Thursday, March 26, 2009

Healthy for 2: Class Warfare, Part III

I know, class warfare again. I swear, this one just fell into my lap, so I'm gonna go with it.

This post, which I arrived at via Feminocracy, is a great example of the history within medical research of not taking the informed consent of minority and lower-class subjects seriously when recruiting them for research. The study subjects, who are lower-income, "overweight," black and hispanic pregnant women, are being led to believe that they're "being enrolled into a free health program" which will increase their chances of having a healthy birth. However, the treatment that they're receiving actually seems to result in increased risks to mother and baby.

While it's obviously true that things have improved in this area, this latest example of coercion in which the autonomy and rational decision-making of minority and poor women is underestimated and undervalued shows that the same old historical mindset is alive and well. I have no problem with researchers recruiting pregnant women who are probably at higher risk for complications to participate in their research. But if that requires misleading them on the true risks to their babies and themselves, then that's just a deal breaker, and the desired info is going to have to be acquired elsewhere.

3 comments:

  1. All of this research appears to be connected to Northwestern Medical...

    Shouldn't there have been an IRB review since the reseach was attached to the Univerity, and if so, how did the patient information clear the review?

    Also, if somehow the hospital is separate frothe university, don't hospitals have their own ethics boards for clinical trails or reseach?

    Further, federal law and regulations require all research that uses federal funds to be approved by an IRB board.

    The IRB process was started in the '70s after the Tuskegee experiments. Reserachers should be familiar with the process and legal requirements with the process in place for over 30 yeras.

    Someone should shit-kick the IRB that approved the prospective patient information. Or the research team should be sanctioned.

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  2. LetThemEatCake3/26/2009

    I think there's this big gap or double standard in the medical practices that are approved for pregnant women vs other patients. Maybe that explains the failure of the IRB process in this case.

    If you look at most of the common interventions that are routinely practiced during childbirth in the US (episiotomies, c-sections, etc) they're so high risk and cause so many problems that they probably would have been banned or severely restricted by now if the patients were male. Look at how strictly they monitor and restrict these things in most European countries, for instance. And they all have significantly lower mother and baby mortality rates than we do. Also, obstetrics is viewed as a huge moneymaker, and the more interventions you engage in the more money you make. So complication-free pregnancies and births and natural healthy processes are not what you're going for. This makes it unsurprising that this study is focused on increasing the medical interventions rather than decreasing them.

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  3. It is really hard to explain why our medical industry is so pro-intervention when it's been shown time and again that a higher intervention rate produces more risk for mother and baby. The increased charges billed to insurance for each intervention is certainly one plausible explanation. Apologists for the medical industry claim it's because of fear of malpractice suits, but if what you're doing increases the chances of injury or death then that doesn't make much sense.

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