after release). The authors concluded that public policies created a class of people who are perpetually labeled as unqualified for public support, limiting or precluding access to health insurance, public housing, and employment opportunities.

History of Research with Prisoners

In 1997, Hornblum detailed the history of prisoners as research subjects in 20th-century America, stating that “From the early years of this century, the use of prison inmates as raw material for medical experiments became an increasingly valuable component of American scientific research. Postwar American research grew rapidly, as prisoners became the backbone of a lucrative system predicated on utilitarian interests. Uneducated and financially desperate prisoners “volunteered” for medical experiments that ranged from tropical and sexually transmitted diseases to polio, cancer, and chemical warfare.” By the 1960s, new drug-testing regulations mandated by the Food and Drug Administration permitted increased human experimentation as large pharmaceutical companies sought stronger relationships with penal institutions. This article references earlier work by Jessica Mitford (1974), plus reports of prisoner involvement in studies of treatments for malaria, syphilis vaccines, radiation experiments, and more. In his 1998 book, Acres of Skin: Human Experiments at Holmesburg Prison, Hornblum details the medical experimentation that went on in one facility, Holmesburg Prison, a county facility in Philadelphia, which he says became a “supermarket of investigatory opportunity,” where an array of studies explored everything from simple detergents and diet drinks to dioxin and chemical warfare agents. Sponsors included major pharmaceutical houses, RJ Reynolds, Dow Chemical, and the U.S. Army. From 1962 to 1966, a total of 33 pharmaceutical companies tested 153 experimental drugs at Holmesburg Prison alone, including Retin-A. After the national commission’s 1976 report, medical research in prisons was sharply curtailed.


Echoes of Tuskegee and Retin-A Attitudes of blacks toward medical care in general and medical care within the prison system are extremely complicated and have become even more so since the emergence of AIDS. In communities of color, among some community members and advocates there was, and still is, a suspicion that AIDS was created in some form or fashion by sinister forces, either government or otherwise as a part of a scourge on black persons (Dalton, 1989). This suspicion was grafted onto an existing and ongoing refusal to participate in research, which is considered in the black communities, as “being used as guinea pigs.” Much of this is the legacy of Tuskegee and of Retin-A. In the first, the Tuskegee experi-



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement