People who are incarcerated require additional regulations to be followed when being considered as clinical trial subjects and according to the Department of Health and Human Services Code of Federal Regulations, a full board IRB comprised of board members not associated with the prison and at least one prison inmate with expertise has to be review appropriateness of the research study.
Prisoners are in a resource limited setting and certain things would need to weigh the risks and benefits. First of all, the payment for the participation would have to be reviewed to ensure that it is not an imbalance from the normal resources available to inmates who would choose to not participate. If the payment/reward is of a great magnitude, prisoners might sign up for the study as a means of getting more resources. Prisoners also need to understand that participation in the study would not give them any special preference or weight during parole hearings. The board would also need to consider the length of the research study and help define the prison sentence terms that might be appropriate when considering the prisoners.
Most importantly, with the study being one that is addressing traumatic childhood experiences, the board has to carefully examine resources that would be available to prisoners who would require behavioral health services to help them cope with triggers and retraumatization.
References:
John Carroll University. Types of IRB Review. Retrieved from http://sites.jcu.edu/research/pages/irb/review/review-types/
U.S. Department of Health and Human Services. (2009). Code of Federal Regulations TITLE 45. Retrieved from https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html
I almost think that it is unethical to use prisoners for studies. I agree that there should be extra precautions taken if we must use them for the studies. Prisoners do not have the same resources and abilities to communicate issues should they arise. I also feel that it is a way to take advantage of someone who is being jail for crimes. Because they are being provided monetary gifts then it gets shady due to the fact that they probably don’t have money and we are giving them money to, possibly, harm their bodies. I realize that it is important to do these studies in order to get approval for use in the field, however, I am not convinced that the prison system is the place to conduct these studies. I am glad that they take extra precautions when considering prisons for case studies.
I agree that prison systems might not be the ideal places to conduct research. It is complex enough trying to set up research in the free world with extra precaution that harm should be minimized to the greatest extent. I would argue that it would depend on the type of research being conducted and would therefore not rule out all research in prison systems.
One of the questions that needs to be asked is what will the prisoners benefit by participating in the research study. “Prisoners live in conditions that restrict their social, healthcare, and economic freedoms.” Research offers inmates the opportunity for resources that would otherwise not be available to them. “Research studies …may seem to exploit inmates’ circumstances, particularly if prisoners would choose not to enroll if they were in the community or if resources were more readily available in prison.” The prisoners are not persuaded to participate, and it may appear “equally unjust to exclude them from research, especially if studies offer help to individual participants or seek to improve the care of prisoners in general” (Christopher, Stein, & Johnson , 2016).
Resource:
Christopher, P. P., Stein, M. D., Johnson, J. E., Rich, J. D., Friedmann, P. D., Clarke, J. G., & Lidz, C. W. (2016). Exploitation of prisoners in clinical research: perceptions of study participants. IRB, 38(1), 7–12. Retrieved on June 19, 2018 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793400/
For a study of this nature, investigating childhood trauma on interpersonal relationships, what better population? It could be a means of exploring what behaviors or experiences precipitated the offense that put them in jail Not every crime is because of something that happened to us, but it sounds interesting.
Historically, research on inmates definitely has a checkered past. Post-World War II, medical ethics were disregarded and inmates were considered ideal subjects for experimentation. Prisoners were considered to owe society their participation for the crime they committed. Most notable was a prison in Illinois in 1944 when hundreds of inmates were infected with malaria. Compensation was definitely called into questions as some participants were paid with reduced sentences or even release (Cislo, 2013). Clearly, the schools of thought on this subject are at opposite ends of the continuum.
Subsequently, in 1948 a committee report to the Governor of Illinois proposed the following guidelines for human rights advocacy with regard to participation in research: “1) That all subjects should be volunteers in the absence of coercion in any form; 2) Before volunteering, they should be adequately informed of the hazards, if any, and; 3) That the choice to volunteers should be made on the basis of established criteria” (Crislo, 2013). Here we may see the birth of informed consent, which is still a huge point of consideration today.
I completely see both sides of this ethical dilemma. Inmates are stripped of certain rights in prison, such as voting in some states. One side of the isle could advocate that they gave up some their rights when they took the rights of the victim in their crime. The other side of the isle is willing to look past some ethical boundaries because they are criminals. I believe the honey spot is somewhere in between. In my opinion, they are still human beings and should still be offered the right to choose to participate or not.
Reference:
Cislo, A. M., & Trestman, R. (2013). Challenges and solutions for conducting
research in correctional settings: The U.S. experience. International
Journal of Law and Psychiatry,36, 304-310.
http://dx.doi.org/10.1016/j.ijlp2013.04.002
I agree that prisoners have long been exploited for the sake of medical research. I would however argue that unethical research on human subjects has also occurred in the free world, even with the participation of the U.S government and military. In my opinion, we need to continue being vigilant that history does not repeat itself. Thanks for sharing.