Homeless Participation in Drug Trials

           Until 1990, Eli Lilly actively recruited homeless people into her phase I clinical trials. More often than not, these subjects struggled with substance abuse. Eli paid at some of the lowest reward rates compared to other pharmaceutical companies.

 

           The ethics of homeless participation in drug trials is questioned as it defies three principles established by the Belmont Report: the ethical principles and guidelines for the protection of human subjects of research.

 

           The first principle is the respect for persons, which is set to ensure voluntary informed admissions, the protection for the vulnerable and their autonomy, and no undue influence. The second is beneficence, which is the obligation to ensure the protection of the subjects in which the benefits outweigh the harm. Lastly, the third is justice, standing to ensure trials are scrutinized for systematic selection due to manipulability, accessibility, and compromising positions. 

 

           With these principles in mind, consent is blurry as homeless people are in compromising positions. Phase I of clinical trials is the most dangerous as this is where the side effects are unknown and the trial is navigating how safe the drug is. Many will participate, regardless of the extent of the risks, as they need the reward to make ends meet. It gets even more complicated when you think about the homelessness demographic and who is most vulnerable. Pacific Islanders, Black people, and Native Americans make up the majority of the homeless population in the United States, and could therefore be most prone to these exploitive trials. 

 

Works Cited

           Czubaruk, Kim. “The Belmont Report: What Is It and How Does It Relate to Today’s Clinical Trials?” Cancer Support Community, 17 Oct. 2019, www.cancersupportcommunity.org/blog/2019/10/belmont-report-what-it-and-how-does-it-relate.

           “Eli Lilly & Co., 1915 (Bass #45117).” CONTENTdm, images.indianahistory.org/digital/collection/dc012/id/4723/rec/13. Accessed 1 Apr. 2024. 

“Eli Lilly and Company.” Indyencyclopedia.Org, 29 Nov. 2023, indyencyclopedia.org/eli-lilly-and-company/. 

           Elliot, Carl. “(PDF) the Best-Selling, Billion-Dollar Pills Tested on Homeless People.” Research Gate, July 2014, www.researchgate.net/publication/301778682_The_Best-Selling_Billion-Dollar_Pills_Tested_on_Homeless_People

           Kidder, Tracy. Rough Sleepers: Dr. Jim O’CONNELL’s Urgent Mission to Bring Healing to Homeless People. Random House, 2023.

           National Museum of American History Smithsonian Institution. “Iletin Insulin, Lilly, 1920s.” Flickr, Yahoo!, 1 Apr. 2024, www.flickr.com/photos/nationalmuseumofamericanhistory/10577544635. 

           Team, USAFacts. “How Many Homeless People Are in the US? What Does the Data Miss?” USAFacts, 23 May 2023, usafacts.org/articles/how-many-homeless-people-are-in-the-us-what-does-the-data-miss/.

           The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. [Bethesda, Md.]: The Commission, 1978.

           SITNFlash. “Racism and Exploitation in Phase I Clinical Trials.” Science in the News, 26 Oct. 2020, sitn.hms.harvard.edu/flash/2020/racism-and-exploitation-in-phase-i-clinical-trials/. 

           Wood, Elizabeth. “Exploitation of Homeless Populations in Phase One Drug Trials.” The Ethics and Society Blog, 9 July 2020, ethicsandsociety.org/2020/07/09/exploitation-of-homeless-populations-in-phase-one-drug-trials/