Human medicine advances in the way much of science does. People make systematic observations, form plausible hypotheses, and collect data. One of the more important questions in medicine is how people are affected by certain exposures. When that exposure is a medicine, we prefer data from double-blinded, randomized controlled trials. Other types of exposures (such as cigarette smoke) are less amenable to RCTs and we must rely on case-control, cohort, and other studies that examine correlation.
But before we can run RCTs on human subjects we need more than just a plausible hypothesis; we need to know that the medicine appears to be safe and effective in a biological system. Usually, we use animal models, with the choice of species being dependent on the study design and the biology of the drug and the disease. By choosing this approach, we have made a value judgment: human health is important enough to allow us to test drugs and procedures on non-human animals. Our alternatives are limited: either we test drugs first on humans, or we don’t develop new drugs.
So I was watching my local PBS station yesterday (perhaps for the last time) and I came upon Dr. Neal Barnard shilling some book or other on curing diabetes. That pissed me off enough to go to his website and check him out, but before I got into the other details I see that he founded something called the Physicians Committee for Responsible Medicine (PCRM). I vaguely recall hearing about this group during medical school. There were some students who joined as advocates of “ethical animal research”, apparently unaware that ethics are already a big part of animal work. Since then, I haven’t thought about the group.
PCRM advocates higher ethical standards in conducting human research and providing access to medical treatment.
A more widespread ethical problem, although one that has not yet received much attention, is raised by new pharmaceuticals. All new drugs are tested on human volunteers. There is, of course, no way that subjects can be fully apprised of the risks in advance, because that is what the tests are conducted to find out.
Human beings, of course, are not the only potential victims of unethical research practices. Given the emerging history of abuses and secrecy in human experimentation, the idea that animals–the 20 million chimpanzees, cats, dogs, and rabbits used every year in laboratories–will somehow be better treated is unconvincing, to say the least. Whether the subjects are humans or animals, any assumption that experiments are always necessary, always carefully monitored, and always ethical is a fiction.