[HN Gopher] Infected blood scandal: Children were used as 'guine...
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       Infected blood scandal: Children were used as 'guinea pigs' in
       clinical trials
        
       Author : fidotron
       Score  : 110 points
       Date   : 2024-04-19 13:01 UTC (10 hours ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | aredox wrote:
       | The next time people ask "why so much paperwork, why so many
       | regulations, why is it so complicated": this is why.
       | 
       | Don't blame the regulators (legal (state) and paralegal (ethics
       | committees)), blame those who abused their power.
        
         | kbolino wrote:
         | Observing the banality of evil in action, one could just as
         | well surmise that the function of paperwork is to normalize
         | grossly unethical practices and disconnect individuals from
         | their moral agency.
        
         | sidewndr46 wrote:
         | Given that the perpetrator here was in fact the government,
         | your argument carries no weight.
         | 
         | Legal paperwork cannot prevent the government from choosing
         | evil. In fact, it only serves to sanction it in most cases.
        
           | ClumsyPilot wrote:
           | > Legal paperwork cannot prevent the government from choosing
           | evil
           | 
           | This is deeply mistaken attitude - paperwork allows your to
           | prosecute the person in the government that signed off on
           | this decision. Without paperwork, you wouldn't be able to pin
           | the decision on anyone
           | 
           | And it is entirely normal to have the next government
           | prosecute corrupt officials from the previous one
        
             | cryptonector wrote:
             | > And it is entirely normal to have the next government
             | prosecute corrupt officials from the previous one
             | 
             | Has this happened recently in the UK? Like, in the past 50
             | years, or in the past 100 years?
        
         | eviks wrote:
         | All these regulations and paperwork didn't help prevent the
         | crisis described in the article, so can we blame useless
         | complications now?
        
           | sp332 wrote:
           | The ones in the article ended in the 80's.
        
           | aredox wrote:
           | Most of them didn't exist at the time.
        
         | ajkjk wrote:
         | You can still blame the solutions for their problems while
         | acknowledging that they exist to solve another problem...
        
           | toomuchtodo wrote:
           | "We are inconvenienced because some humans are otherwise
           | monsters."
        
           | infamouscow wrote:
           | This site heavily skews towards progressive ideology and has
           | a lot of trouble with the idea of government being anything
           | less than the solution everything. (Of course this only holds
           | true when their favorite person is running it. As soon as the
           | other guy runs it, the world is moments from ending.) You can
           | see it first-hand by scrolling through my comment history.
           | Rarely does anyone attempt to engage directly with any of the
           | dissenting points, despite most of them being as old as _War
           | and Peace_. The only tool available to them is perverting the
           | voting system with downvote brigades and flagging.
           | 
           | When alternative approaches are suggested, they're met with a
           | mindless regurgitation of emotionally charged rhetoric rather
           | than careful thought and reason. Their narcissism allows them
           | dismiss anyone that even slightly disagrees with their
           | approach. Those broadcasting alternative points of view are
           | demonized and viciously attacked with the same oppressive
           | tactics employed by the Sturmabteilung. The only saving grace
           | here is ignoring reality is very costly. Eventually the
           | payments are going to come due and the Schadenfreude is going
           | to be very satisfying.
        
           | alistairSH wrote:
           | History shows we need regulation of medical trials.
           | 
           | We can and should continually improve the system of
           | regulation we have in place.
           | 
           | We must not throw out the system completely, as that will
           | likely result in a regression to previous behaviors and
           | outcomes (which we've already determined were wrong).
        
         | ekidd wrote:
         | > _The next time people ask "why so much paperwork, why so many
         | regulations, why is it so complicated": this is why._
         | 
         | Yes, as the saying goes, regulations and safety rules are often
         | written in blood.
         | 
         | But that doesn't mean that all regulations are automatically
         | good and proportionate. For example, many institutional review
         | boards would have zero problem with researchers deliberately
         | submitting security holes to the Linux kernel. Sure, you're
         | experimenting on kernel maintainers without their consent, and
         | sure, you might make hundreds of millions of people vulnerable.
         | But it's not _technically_ "human research", so the IRB may
         | sign off.
         | 
         | https://www.zdnet.com/article/the-linux-foundations-demands-...
         | 
         | Meanwhile, if you're a psychiatrist working in a hospital, and
         | if you want to (say) compare the results of your standard
         | screening questionare against the results of your standard
         | patient intake interview, you might think this is easy.
         | Patients will usually do both anyways, so how hard can it be to
         | design an ethical process to compare the two? Well, it's harder
         | than you might expect:
         | 
         | https://slatestarcodex.com/2017/08/29/my-irb-nightmare/
         | 
         | I agree that we need to have rules and regulations about many
         | things. But we should still discuss whether specific
         | regulations accomplish the intended goal, and how big a cost
         | those regulations impose on society.
         | 
         | It is perfectly possible for a large organization to design a
         | software development process that makes it impossible to ever
         | ship software. And similar pathologies often appear in any
         | large organization, public or private. Designing _good_
         | policies is hard but worth it.
        
         | cryptonector wrote:
         | Tuskegee.
         | 
         | > Documents just released show the government in 1973 knew
         | about the trials at Treloars and covered some costs.
         | 
         | There's no perfect system. When the regulator, or the
         | regulator's boss, is in on it, or when the industry has
         | captured the regulator (which invariably happens), all that
         | paperwork, all those regulations, all that complication -- they
         | do nothing to protect the victims.
        
           | malfist wrote:
           | A solution doesn't have to be perfect to be a solution. It
           | just has to be better than the alternative.
        
             | cryptonector wrote:
             | Regulations and regulators are awesome right up until they
             | are captured, and then they can be worse than no solution,
             | especially when the "solution" comes with immunity from
             | civil suits.
        
               | marcinzm wrote:
               | And yet despite a century of ever increasing regulations
               | mining and factory injury and death rates have somehow
               | not gone back up to their 1900 levels as you seem to
               | claim they should have.
        
               | cryptonector wrote:
               | > as you seem to claim they should have.
               | 
               | Please don't do that. I said nothing of the sort. Plus
               | what you did, besides being the "have you stopped beating
               | your wife yet" sort of disgusting attack, is also
               | whataboutism.
               | 
               | The thing about workplace safety is that a) employers
               | don't relish their employees getting hurt or dying on the
               | job, b) employers don't benefit when their employees get
               | hurt or die on the job, so even if there were no
               | regulations employers would still not go back to 120
               | years ago states of workplace safety, c) regulations here
               | can help force employers to make better calculations
               | regarding costs and benefits of _improving_ workplace
               | safety as it 's on the improvement side that the costs
               | mostly lie. So you see, there is not much benefit to the
               | industry in capturing the regulator for the purpose of
               | undoing workplace safety regulations.
        
             | marcosdumay wrote:
             | Regulations that don't solve a problem won't solve a
             | problem.
             | 
             | Lots and lots of regulations are ok to exist only as long
             | as they do something useful. If they are useless, piling
             | more useless ones isn't better than the alternative.
             | 
             | On the real world, we tend to have plenty of the useless
             | ones, and only a few of the very useful ones. When someone
             | complain about the first set, people are quick to throw the
             | second set at them like if it addressed the problem.
        
         | alex_lav wrote:
         | Why must I choose which offensive and inadequate system to be
         | outraged at?
        
         | vlod wrote:
         | You know paperwork gets "lost" right? I know someone which was
         | allergic to something and got prescribed that something by
         | their general doctor (which had those records).
         | 
         | That person died and the all medical records (from that doctor)
         | somehow went missing. fyi: This was during the 1980's in the
         | UK.
        
       | jcutrell wrote:
       | How isn't this categorized as manslaughter?
        
         | Steven420 wrote:
         | I guess because the criminals are dead?
        
           | ClumsyPilot wrote:
           | Funny, but not legally relevant
        
       | adamnemecek wrote:
       | I wonder how the doctor justified m this to themselves.
        
         | sidewndr46 wrote:
         | Your question assumes the thought ever crossed their mind. It
         | may have not.
        
         | soco wrote:
         | How do software developers justify creation of weapons
         | intelligence? Or of computer viruses? Or of targeted
         | surveillance?
        
           | n4r9 wrote:
           | > targeted surveillance
           | 
           | This one is really interesting. I thought a lot about it
           | after the revelations that Uber were targeting law
           | enforcement based on user behaviour, and refusing to offer
           | them rides in areas where they were breaking regulations.
           | 
           | Of course, one option is that the developers were fully aware
           | of what they were doing, and were perhaps motivated by money
           | or some sort of libertarian ideology.
           | 
           | The other option - more compelling in my mind - is that this
           | functionality was carefully broken down into innocuous pieces
           | and distributed on a need-to-know basis. One feature which
           | groups users in configurable ways based on their history.
           | Another feature that allows on-the-fly ride prioritisation
           | based on user groups. Another feature that localises
           | prioritisation to geographic areas. The upshot is that only
           | some managers knew what the full potential of the
           | functionality was.
        
             | Traubenfuchs wrote:
             | Why would you NOT help the company you are working for
             | thrive with a task like that? Assuming you don't do
             | anything that would be a personal legal risk. It would be
             | masochistic.
        
               | n4r9 wrote:
               | If you knew that your employer was knowingly and
               | deliberately flouting national or state regulations, and
               | they asked you to put surveillance tech in place to
               | prevent law enforcement from finding out, you would
               | happily comply if there was no personal risk?
        
               | Traubenfuchs wrote:
               | > put surveillance tech in place to prevent law
               | enforcement from finding out
               | 
               | That idea is so exciting to me, I'd volunteer to be part
               | of that project, ESPECIALLY
               | 
               | > if there was no personal risk
        
               | n4r9 wrote:
               | Interesting. Can you give any examples - short of
               | physically hurting people - of tasks you'd refuse to do
               | on ethical grounds?
        
               | Traubenfuchs wrote:
               | I can't imagine doing (clearly harmful) medical
               | experiments without consent.
               | 
               | And nothing that would harm a group I belong to or
               | support.
               | 
               | I generally wouldn't find pleasure in working on things
               | that make people I have nothing against more miserable.
               | 
               | It's a very broad question. Really depends on a case by
               | case basis.
               | 
               | I think I just really don't care about ethics at all,
               | just my personal feelings.
        
           | Traubenfuchs wrote:
           | It pays well and gives you the certainty of your code having
           | some heavy impact across borders, often against the kind of
           | people you don't like as well.
        
           | ericmcer wrote:
           | Developers can't physically see the people that will be
           | effected and they are usually just following orders from
           | managers. It is shitty but it is way easier to know a bomb
           | you were ordered to make is blowing people up on the other
           | side of the world than it is to shoot someone directly in
           | front of you.
        
         | DoreenMichele wrote:
         | Some people don't have a moral compass. "Oh, look! Interesting
         | opportunity to entertain myself in the name of furthering
         | medicine while power tripping because I have so much more
         | schooling than my idiot patients!"
        
         | andai wrote:
         | I think that in the belief system of utilitarianism, if one
         | believes an action will save more lives than it costs, then it
         | is justified? (Not sure if that's what went on in their heads
         | though.) If the calculus leans heavily in one direction, then
         | arguably one is killing people by not taking that action (by
         | preventing their lives from being saved).
         | 
         | (In my opinion this article represents a pretty compelling
         | counterargument to that philosophy...)
        
           | drdeca wrote:
           | Well, if the action produces "more utility". Lives is one
           | measure, but, while "lives saved - lives lost" will probably
           | play a role in most ways of defining "utility", I don't think
           | most utilitarians would have it by itself as what they
           | consider to be "utility"?
           | 
           | (I'm not a utilitarian, or even a consequentialist, I just
           | want to be fair.)
           | 
           | A utilitarian may also consider things like, "likely impacts
           | on public trust in medicine" and what effects that is likely
           | to cause, when considering how an action might influence
           | "total utility".
        
       | ericmcer wrote:
       | Is this just a few doctors experimenting and manufacturing this
       | stuff on their own? Is there a pharmaceutical company behind
       | this? The article doesn't mention anything other than "Factor
       | VIII".
        
         | cryptonector wrote:
         | > Documents just released show the government in 1973 knew
         | about the trials at Treloars and covered some costs.
        
       | JeanMarcS wrote:
       | And that's why we end up with antivax, and anti science
       | conspiracies.
       | 
       | This is food for their argumentation, and with that kind of
       | stuff, it's hard to explain that science should prevail.
       | 
       | This is sad.
        
         | basil-rash wrote:
         | Plenty of such cases: https://www.euronews.com/2023/06/08/how-
         | did-sweden-sterilise...
        
         | loceng wrote:
         | Do you know of how Pfizer designed the COVID-19 shot clinical
         | trial, and how they designed the app to collection symptom
         | reports from the clinical reserch participants?
         | 
         | Do you know of Maddie de Garay's story?
        
         | ClumsyPilot wrote:
         | I don't agree with this whole attitude, the idea that plebs
         | should not question the medical experts because they are
         | unqualified is how you get corruption, fraud and abuse.
         | 
         | It is right to hold people accountable
        
         | cryptonector wrote:
         | When government perpetrates anti-science... Our governments
         | have done awful things in the name of science, including
         | eugenics and forcible sterilizations.
        
         | ericmcer wrote:
         | Some anti-vax people take it too far, but calling anyone who
         | asks questions a crazy anti-vaxxer doesn't make sense.
         | 
         | How can you simultaneously know that pharmaceutical
         | corporations are corrupt and choose profits over health, but
         | also think it is crazy to question the vaccines they produce.
         | Those are two contradictory ideas, but the vast majority of
         | people would agree that both are true. It seems like we have
         | been manipulated.
        
       | loceng wrote:
       | I'm still surprised the scandal of how Pfizer's clinical trial
       | for COVID-19 was designed isn't widely known - most specifically
       | with how the app to collect clinical trial participant reports
       | was designed:
       | 
       | 1) there was no free-form writing field to mark down symptoms
       | that weren't on an existing list of pre-approved or allowed-to-
       | be-reported symptoms, and
       | 
       | 2) the clinical research director for the ignored participants
       | who attempted to contact them to report symptoms not reportable
       | in the app.
       | 
       | Source: a teenager and her mother who were participants in the
       | clinical trial, here in their ~10 minutes of testimony -
       | https://www.youtube.com/watch?v=L2GKPYzL_JQ
        
         | jtbayly wrote:
         | Source?
        
           | loceng wrote:
           | It's all in the Maddie de Garay ~10 minute testimony here:
           | https://www.youtube.com/watch?v=L2GKPYzL_JQ
        
             | bondarchuk wrote:
             | Just a heads up, you're gonna have to give a source that's
             | not a youtube video if you want to be taken seriously.
        
               | loceng wrote:
               | Who would you accept as a credible source? Will it be
               | from any of the people complicit in what's being
               | testified to in an official government senate hearing?
        
               | cryptonector wrote:
               | > Just a heads up, you're gonna have to give a source
               | that's not a youtube video if you want to be taken
               | seriously.
               | 
               | Are you kidding? Sure there's lots of garbage at YT, but
               | so what, you can often tell if something is hot garbage
               | or real.
               | 
               | Anyways, this is testimony taken by Senator Ron Johnson.
               | It's trivial for you to verify that Senator Johnson is
               | the one running that meeting, and that this is video of
               | that meeting, and you can follow up with his office if
               | you have any questions. You would know this if you merely
               | loaded the video, even if you didn't watch more than 5
               | seconds of it. You asked for a source, and you got it,
               | and it is a reputable source even if it is a YouTube
               | video.
        
               | hollerith wrote:
               | No, he is not.
        
           | logicchains wrote:
           | Here's a source on the trial being poorly run:
           | https://www.bmj.com/content/375/bmj.n2635 .
        
       | sunshine_reggae wrote:
       | I find it interesting to see how massive crimes like these take
       | approximately 50 years to be uncovered. And how little impact
       | such an uncovering ends up having.
        
         | ClumsyPilot wrote:
         | It is surprisingly common, we are much more similar to
         | Developing nations than we would like to believe
        
       | fabian2k wrote:
       | I'm rather confused by the description of events here. The
       | article focuses on the lack of consent, which of course is a very
       | important topic. But the main issue to me here seems to be the
       | use of blood products that were known to be often contaminated.
       | 
       | If it was known that those products had a high chance to be
       | contaminated, no amount of consent would make any of this
       | ethical. The only ethical way to use them would be if there was
       | no alternative available and the potential infection with
       | Hepatitis C or other viruses would be less dangerous than no
       | treatment at all.
       | 
       | Consent is a necessary requirement for an ethical clinical trial.
       | But it is not sufficient by far, the risks and benefit of the
       | trial need to be proportionate for the patients.
        
         | DoreenMichele wrote:
         | My impression is that they were trying to determine if the heat
         | treated products were actually safe.
         | 
         | But, you know, that should have happened before they were
         | approved as products.
         | 
         | I'm horrified and don't know what the hell to say. Humans have
         | a long history of gruesome medical experimentation and I'm just
         | not in a good space for addressing this well.
        
         | lakhim wrote:
         | Yes, that's the part here - you die without factor VIII. Its
         | why severe hemophiliacs almost always died before factor VIII
         | because available, and why almost 100% of them had HIV and hepC
         | in the window between those viruses entering the blood supply
         | and 100% testing / heat treatment (which is darkly funny
         | because one of the trials involved was about heat treatment,
         | seems to work for HIV but not for hepC).
         | 
         | From what I can tell, the issue is twofold: Informed consent,
         | of which there was very little, but that's not exactly rare
         | until recently, and running the trials on "marginal cases" -
         | hemophilia comes in differing severity, and given the risks of
         | using known contaminated factor VIII using it unless necessary
         | probably wasn't the best idea.
        
         | trebligdivad wrote:
         | One of the campaigners was saying they had a document from the
         | 50's recommending that blood products be made from a small
         | number of people in each batch, so that there was a decent
         | chance that most batches were fine, and in the case of this
         | trial each batch was made from vast numbers of people, so were
         | bound to have something in.
        
       | vlod wrote:
       | I'm pretty shocked with this. I grew up in the UK during this
       | time and the trust in doctors was absolute. We were all plebs and
       | were told what to do, no questions. We all complied. Yes sir, no
       | sir, three bags full sir.
       | 
       | As someone who previously trusted "people of science" and the
       | scientific method, I've come to realize that my assumptions were
       | misplaced. The shenanigans of the COVID period, government
       | censorship etc.
       | 
       | I find it exceeding hard to trust _anyone_ is competent in
       | anything. The overpriced general contractor that take shortcuts
       | and have to pay someone else to redo work, medical people that
       | prescribe medication /procedures based on a script (e.g.
       | prescriptions of Ozempic).
       | 
       | I tend to go down the path of treating people respectfully and
       | then quite rapidly, it goes down to they just start saying stuff
       | that doesn't make sense (logically) and just want me to accept
       | it.
       | 
       | This sounds ridiculous but FFS. My tech/analytical, data-driven
       | approach to solve problems seems to be a better model that anyone
       | I deal with.
       | 
       | Hopefully it's not Occam's razor that AITA.
        
         | cryptonector wrote:
         | The UK used to be quite extreme in forcing people to get the
         | smallpox/cowpox "vaccine" in the 19th century. Compliance rates
         | were quite high in the 1840s, but by the 1880s they were very
         | low because people started to figure out that there were
         | serious issues with that vaccine. Similar things happened in
         | the Spanish Flu period as in the covid period, including anti-
         | vaccine protests in Ottawa and anti-masking protests too, but
         | by the mid-1920s everyone had forgotten completely all about
         | that. I wonder how soon we will forget all about covid.
        
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