Trials by violation
MEDICAL research aims at producing technologies for the human good. But in pursuit of this objective, should we allow medical research to violate basic human rights? The violence of a male-dominated scientific establishment is being directed against the weaker members of society: women, the poor, and the illiterate.
This exploitation of the weak is manifest both nationally and internationally. Industrial nations reject medical trials of new drugs on their own people but happily shift them to the developing world. In the developing world, too, the small but powerful intelligentsia, which generates the primary practitioners of science, often disregards the health and well being of the disadvantaged in its search for scientific panaceas.
The decision of the Indian Council of Medical Research (ICMR) to take Norplant -- the hormone-based contraceptive for women -- into the next phase of clinical trials is an example of the callousness of the medical research community. Despite protests from activist groups representing women who have been implanted with the contraceptive in India and abroad, the ICMR plans to pursue its line of research. This is not the first time that the ethical credentials of the ICMR have been questioned. Several members of the medical community, for instance, have questioned the ethical basis of the WHO leprosy vaccine trials in Madras.
Norplant trials have revealed that the contraceptive interferes with the woman's hormonal balance and, by the ICMR's own admission, "most of the women had menstrual irregularities at some time during the use of Norplant II implants". In a country like India, where medical records are almost absent and where resources are scarce, it is almost impossible for researchers to undertake surveillance of contraceptive recipients to ascertain the long-term effects of a drug.
The violation of women and their bodies, perpetuated in the Norplant trials, raises the question of whether risky and long-term contraceptives are an appropriate way to control population growth. The ministration and removal of Norplant and other similar implantable contraceptives is dependent on the availability of medical personnel. In the absence of adequate family planning services, other approaches to birth control may be more appropriate.
Population growth rates do not get reduced just by physical or chemical interventions inside the human body. Though safe and effective contraceptives are necessary in providing women with birth control options, improved health care for the mother and the child and increasing female literacy also play a key role. Total development of society -- and of women in particular -- can do as much to enhance human health and reduce population growth as contraceptives dreamed up in laboratories. A more holistic approach to family planning is needed.
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