Who participates in clinical trials? And Why?

As I’m making my way through Polio: An American Story, I’m struck by the descriptions of Salk’s vaccines going missing during The Clinical Trial. Participating clinicians wanted to use the vaccines on themselves and their families to protect them from polio. It stands in stark contrast to contemporary reports of vulnerable populations being misinformed and misguided into participating in clinical trials overseas. Here’s a BBC article on clinical trials conducted in India among individuals affected by the Bhopal gas leak I found via Mara Hvistendahl on Twitter:

Time after time in Indore, I heard a depressingly familiar tale of poor, often uneducated people saying how flattered and privileged they were made to feel as they were suddenly offered the chance to receive medicines usually out of their reach. All of them claim that, contrary to Indian laws governing drugs trials, there was no informed consent.

I’ve been pondering how did we, as a society, go from stealing study vaccines for our own use to administering study medications to the underprivileged? And from having absolute certainty and faith that a vaccine would be safe+effective to doubting the safety+efficacy of vaccines that have long been in use? I’m looking forward to our discussion of Polio next week. 

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One Response to Who participates in clinical trials? And Why?

  1. bsbnerds says:

    The answer to the first question you pose is a bit sticky, since it gets into all that bioethics stuff we love to ruminate on, but Oshinsky does point out a couple of polio trials which occurred in less-developed nations with less oversight that could “interfere.” The second question, though, can be summed up nicely by Oshinsky–it was, in fact, one of the passages I flagged to share this evening: “‘We’re prisoners of our own success. … When formerly dreaded diseases are pushed into the shadows–or eliminated–questions about the vaccines themselves begin to spring up.'” (p.282) This is similar to a lot of the feelings I have about the vaccine debates we have been having in the U.S. for the past several years. The state of the art in medicine when most vaccines were developed can certainly be called into question when it comes to unexpected sterility or side-effect issues, but at what point are we just looking for something else to rally against / be collectively fearful of / etc.? And, for us today, how much of the worry & outrage is actually lack of knowledge about the pathology & history of these diseases, as well as the lack of personal experience with them to remind us about what things were like pre-vaccine?

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