Eli lilly, the discoverer of erythromycin, Darvon, ceclor , and Prozac, is a major pharmaceutical company that sold $6. 8 billion of drugs all over the world in 1995 , giving it profits of $2. 3 billion. Headquartered in Indianapolis, Minnesota, the company also provides food, housing and compensation to numerous homeless alcoholics who perform short-term work for the company. Before approving the sales of a newly discovered drug the U. S. Food and Drug Administration requires that the drug be put through three phases of tests after being tested on animals.
In phase one the drug is taken by healthy human individuals to determine whether it has any dangerous side effects. In phase two the drug is given to a small number of sick patients to determine dosage levels . in phase three the drug is given to large number of sick patients by doctors and hospitals to determine its efficacy. Phase one testing is often the most difficult to carry out because most healthy individuals are reluctant to take a new and untested medication that is not intended to cure them of anything and that may have potentially crippling or deadly side effects.
To secure test subject, companies advertise widely and offer them 250$ a day. Eli lily however does not advertise as widely and pays its volunteers only $85 a day plus a fresh room and board, the lowest on the industry. One of the reasons that lily rates are so low is because, as a long time nurse at the lilt clinic is reported to have indicated, ’’the majority of its subjects as homeless alcoholics’ recruited through word of mouth that is spread in soup kitchen, shelter, prisons all over the united states. Because they are alcoholics, they are fairly desperate for money.
Because phase one test can run for several months, test subjects can make as much as $4500 an enormous sum to people who are otherwise unemploeble and surviving on handouts. Interviews with several home less man who have participated in lily’s drug test and who describe themselves as alcoholics who drink daily suggests that they are buy and large, quit happy to participate in an arrangement that provides them with “easy money”. When asked, one homeless drinker hired to parti sipate in phase 1 trail said he had no idea what kind of drug was being tested on him even though he had signed an informed-consent form.
An advantage for lilly is that this kind of test subject is less likely tosue if severely injured by the drug. The tests run on the homless men, moreover, provide enormous benefits for society. It has been suggested, in fact, that in light of the difficulty of securing est subject, some tests might be delayed or not performed at all if it were mot for the large pool of homless men willing and eager to participate in the tests. The Federal Drug Administration requires that people who agree to participate in Phase 1tets must give their”informed consent” and maust make a “truly voluntary and uncoerced decision”.
Some have questioned whether the desperate circumstances of alcoholic and homeless men allow to make a truly voluntary and uncoerced decision whem they agree to take an untested potentially dangerous drug for $85 a day. Some doctors claim that alcohoics run a higher risk because they may carry disease that are undetectable by standard blood screening and that make them vu Wnerable to being sevely hared by certain dugs. one former test subject indicated in an interview that the dury he had been given in a test several years befor ha arrested his heat and “they had to put things on my chest to start my heart up again. the same thing happened to another subject in the same test another man indicated that the drug he was given had made him unconscious for 2 days while others told of excruciating headaches. In earlier years, drug companies used prisoner to test drugs in Phase 1 tests. During the 1970s, drugs companies stopped using prisoners when critics complained that their poverty and the promise of early parole in effect were coercing the pisoners into “volunteering. ” When lilly first turned to using homeless people during 1980s ,a doctor at the company is quoted as saying, We were constanty talking about whether we were exploiting the homless.
But there were a lots of them who were willing to stay in the hospital for weeks. Moreover, he adds, “providing them with a nice warm bed and good medical care and sending them out drug and alcodlo-free was positive thind to do. ” A homeless alcoholic indicaed in an interview that when the test he was participating in was completed, he would rent a cheap motel room where”ill get a case o miller and an escort gil and have sex, the girl will cost $200 an hour. ” He estimated that it ould take him about two weeks to spend the $4650 lilly would pay him for his services. The manager at another cheap motel said that when test subjects completed their stints at lilly, they generally arrived at his motel with about$2500 in cash: “the guinea pigs go to the lounge next door, gt dunk and go back to lilly and do the next one. ”
QUESTIONS 1. Discuss this case from the perspective of utilitarianism, rights, justice, and caring. What insight does virtue theory shed on the ethics of the event described in this case? . “ In a free enterprise society or adults should be allowed to make their own decisions about how they choose to earn their living’. Discuss this statement in light of the lily case. 3. In your judgment is the policy of using homeless alcoholics for tests subjects morally appropriate? Explain the reasons for your judgment. What does your judgment imply about the moral legitimacy of a free market in labour. 4. How should the managers of Lilly handle this issue?