More Issues with Clinical Trials

As noted in an earlier article on this website, ethical issues are always present in clinical trials because the experimental subjects involved are human beings.

In the past, many clinical trials were (and often still are) funded by the government and carried out in academic medical centers; in the United States, one of the principal government funding sources for clinical trials is the National Institutes of Health. In other words, these trials were funded by public monies and designed ultimately to improve the public health.

In recent decades, however, changes in the funding of clinical trials have caused new ethical concerns to arise. In particular, the line between the public and the private in the financing of clinical trials has become much more blurred. Now, university medical centers rely not only on funds from the government, but also on funds from private pharmaceutical companies. As an article in last week’s Washington Post pointed out, “The research centers provide expertise, academic cachet and willing patients for companies developing drugs, while the companies provide income for the institutions and, in many cases, for doctors and faculty members serving as consultants, officers or board members.”

Although the article reported that many patients did not object to this arrangement, this empirical fact does not eliminate the underlying ethical problem with these changes in the funding of research. Rather, it illustrates again the argument articulated by Michael Walzer (and discussed in the article on Social Justice v. Market Incentive) that research in the health care arena might be a “sphere” where the logic of the marketplace should not dominate. Some of the problems with letting the logic of the marketplace dominate in the field of academic research are discussed in a report produced by the American Federation of Teachers in 2004.