• Vol. 38 No. 12, 1019–1020
  • 15 December 2009

Using Medical Students as Research Subjects: Is It Ethical?

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Should medical students be allowed to participate in clinical research? One guiding principle, as stated in the rules governing the use of medical students in medical experiments in Harvard University (the first to issue such guidelines), is “the belief that as far as their health and well-being are concerned, no student should be exposed to risk different from that considered generally acceptable for normal adult subjects by the Committee on Human Studies.”1 The tradition of self-experimentation and self-sacrifice in medicine should not justify the exposure of medical students to unacceptable levels or types of risks to health and well-being, even if some investigators are willing to undertake such risks to achieve their professional goals. The principle does not, however, rule out the permissibility of recruiting students to participate in research which poses higher than minimal risks, including Phase 1 drug trials. Universities that bar students from doing so, or that create special protections such as echelons of review that do not extend to other participant pools, have been criticised as overly paternalistic,2-4 and for fostering an elitist double-standard for “considering the participation of medical students versus the public at large.”3,5 (As Angoff asks: “One may wonder why it is acceptable to ask the masses to accept risk in the name of science but not the very people whose futures are linked to the successful perpetuation of biomedical research.”2 ) While these critics contend that students should be as free as the rest of the population to participate in clinical research as an expression of their autonomy, the tragic case of the death of a freshman participating in an experiment involving invasive procedures at the University of Rochester points to the need for close ethical scrutiny whenever students are involved as research participants.6

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