Prisoners are being unfairly excluded from taking part in potentially beneficial clinical research, on the grounds that it would be too difficult and expensive to include them, according to a study published online in the Journal of Medical Ethics.
Current guidance governing research in prisons is too ‘protectionist’ and restrictive, denying prisoners the chance to access the same research opportunities as the rest of the population, noted authors from Birmingham (UK), Zurich (Switzerland) and London (UK). They added that it may be time to review this.
The authors analyzed UK applications to carry out research involving prisoners to the National Research Ethics Service (NRES). Between 2010 and 2012, 14,355 applications were made to NRES, of which just 100 (0.7%) planned to involve prisoners/prison service. Almost two thirds (61%) of these studies involved mental health or infection, but only seven studies involved potentially beneficial treatments for conditions that were not specific to prisoners. Of these, only one offered prisoners the chance to take part in a clinical trial on the same basis as the rest of the population.
The strongest factors prompting researchers to exclude prisoners were the perceived difficulties/costs of recruiting and involving them, with over half (59%) citing this. Yet most researchers (61%) and ethics committee members (57%) agreed that prisoners should be treated the same as everyone else and given the chance to take part in ‘non-prison specific research.’ Only 15% and 28%, respectively disagreed.
The researchers acknowledge that prisoners have been exploited in the past as a captive population on which to experiment, but they suggest that there are good reasons why they should be included in general clinical research, with the appropriate safeguards in place. These include a shift in attitude towards research from one of paternalism to one emphasizing equality and access and the potential health benefits prisoners stand to gain from being involved in trials offering cutting edge treatments that would otherwise not be available.
Prisoners should have access to the same healthcare and research opportunities as the population of the country in which they are detained, and have the same opportunities to decide whether they want to take part in research, concluded the authors.
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