Ethics of using homeless test subjects discussed

by Ingrid Skjong

Leading ethics scholar Tom Beauchamp recounted a story Monday of a homeless man down on his luck and desperate to make some money.
Odd jobs weren’t enough to get off the streets, so the man joined the ranks of the homeless who become “research subjects” for the pharmaceutical industry, Beauchamp told 40 people at a speech in the Basic Sciences and Biomedical Engineering building.
Drug companies pay daily allowances to low-income people, often college students, to participate in research studies. Beauchamp, a Georgetown University senior research scholar, spoke on the ethical implications of the practice.
But for sponsors, the Carlson School of Management and the Center for Bioethics, the speech carried a larger agenda. “It’s a perfect opportunity for us to build bridges between the ethics program in Carlson and the medical ethics here,” said Norm Bowie, Carlson’s business ethics chairman.
Beauchamp, who last spring sat on a panel to examine the practice, said he finds little intrinsically wrong unless specific groups, such as the homeless, are actively sought out.
The panel, commissioned by pharmaceutical giant Eli Lilly & Co., came in response to published reports which detailed the company’s recruitment of alcoholics at Indianapolis homeless shelters.
Approximately 6 to 8 percent of the company’s subjects are homeless, Beauchamp said. The firm pays $85 a day plus room and board for people who volunteer to undergo testing.
Company officials say they use homeless subjects because those with full-time jobs can’t meet the time commitment.
Beauchamp said drug companies must be sure they are not taking advantage of vulnerable participants. But overall, he downplayed the risk involved.
“In general, it is not particularly hazardous to be a test subject,” Beauchamp said. He referred to a study of 8,201 subjects where only three adverse reactions occurred, including two headaches and a case of pneumonia.
For practice opponents, the physical risks must be coupled with philosophical and social concerns.
“You have a situation where there is sort of a broader injustice in the world that we tolerate,” said philosophy graduate student Andrew Burnett.
Many of the volunteers will never have the opportunity to benefit from the drugs they are helping to develop because they cannot afford them.
Still, Burnett said homeless people are not really worse off as research subjects. And he is more comfortable now that the Food and Drug Administration and the National Institutes of Health have a closer eye on companies such as Eli Lilly.
“If there were a lapse, people would get a hold of it,” he said.