Some arguments for making life-term inmates or prisoners with long sentence medical test subjects to pay back society, with the reduction of sentence based on risk factors as an incentive.

Opinions on Debatable Issues #38

Currently, prisoners are encouraged to volunteer in medical experiments, and many have been actively participating in some. Though the word “incentive” might be interpreted as suggesting nonobligatory participation, thus article brings some arguments that justify mandatory medical testing involvement. Disclaimer: it does not represent my personal stance on this issue by any means. The arguments below are presented with the purpose of engaging in meaningful conversation and evoking deeper thinking about life, ethic, human rights, fairness, and law.

First of all, the ethical requirements of fair compensation are met. Calling for “a fair distribution of benefits and risks”, IRB requires research subjects to get “benefits that compensate their time and effort and placing themselves”. Time is universally acknowledged to be priceless. It is especially true in the case of sentence reduction for life-term prisoners. Being able to live a normal life at some point in the future keeps people hopeful. For many, a life-term sentence is worse than a quick death. William Blake, who was sentenced to 70 years of life said “I have died a thousand internal deaths” after being imprisoned for 25 years, according to The Marshall Project. Thus, a chance of getting out of prison is fair compensation for a clinical trial, which many already volunteer to participate. A study published in PMC that analyzed 70 prisoners’ perception on whether their participation in 6 different studies was exploitative found that “prisoners … do not view their involvement in clinical research as inappropriately exploitative.” Based on this finding, it can be inferred that most prisoners will have a positive attitude towards this resolution. 

In addition, the compensation of “reduction in sentencing” is shown to be perceived as beneficial by prisoners. An NCBI study found that “…prisoners, compared to non-incarcerated individuals, were more likely to be motivated to enroll in a hypothetical drug trial out of a desire to appear cooperative, avoid boredom, meet someone new, and help others; prisoners were significantly less likely than non-prisoners, however, to be motivated by compensation.” Therefore, most prisoners likely feel that becoming testing subjects is helpful for their parole consideration and are more inclined to accept it. 

In addition, the abundance of life-sentence prisoners is unquestionably a burden on the nation and for each individual state. Decreasing the confinement time while getting human subjects for drug and treatment testing helps save precious resources. According to Princeton, Dataspace, “nearly 162,000 people in the US are serving a life sentence. An additional 44,311 individuals are serving “virtual life” sentences of 50 years or more”. Those people are fed and taken care of using taxpayer’s money. According to the Vera Institute of Justice, incarceration costs an average of more than $31,000 per inmate every year in the US, which means about one hundred fifty thousand dollars for 50 years. Those costs would be greatly saved to be devoted to other areas, such as rehabilitation, community, service, and juvenile education if reduction for many adds up.

Unsurprisingly, significant medical benefits brought by the abundant human testing subjects that will become available have to be mentioned. Potentially, hundreds, thousands, even millions of people can be saved because an effective way to recruit enough clinical test subjects is crucial for promptly implementing medicines and treatments for severe and illnesses. According to OAT, Dickert et al. found that the “recruitment for reduced cardiac ejection fraction trial to assess the use of Warfarin versus Aspirin took more than seven years. Whereas, successful randomization of 7141 subjects in less than three years was achieved for a study that intended to prove the clinical effectiveness of Nesiritidein decompensated heart failure.” A couple of years saved from recruiting human subjects potentially saved thousands suffering from heart failure with the new effective drug. 

Some argue that animals are enough for testing, but the reality is that the different physiology and genetic makeup of homo-sapiens and other animals are crucial for drug, vaccine, and treatment trials. Human subjects are necessary to show the safety of unproven medical therapies. A great example is the COVID-19 vaccines. Since most of the world population must get vaccinated to end this pandemic, the safety of the vaccine is the topmost thing to be ensured before it is authorized for even just an emergency usage. There were three phases of Clinical trial, with the first one designed to determine if the vaccine is safe and detect serious side effects, the second focuses on testing how well the vaccine works, and the third to double-check safety and side effects on a large population. There is no way any drug can be authorized for most of the population without reliable human subject tests results. 

Some argue that this is unconstitutional because the 8th Amendment says that there should be no “excessive fines imposed, nor cruel and unusual punishments inflicted.” According to Oxford Dictionary, cruel and unusual punishments (called by many as “torture”) is “the action or practice of inflicting severe pain or suffering on someone as a punishment or in order to force them to do or say something.” Meanwhile, the definition of Torture Under 18 U.S.C. §§ 2340–2340A is “an act must be a deliberate and calculated act of an extremely cruel and inhuman nature, specifically intended to inflict excruciating and agonizing physical or mental pain or suffering”. Having prisoners becoming test subjects is not a deliberation of inflicting pain because we all want the drugs to be effective. Otherwise, all volunteers that participated in medical experiments are asking for or willing to be tortured. This is not the case when life-term prisoners participate in medical trials because the intent is to make them engage in an alternative form of community service with the ultimate goal of saving and improving many’s lives, not punishing the prisoners by making them painful or force a confession. The harms are side effects that no one wants because the safety and efficacy of drugs are the ultimate goals for any medical experiment. Rather, is an act of paying debt, or one can say an alternative form of community service that entails larger risks and contribution but also corresponding compensation of sentence reduction. Thus, the 8th amendment is not violated. 

Those are some arguments that support life-term/long sentence prisoners’ mandatory participation in medical trial. Without a doubt, the other side of the debate can raise many great arguments, such as violation of basic human rights to the sole owner of one’s body, the inhumanity of justifying the means using end of achieving “common good”, and the procedual, legal, and social practicality of this proposal.

Sources:

• https://soapboxie.com/government/DEATH-ROW-INMATES-IN-CLINICAL-TRIALS-THE-BENEFITS-OF-HUMAN-VS-NON-HUMAN-SUBJECTS
• https://www.oatext.com/human-subjects-in-clinical-trials-ethical-considerations-and-concerns.php
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356487/
• https://highschoolbioethics.georgetown.edu/units/cases/unit3_timeline.html
• https://www.marketplace.org/2017/05/19/how-much-does-it-cost-send-someone-prison/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793400/
• https://www.themarshallproject.org/2014/11/30/what-death-penalty-opponents-don-t-get
• https://dataspace.princeton.edu/handle/88435/dsp01jd473053m#:~:text=Nearly%20162%2C000%20people%20are%20serving,sentence%20reached%20206%2C268%20in%202016.
• https://www.justice.gov/file/18791/download#:~:text=torture%2C%20an%20act%20must%20be,pain%20or%20suffering.%E2%80%9D).

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