‘All Animals Are Equal’ (Peter Singer)^15
Kant argues that we do not have a direct duty to
animals, and, therefore, killing them for food is
acceptable.Ontheotherhand,beingcrueltoanimals
is undesirable because it diminishes us morally.
Bentham argues that use of animals for human
good, if carried out as humanely as possible, is
justified if it results in an overall benefit to humans.
Thus, harm inflicted to one species is justified if it
results in overall benefit to another. This justifica-
tion assumes an inherent moral superiority of
humans over the animals being experimented
upon. Such arguments meet their greatest chal-
lenge when the test subjects are necessarily pri-
mates (e.g., HIV research); a degree of self-
awareness can be deduced in these species, and
yet their consent is obviously absent.
Singer, in contrast to Bentham, believes all
animals (humans included) are morally equal,
and that Bentham’s arguments are ‘speciesist’
(although Bentham does question the inherent
superiority of humans, tending toward Singer’s
viewpoint).
45.5 Further issues of concern to
the pharmaceutical industry
and medical researchEthical violations in human
experimentation
There is a long history of unethical human experi-
ments. King George I of England offered pardons
to inmates of Newgate Prison (London), in return
for inoculation with smallpox, as part of a variola-
tion experiment.^16 We delude ourselves if we
assume that such ethical violations are now a
thing of the past. In 1966, Beecher reviewed a
series of unethical medical experiments.^17 These
included problems with consent, the withholding
of known effective treatment and studies to
improve medical knowledge but without obvious
benefit (and with inherent risk) to the participants.
A sample of more such studies is offered here, in
addition to those of the egregious government of
Nazi Germany, mentioned above.
In 1932, the Tuskegee Syphilis Study^18 began,
sponsored by the US Health service. Over the next
40 years, 399 rural African American men, living in
Tuskegee, Alabama, were enrolled in the study. The
study participants received regular medical exami-
nations, but werenot toldthey hadsyphilis, and were
left untreated. The unethical aim of the study was to
observe the natural history of the disease, and the
study continued until 1972 – long after the discovery
of a proven treatment, penicillin, in the early 1940s.
In 1996, Nicole Wan, a student at the University
of Rochester, underwent bronchoscopy as a
healthy volunteer. She collapsed at home shortly
afterwards and died at home two days later. The
cause of death was an excessive dose of lidocaine
administered to help the procedure. An investiga-
tion determined a failure to establish safe dosage
guidelines for lidocaine administration during
these procedures.
In 1996, an antibiotic study of bacterial meningi-
tis was conducted in children in the city of Kano in
Nigeria – a strife-torn city suffering an epidemic of
bacterial meningitis.^19 In a study organized by a
pharmaceutical company, 100 children received
the antibiotic trovafloxacin (which had not yet
been approved for use in children), and another
100 children received ceftriaxone (a well-
established antibiotic). Eleven children died – five
taking trovafloxacin and six taking ceftriaxone.
Subsequent investigations suggested that the study
had not been properly approved, that the dose of
ceftriaxone was too low, that informed consent had(^15) Singer P, Philosophic Exchange. 1974. pp. 103–116, and
reprinted in ‘Bioethics: an Anthology’ Kuhse, Singer (eds).
Blackwell Publishers: Oxford and Malden; 1999.
(^16) Huth EJ. ‘Quantitative evidence for judgments on the
efficacy of inoculation for the prevention of smallpox:
England and New England in the 1700s’. The James Lind
Library (www.jameslindlibrary.org), at http://www.jameslin-
dlibrary.org/trial_records/17th_18th_Century/nettleton/net-
tleton_commentary.php.
(^17) Beecher HK. 1966. ‘Ethics and clinical research’.N. Engl.
J. Med. 274 (24): 1354–1360.
(^18) http://www.gpc.edu/~shale/humanities/composition/assign-
ments/experiment/rivers.html.
(^19) Sources include http://www.mindfully.org/Industry/Pfizer-
Trovan-Nigerian-Suit.htm.
592 CH45 INTRODUCTION TO BIOETHICS FOR PHARMACEUTICAL PROFESSIONALS