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Exploring the Holmesburg Prison Experiments

Mounica Gummadi

Basics

  • The Holmesburg Prison is located in the Northeast region of Philadelphia.
  • The prison was built in the late 18th century and was in use until 1995.
  • It was in the 1950s through the 70s that the prison became the "supermarket" or "kmart" for human medical research.
  • In 1951, Dr. Albert M. Kligman, a dermatologist at the University of Pennsylvania, was called to the prison to help with a case of athlete's foot that had been spreading among the inmates.
  • Dr. Kligman went to the prison and was overwhelmed by the large number of men simply milling around in a confined environment.
  • It was at this moment that Dr. Kligman stated that "he felt like a farmer" with acres of skin in front of him ready to "harvest".

Type of Experimentation

  • Tests involved commercial items such as toothpaste, deodorant, shampoo, skin creams, detergent, liquid diets, eye drops, foot powders, and hair dye.
  • These items are seemingly benign, but were accompanied by constant biopsies and other painful procedures.
  • It was later found that there were also other more harmful experiments using mind-altering drugs, radioactive isotopes, and other harmful compounds.
  • Dow Chemical and pharma companies funded large projects that involved using the prisoners for research.
  • For instance, Dow Chemical funded Dr. Kligman with $10,000 to test the effects of dioxin (a major chemical in Agent Orange).

Impact on the Prisoners

  • Prisoners were paid around $1/$2 a day for participating in the trials. Some walked out with almost $1500.
  • This was a lot more than the few cents they could earn doing prison jobs.
  • However, the experiments had such a detrimental effect on the patients that many still have scars, blisters, cysts and ongoing rashes even years later.
  • Video (2 minutes)

Aftermath

  • Dr. Kligman went on to become a very famous (and very rich) researcher and discovered Retin-A, which is a widely used medication for both acne and aging skin.
  • It was not until the 1970s that the Holmesburg Prison Experiments and the human rights violations that were happening there were exposed.
  • It was after these incidents, that new regulations were put in place for use of prisoners for research.
  • The main reason that this had been highlighted is in light of the controversy surrounding the Tuskegee Syphilis experiments.
  • Former inmates filed a lawsuit in the 2000s against Dow Chemical, Johnson and Johnson as well as Dr. Kligman for their painful experiences ($50,000 in damages) and lack of proper awareness of what was being done.
  • This case was thrown out as the statute of limitations had expired 20 years before.
  • Dr. Kligman, until his death, felt he did not do anything wrong as his actions had fit the national protocols at that time.
  • The result of increased regulation of this population is what pushed pharmaceutical companies to outsource research--which is not exactly a solution but rather an extension of the problem.

A "Sentence to Science"

Ethical Considerations

POLL!!!!!

http://www.polleverywhere.com/free_text_polls/LrsLbRuHQ92eFyV

  • Very similar to the Tuskegee case in that the population was a large population of vulnerable, poor and uneducated members.
  • The prisoners are in a compromised position where they are entirely dependent on the state (Petryna). They almost had no choice but to participate because of the conditions in which they were in.
  • The prospects of money is the only incentive that these prisoners had, which changed the normal practice of conducting medical research on those who directly benefit from it.
  • The responses of the researchers in the Holmesburg case depict the concept of "ethical variability" in that their excuse involves the reasoning that they acted within the constraints of legality.
  • Prison research continues to this day, however, there are IRB (Institutional Review Boards) that must approve the research projects ahead of time.
  • At least one member of the IRB has to be a prisoner, which helps make sure that the perspectives of those involved is also represented.

Possible Discussion Questions

Sources

  • Can IRBs serve as the main monitoring agent for research ethicality?
  • Can ethical variability be controlled on a global scale?
  • How can we change the attitudes of pharmaceutical companies and researchers towards valuing individual autonomy versus their interests or society's interests?
  • Should research done here and in other countries have direct benefit to the very subjects who are participating?
  • This is obviously a topic very close to us and within our own community. How can we play a role in addressing the ethics of population research?
  • http://www.upenn.edu/gazette/0101/0101gaz3.html
  • http://articles.baltimoresun.com/1998-07-21/news/1998202099_1_holmesburg-prison-kligman-philadelphia
  • http://www.youtube.com/watch?v=sfd1vCC3YC
  • http://www.californialawreview.org/assets/pdfs/97-2/09Apr_Reiter.pdf
  • http://www2.pslweb.org/img/lib/1507.jpg
  • http://www.nytimes.com/2006/08/13/us/13inmates.html?pagewanted=all&_r=0
  • http://www.dshs.wa.gov/pdf/ms/rda/hrrs/PRISONER%20RESEARCH.pdf
  • http://www.wnd.com/2002/05/14067/
  • http://www.hhs.gov/ohrp/policy/prisoner.html
  • Petryna- Ethical Variability- Class reading
  • http://www.albany.edu/scj/jcjpc/vol6is1/shuster.html

In Context

  • Informed Consent (willing but poorly informed prisoners)
  • Issue is beyond a simple call for better informed consent as stated in the readings this week
  • Informed consent does not change the social conditions or the compromised position of those dependent on the state and trusting the state as stated by both Farmer and Petryna.
  • Now, researchers are looking for "prisoners of poverty" not prisoners of stone.
  • Taking a more global context, like prisoners, subjects in "developing" nations are vulnerable. They view research as a way to draw attention to their medical problems.
  • System of tradeoffs: risks to the subjects versus social benefits
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