Again better late than never tonight I comment on an October 17, 2013 New York Times article entitled "Decades Later, Condemnation for a Skid Row Cancer Study."  The author, Gina Kolata, reviews a 1950s and 1960s era prostate cancer study performed by urologist Dr. Perry Hudson.  A key issue for the libertarian reader is that this study was funded, in part, by the National Institutes of Health.

The purpose of the study was to attempt to determine if prostate cancer could be diagnosed early and cured.  Thus, consenting patients underwent a prostate biopsy.  If prostate cancer was discovered, the patient underwent surgery +- estrogen hormonal therapy.  The bioethical problems with Dr. Hudson's study are the following: he did not adequately inform the patients of the relevant risks associated with the prostate biopsies and subsequent cancer treatment, he lied to consenting patients about the cure rate for prostate cancer, he treated the patients who were diagnosed with prostate cancer with nonstandard therapy, he did not conduct an appropriate study as no control group was created, and he recruited impaired patients (mentally ill, addicts, etc.) who were unable to give informed consent.  So, the relevant physician conducted a grossly unethical study funded by the American State.

A telling anecdote about the study was mentioned in a 1961 book entitled The Bowery Man.  The author, Elmer Bendiner, reported that study volunteers at a New York City-run lodging house were not fed until they kept their scheduled appointment with Dr. Hudson to enroll on the study.  In other words, State officials starved homeless men until they participated in a clearly fraudulent medical study in which multiple crimes of aggression against their bodies were committed.  The LIBERTARIAN BIOETHICS BLOGger is not surprised.  You should not be either.

Better late than never, tonight I write about a September 28, 2013 cnn.com article entitled "In Cancer Drug Battle, Both Sides Appeal to Ethics".  This story is about a metastatic ovarian cancer patient who wishes to take an experimental drug (BMN 673), but the pharmaceutical company that makes the relevant drug is refusing to give it to her for free.  What the hell?

More details: The patient is currently not eligible for any of the trials investigating the drug; the patient is seeking use of the drug via a "compassionate use" clause via which the FDA "allows an unapproved drug still in development to go to a patient with few alternatives remaining, also absolving the drug maker of liability should the drug not work or cause harm"; pharmaceutical companies are not required to provide a drug requested under the "compassionate use" clause.

So why is the relevant drug company really refusing to give the drug to the patient for free?  Let us count the reasons: the drug company would lose money by giving an incredibly expensive drug away for free, the drug is incredibly expensive due to the onerous FDA regulation/drug approval process, the drug is also incredibly expense due to the State-decreed IP intellectual monopoly system.  There are probably additional reasons, all caused by the fascist nature of the U.S. medical system.

What is the drug company's PR stance?  The company interestingly claims it "would be unethical and reckless to provide end-stage refractory ovarian cancer patients outside a clinical trial with BMN 673 at this early stage of development".  What is the patient's PR stance?  It is unethical for the company to refuse to provide the drug to her for free to protect "its wallet at the expense" of the patient possibly dying.  Art Caplan, the national bioethics "expert", told the reporter that "it's too early in the process for a compassionate use exception for a different form of cancer than the one" the pharmaceutical company is targeting, especially because the drug could harm the patient even "speeding her death".  

As usual everyone is wrong in this case.  The libertarian analysis is as follows: the pharmaceutical company has no legal obligation to provide the drug for free to the patient, however the pharmaceutical company should provide the drug for free to the patient purely for strategic PR reasons, the patient (any patient) should not entertain the absurd idea that a pharmaceutical company has the legal obligation to provide her with free drugs, the drug is only expensive because of the State, eliminate the State (and therefore the "compassionate use" clause and the FDA and IP) and the problem is eliminated.