Subject:   An Ethical AIDS Study? The Use of Non-Standard Care
Date:   2004-08-09

A recent trial study, reported in the New England Journal of Medicine and whose lead researcher is from the Harvard School of Public Health, studied the impact of micronutrients on AIDS patients. Using a cohort of some 1000 women, it gave vitamins to one AIDS infected group and placebo to another. In the vitamin group only 67 women died who took vitamins, compared to 267 women who died using only placebo. (N Engl J Med. 2004; 351:123-32.) If this study had occurred in the United States, it would have of course been met with outrage, for neither vitamins nor placebo is a treatment for AIDS. Currently there is a treatment that has effectively made AIDS a chronic disease, allowing people to live out their lives in a substantially more normal way. In addition, one might have concluded without any study that having healthier, less malnourished subjects would significantly reduce the risk of death from any major disease.

This study, however, was conducted on women in Africa. The rationale for use was that since treatment is being made available to only some 10% of the AIDS infected population (mostly in the industrialized world) that we can at least study low cost ways to delay the onset of the disease and save scarce resources for urgent needs. However, the lack of world commitment to helping poorer nations save their citizenry from this disease – due to lack of profitability in granting sufferers access to the standard care for AIDS –  can be seen as an ethical wrong.

Medical researchers, who knowingly give only placebo, non-standard care to AIDS infected people can be seen as participating in a larger ethical wrong. It would be the duty, it would appear, of medical personnel to advocate for and devote scarce resources to the standard of care, no matter where humans live. Along with the medical standard of care, a minimum standard of human care is also warranted, so that people in the less industrialized world are properly nourished and their immune system maintained.

We at CIRCARE are concerned by researchers who guide studies which willingly allow people to die by employing non-standard care and who do not address the fundamental disparity of treatment around the world.

Michael A. Susko MS, CIRCARE President
(410) 499-4895

Paul Gelsinger, Vice President, CIRCARE

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Last Updated: 2006-04-25

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