner, cannot
sign away those rights.
Now, let's go
back to Mr. Bourdeaux.
Miss Mitford, Mr. Morris was asking you about
looking into this thing a little more. Didn't you go to the Food and Drug
Administration which is supposed to pass on these tests to try to find out
I did indeed, and I thought
they're supposed to be the watchdogs of the public health, but in my view
the Food and Drug Administration is totally derelict in its responsibility
to prisoners and people in these experiments. They simply . . .
Were they able to give you any facts and figures
that you asked for?
They were not. They
were not even able to give a list of prisons in which the experiments go on.
They gave me what they called an "imperfect" list, which indeed proved to be
All right, back to you, Mr.
All right. How can you say, Miss Mitford, that these prisoners are coerced
when 80% of them don't volunteer? More than half of them don't in the
beginning, and some drop out along the way.
Well, I don't know what that proves. It seems to me, you see, that
the coercion exists in precisely what Mr. McCue was talking about before,
and that is the incredible exploitation of labor in prison to begin with,
where you make two cents an hour, so obviously a dollar a day for being in
the experiments is riches.
But how can
you be coerced if you're free to drop out? The choice has to work both
Make this very brief.
Well, I mean, as I said, I think that the whole
situation is totally coercive.
right, Miss Mitford, I want to thank you very much for being with us
tonight. Thank you. For those of you in our audience who may have joined us
late, Mr. Bourdeaux and his witnesses have just presented the case in favor
of banning all medical experiments on prisoners. And now for the case
against, Mr. Morris, the floor is yours.
All right. Ladies and gentlemen, we come now to the other side of the coin,
and there are always two sides to every question. I ask you to consider why
prisoners are used. You've heard the proponents tell you the horror stories,
stories of experiments that are ill-designed, shouldn't have been brought,
ended disastrously. On that basis, of that infinitesimally small number out
of all of the safe programs that have gone on, they ask you to ban all
testing. Before you decide to do that, there are some things I want you to
consider. First, consider the miracles of modern medicine. Think of
today—and you may have forgotten this, but think of today—when you see the
little children running in the playground. Think back when they were
crippled with poliomyelitis, and we don't have poliomyelitis around with
little children any more, and the reason we don't is the Salk vaccine and
the Sabin vaccine, and where did those vaccines come from? They came from
testing on human beings, and they came from testing in part on prisoners. If
we give those up, what will we do for the diseases of tomorrow? How are we
going to cure heart disease and cancer and crippling arthritis? What about
the future of all of us? If you stop this testing, then all of that will be
gone. Consider also why prisoners are used: because there are no suitable
substitutes. We can stop testing. If we stop testing, what are the
alternatives? What are we going to do without new drugs, or are we going to
take new drugs that have never been tested and thrust them out on an
unsuspecting public and have everything go bad? To speak to the importance
of drug experiments on prisoners, let me call my first witness, Dr. Arnold,
a man who won the Army's Medal of Merit for the role he played in developing
an anti-malarial drug during the Korean War.
` Dr. Arnold, welcome to The Advocates.
Dr. Arnold is Director of the Harry S. Truman Research Laboratory
in Kansas City and Professor of Medicine at the University of Missouri. Dr.
Arnold, what is drug experimentation, and why is it important?
Well, Mr. Morris, we're facing a crisis of medical
care, and the crisis isn't truly appreciated because very few people talk
about this. We are losing control of many of the diseases that were
controlled originally by the miracle drugs of the 1940’s and 1950’s. The
second thing is that we're having a new disease pattern. Our life styles has
led to a change in disease. We have an epidemic of heart disease in this
country, and as I look around here, I can say that one out of every two
people in this audience will die of heart disease in this century. There are
changes in the age spectrum of our population. There are vastly new medical
problems developing because our population is older, and new disease
entities have appeared. To solve these problems, it is imperative that we
use human volunteers.
Have you ever done
medical experimentation on human beings?
Yes, Mr. Morris, I have spent twenty-seven years of my life working with
clinical studies in human volunteers.
do you have to test on normal human beings?
First of all it's safety. Second, it's safety. Third, it's safety.
It's safety for the general public. Unless we know the adverse effects of
drugs before they get on the market, we're forever handicapped in
identifying and removing these drugs from the market.
Have you ever done any tests on yourself a
Yes, I did, as a young
How do you go about testing with
these drugs on humans for the first time?
Well, the primary requirement is control, and the primary reason for control
is safety. We must see and monitor every subject of a medical experiment of
this sort, and the monitoring requires twenty-four hours sometimes three,
four, and six weeks observation. There are very few places in which human
beings can be observed so closely. There are very few places where as
medical experiments have been so safe. Now, I disagree with Miss Mitford:
there has never been—I repeat, there has never been—a fatal accident in
Phase I drugs testing in prisons, and, I repeat, there have been fatal
accidents in Phase I drug testing in patient volunteers.
Why do you choose prisoners as subjects?
Well, the problem is time demand. Most of us in
society are busy. Few of us are willing to take two weeks or four weeks or
six weeks to go into a hospital, away from family and job, to be observed so
closely as is required for human testing.
Can these prisoners make a free choice as to whether or not they want to go
twenty-seven years of work, I believe they have the freest choice of any
segment of our society. I have no control over prison volunteering. We send
out an appeal, and an answer comes back spontaneously. I have no coercive
pressure over volunteers in a prison, but I do have in patients, and I
frequently have as a Professor of Medicine over students. There are very few
segments of our society which are as free— I repeat, as free—of coercive
pressure as prison volunteers.
prisoners benefit in any way from having gone through the
Well, there's a
multitude of effects on a prisoner, and it's very easy to become tangled up
in these effects. They do need money, and I think that money has been an
enormous help in the lives of many of these people who have no other source
of money, but there's something bigger than this involved. A number of these
people gain a new self-image. Can you imagine a man who has never done
anything—I mean, anything— for social good in his life? Can you imagine the
new sense of self-respect that he has when he has contributed to the
development of a new life-saving drug?
All right, let's go to Mr. Bourdeaux for some questions.
Dr. Arnold, the truth of the matter is that what
you are really saying is that you as an experimenter have made a judgment
that society and the requirements of society offset the moral and ethical
implications of prisoner testing.
Mr. Bourdeaux, we're making judgments like that every day. We make
cost-benefit judgments about everything we do, and these cost-benefit
judgments are made about human experimentation. They really ought to be made
about everything else, and I don't make those judgments, Mr. Bourdeaux.
They're made by an institutional peer review group. They're made by
citizens. The same kind of people that sit in this audience look over these
experiments, and they make the judgments.
Do they make the judgments, Doctor, about what motivates a
prisoner to submit himself to the experiments?
You bet they do, and they contain people who have been in prison,
they contain people who have worked with prisoners, and these committees
contain people in every walk of life.
Is there an atmosphere of fear in a prison?
Well, I think this varies widely. Prisons are not a generic
species. Miss Mitford may think they are, but there are a great many prisons
which are not like the ones she describes.
Didn't you write. Doctor, in 1968 in the New York Scientific
Journal that there's a general level of fear that exists in many city,
county and state prisons?
that I qualified that, Mr. Bourdeaux.
Have you changed your mind?
Now, Doctor, in testing with
a prisoner, the first thing that you've got to do is get that prisoner's
informed consent, isn't it?
No, the first
thing you have to do is to get his inquiry. He has to ask to be a
The second thing you do is to get his informed
All right, I stand corrected.
The second thing you do is get his informed consent. This means that you've
got to tell him what you're going to do to him, and what may happen to him,
and then he's got to consent to it, is that right?
And has it been your experience that these prisoners understand the
information that you give them?
let's go through this, Mr. Bourdeaux. It's a very interesting
Well, just answer my
question, Doctor. Do you find that the prisoners understand what you tell
them about these drugs?
The prisoner asks
the questions he wants, and he talks to the other volunteers, and he makes
his judgment the same way all of us make our judgment, on his own particular
All right. Do you find
that the prisoner understands?
understands a great many things. He understands the things you tell him, he
understands the answers to the questions that he asks about . . .
Well, Doctor, let me see if I understand you. Is
there any difference between the understanding of a prisoner and the
understanding of a person at large outside the prison?
I think there is no difference. I repeat, there is
no difference in the capability of understanding.
Well then, why is it necessary to use prisoners? Why not use
students, for example?
Well, as students
are appropriate. I didn't say it was always necessary.
So in other words, you really don't think it's
necessary to use prisoners?
Well, I do
because students are not always under close observation. This is a safety
problem. If we're going to lose safety in the interest of these dialectic
arguments, then we have lost the battle. It is safe to observe people, and
it's only safe to observe them closely. Furthermore, there are many
complications with people on the outside of prisons. They use marijuana,
they use alcohol, they find themselves in dangerous positions during the
day, they get involved in all sorts of activities that impair...
All right, go ahead, Mr. Bourdeaux.
Thank you, sir. Now, Doctor, you mentioned and
agreed that it was possible to use students.
I believe that you have
recommended that under certain circumstances we have a national draft for
medical volunteers—I use that volunteer word loosely—for volunteers to
participate in programs, we're going to draft them, is that right?
No, you are misconstruing what I have said, Mr.
I beg your
I have said that if volunteers
cannot be obtained and if we wish to meet the health hazards of the last
part of this century, if volunteers cannot be obtained, there is only one
All right. Doctor,
there is a considerable amount of opinion nowadays that we shouldn't test on
prisoners, is there not? Some of it is pretty respectable too, isn't
Make this brief, Doctor.
Well, the answer is there is an opinion.
You don't think it's respectable.
Well, I respect everybody's . . .
Let me ask you this question . . .
All right, we're going to have to go back to Mr.
Doctor, 80% of the prisoners do
not volunteer, is that correct?
that's about right.
And that's a real
choice, is it not?
All right, back to you, Mr.
Doctor, isn't it true that
in November of last year that the American Public Health Association
resolved at its meeting in San Francisco to oppose further testing on
I believe that's
And that's an organization with
some 100,000 people who work in public health, isn't it?
Well, I don't know that, Mr. Bourdeaux.
You disagree with them, though.
No, I didn't say that.
I see. Thank you, sir.
right, I want to thank you. Dr. Arnold, for being with us tonight.
My second witness is Dr. Monroe Trout. Dr. Trout,
will you take the stand, please.
Trout, welcome to The Advocates.
Trout is Vice President and Director of Medical Affairs for the Sterling
Drug Company. Dr. Trout, Dr. Arnold has said that prisoners are ideal for
experimentation because they're in a controlled environment. Do you agree
Yes, I do. I think, first of
all, they have the time to participate in such investigations. We talk about
students and many of them have to go to class. They don't really have all
the time that's necessary. I think that Dr. Arnold put his finger on the
really important issue, though, and that is safety. I think with close
observation in the prison setup, you have all the safety you need. In our
experience in twelve years we have never had a death and never had a serious
adverse reaction in any of our testing in prisons.
Couldn't we rely on people outside the prison for
Yes, we could, and we do.
Medical students have been mentioned. Other students are used: Seminarians,
for example. They're not necessarily a desirable alternative, however, and
again, we go back to the safety factor. I think that there are many factors
with students, such as they're not on a standardized diet which may
interfere with the scientific validity of the experiment, which means that
you may have to do it over again on another group of subjects. You do not
have the close observation of those particular people as you do in the
Why do prisoners
I think the prisoners volunteer
for the same reasons that non-prisoners volunteer: money is certainly one of
them. Idealism—people who feel that they really want to contribute something
to society and want to get the accolades of society.
What do prisoners think about the proposal to ban
these medical experiments?
I know of no
prison group that is interested in banning the experiments. Every group that
I've been aware of, starting with the Lancaster County prison system where
there was a move to temporarily halt experimentation, 60% of the prisoners
wrote in and said, "We want it to continue." Not a single one wrote and said
that it should be halted.
This is in
Pennsylvania, is that right?
This is in
Pennsylvania. The same thing happened in Connecticut in 1967 and 1968, and
just recently I spoke with the President of the Fortune Society, which is an
organization of ex-prisoners in New York City, and he told me that in the
entire existence of that society they have never had a letter from any
prisoner objecting to experiments in prisons.
Are the prisoners inside the prisons able to make a free choice as
to whether they want to volunteer or not?
I think prisoners inside of prisons are able to make just as free a choice
as anybody on the outside. As a matter of fact, I think if you take away
that choice, you're really adding to their degradation. One of the mottos of
the Fortune Society is "I think, and therefore I am," and I think we're
taking away that choice for the prisoner.
What about these abuses, these, as I call them, horror stories that Miss
Mitford has related to this audience?
Well, I think that there have been abuses. However, if we really examine
them closely, there are about a dozen incidents which keep cropping up in
all the literature. There the same incidents, many of them dating back
thirty or forty years, many of them not even occurring in prisons and
certainly not in drug testing. I'm concerned really with the greater abuse
of having millions of Americans die or suffer each year from cancer,
arthritis, heart disease, malaria and overseas schistosomiasis because there
is a time lag in getting the drug to the marketplace or because we do not
have volunteers to participate in such experiments. For example, 800 people
in the United States alone die of cancer each day, and the President of the
American Cancer Society said that one of the reasons for this is because
experimenters are afraid to take great risks. You're caught in the
Make this very
Doctor, to sum up all your
experiences, would you give the jury your feeling as to what we should do
about this problem?
I think we need—and I
think everybody would agree that we need—to continue to develop new drugs
for all of the diseases that have not been conquered up to now, and for the
new ones which are going to evolve. I don't think anybody will disagree. I
wonder if we ban experimentation in prisons where those volunteers are going
to come from.
All right, Dr. Trout,
let's see what questions Mr. Bourdeaux has for you.
Doctor, you've mentioned that some of all of
these things that Miss Mitford wrote about and other people talk about
occurred back many years ago, or some of them anyway. The Iowa scurvy test
was in 1968, wasn't it?
I believe she
reported that in 1968, but that was not a drug test, as far as I know,
It was medical experimentation,
though. That's the title of this program, is medical
I understand that we're
talking about drug experimentation . . .
... in prisoners in
Phase I testing.
All right, sir. Well,
let me enlighten you a little bit. We're talking about medical
experimentation which includes Phase I drug testing. The Varidase experiment
in Vacaville took place in 1972, didn't it?
No, I believe it occurred in 1962. As a matter of fact, it was
reported in 1962 in the literature, and I believe that it occurred prior to
that time, and 1962, as you know, was when the new amendments to the Food
and Drug Act took place.
A lot of changes have taken place
Yes, sir. Now, are you
familiar with the medical experiment out in Oregon about three years ago,
involving the reproduction organs of male prisoners?
I have heard about this.
That's where they put radioactive material into the testicles of
male prisoners. Are you aware of that?
Well, we put radioactive material into patients every day to determine
whether or not their thyroids are functioning, whether or not they have a
brain tumor. This is not as bad, Mr. Bourdeaux, as it sounds.
Yes, but these prisoners had to have a mandatory
vasectomy, didn't they?
understanding was that they had a vasectomy before the experiment took
place, and it was not any condition of the experiment.
Is that your understanding of it?
And a lot of people, as you
know, have vasectomies today.
Doctor, can you tell us today how many drug experiments are going on in
prisons in the United States?
Can I tell
you how many are going on?
No, I cannot tell you how many are
All right. Would you mind
reminding me what your position is?
sir. My position?
I am Vice President and Director of Medical Affairs
for Sterling Drug.
All right. How many
experiments is Sterling Drug carrying on today in prisons?
I believe that we have less than a half a
Less than a half a
Doctor, have you ever participated in any of
these experiments in prisons?
Have I ever
participated in an experiment in prisons?
No, sir, I have
Well, how are you in a position
to tell us what motivates a prisoner to let himself be made a guinea
I believe that there have been at
least a half a dozen studies . . .
There have been at least a half a
dozen studies which have been reported in the literature by individuals such
as Dr. Arnold, who have spent their entire lives in prisons reporting on
I see. You mentioned that it was
necessary to test these drugs in order to protect ourselves from all these
dread diseases. Now, Doctor, that's not the only testing that's done, is it?
Aren't there some testing of what's called the "me too" drugs, or the
Those tests that you're
talking about and "me too" drugs or bi-availability tests are in large part
not—as a matter of fact, I would say that practically 100% of them are
not—done in prisons.
Bourdeaux, what's a "me too" drug?
Yes, sir, I'm glad you asked me. A "me too" drug, Doctor, is a drug that one
drug company tries to bring out to meet the competition from another drug
company, isn't it?
A "me too" drug, I
think, in large part is what is considered a generic drug which is brought
out by a company that does not perform any research whatsoever.
It's also called a redundant drug?
No, it's the same drug. Many times it doesn't
Doctor, you mentioned something
about using students, that this wasn't a satisfactory method of testing.
Now, isn't it true that the whole prison population of the United States,
outside of the county jails and city jails, is less than 300,000 people, or
do you know that?
No, I did not know that.
It was my understanding that it probably is double or triple that
But that's if you include the
county jails and the city jails and all that sort of thing.
Yes. Total prison population.
Yes, sir. Now, Doctor, that's only a very small
percentage of the total population of the United States, isn't it?
It's probably about a half of 1%.
Yes, sir. What about using, if time is a
problem, what about using students or teachers in the summertime when
they're not in school? Have you ever thought about that?
Yes, that's certainly a possibility. However, most
students in the summertime like to return home and see their
Yes, sir, most of them . .
That's my experience; that's what I
wanted to do.
Most of them need a
little extra money too, don't they?
and they usually go home and find jobs around swimming pools and doing
something which—we've got more of a vacation . . .
You've got 13,000,000 teachers out lifeguarding
during the summertime. Now, Doctor, the truth of the matter is that the
Make this very brief,
Yes, sir, it will be brief.
The only difference between the body of a prisoner and the body of any of
these folks sitting out here is that in the prisons those bodies are
cheaper, isn't that true?
No, that's not
All right. Okay, let's go back
to Mr. Morris.
Doctor, just one or two
questions. The other side would have us ban this experimentation in prison,
which means then that we have to do it on the outside, as you'd call it. If
it's done on the outside and to the extent it already is done on the
outside, do abuses occur there too?
believe that abuses will always occur no matter what you do. Abuses occur in
medical practice. Does that mean that we're going to ban all doctors and not
permit them to practice medicine?
right, back to you, Mr. Bourdeaux.
Well, Doctor, if this is such a wonderful thing, this testing on prisoners,
Why has the federal prison system recently stopped it?
I was not aware that the federal prison system had
stopped it. As a matter of fact, I participated in a conference called by
the federal government last August on this very issue, and those
representatives were there and no mention of that was made.
They haven't announced it to you yet. What about
the American Public Health Association? Why have they voted to ban it and
I think you should go back and
really read what the American Public Health Association has said very
carefully because I do think that they qualify it, and they were talking
about prisoners who were convicted of heinous crimes.
No, sir, let me read you what they say: that
"the American Public Health Association take a well-publicized and
unequivocal stand against all experimentation in prisons." See if I read it
Is that what it says?
I don't know. I don't have time to . . .
Doctor, I want to thank you very much for being with us tonight.
Thank you. Thank you, gentlemen. That completes the cases, and now it's time
for each advocate to present closing arguments. Mr. Morris, could we have
Yes. Ladies and gentlemen,
the miracles of modern medicine you're well aware of. They speak for
themselves. You've lived with them. You've enjoyed them, and they've
enriched your lives, but without this medical research on human beings we're
not going to have these miracles very long. We're not going to have any cure
for heart disease, cancer, crippling arthritis. Tomorrow we'll be suffering
from the same diseases we are today. Prisoners, because of their unusual
stable environment, are ideal subjects, and prisoners are not coerced. The
great majority of them don't volunteer, and to say you won't go into it is a
sign of not being coerced, just as much as they like to argue that those
that do go in are coerced. They're not coerced. They have a free choice.
Prisoners have a right to do this if they want to do it, as much right as
the medical student has it, for all the variety of motivations and reasons:
they have a right to earn some money, they have a right to develop some
status and do some good and be looked up to as they are, but you should not
take that right from them. Don't let a few misguided horror stories, as I
call it, don't let that mislead you into taking the prisoner's rights away
from him and taking research away from us all. Research is extremely safe;
it has a wonderful track record for safety, and the statistics show it, and
the witnesses have showed it. Just because some doctor confesses that he has
done thirty-eight unnecessary back surgery is no reason to give up back
surgery, and because there are some isolated abuses, and sometimes real
horror stories, which we all deplore, that's no reason to give up medical
research, and it's no reason to deprive the prisoners of it. Remember: your
health is the most important thing in your life, so vote no so that we can
keep this medical research and keep ourselves alive.
Mr. Bourdeaux, could we have your
We have been told that drugs
have to be tested on human beings, and we agree with this. But we believe
that the prisoner who submits himself to an experiment for cigarette money
or to enjoy some hospital food or to escape temporarily from that oppressive
guard or that cellmate or in the natural hope that his action will provoke a
reaction, and a favorable reaction, from the parole board is not acting
freely and voluntarily, and no matter how much we are told about the
benefits that society will reap from these experiments, this will not quite
wash. The scandal and the disgrace of the Iowa scurvy test, the Vacaville
Varidase scandal, and the Oregon testicular program. The only safe way to
ensure that we do not continue on this deadly course of believing that the
needs of society as a whole give justification to the abuse of the
individual is to ban the use of prisoners for medical experimentation. Vote
Thank you, gentlemen. Now it's
time for you in our audience to get involved. What do you think about
tonight's question? Should all medical experiments on prisoners be banned?
Send us your "yes" or "no" vote on a letter or postcard to The Advocates,
Box 1974, Boston 02134. We'll tabulate your views and make them known to
your state representatives and others concerned with this problem. Write us
tonight; don't put it off; let us know how you feel. Remember the address:
The Advocates, Box 1974, Boston, 02134.
Advocates will not be seen in the last week of February, but will return the
first week of March to its regular time slot, so let's look ahead to that
program. (PROMOTIONAL MESSAGE)
Now, recently The
Advocates debated the question, Should we rely on nuclear power to help
supply our future energy needs? Of the more than 6,500 viewers who
responded, 42% said yes, that the key to making the United States
self-sufficient in energy lay in nuclear power, and 58% said no, that the
benefits of nuclear energy do not warrant the risks involved.
And now, with thanks to our advocates and to their able and
distinguished witnesses, we conclude tonight's debate.