This article describes the manner in which the pharmaceutical industry organizes its experimentation of new drugs in human beings, as has been occurring since the early 1990s in the United States. This practice is related to economic aspects of the production of medications and their extraordinary expansion, a characteristic of modern life. Traditional practices of clinical medicine related to clinical testing are also described, especially the internationally accepted ethical rules on medical investigation when human beings are involved. These rules were set down after the international reaction of horror which came in the wake of the disclosure of “experiments” carried out by physicians in the Nazi concentration camps.
The article presents part of the debate that the appearance and consolidation of the clinical trial industry has encouraged among professionals working in the medical area, as described in two magazines, The Lancet and the New England Journal of Medicine, as well as in reports published by supervisory organs of the United States Government. Conflict of interests, scientific mal practice, disrespect for the ethical principle of primum non nocere, and the rule of informed consent by volunteers who take part in tests are at the center of the concerns brought up by these professionals.
Clinical tests; medical ethics; medicine based on evidence