L’expérimentation médicale sur les prisonniers est l’une des problématiques éthiques les plus épineuses, car elle met en affront un grand nombre de principes à l’épreuve de la réalité du terrain. Ces principes qui sont universels et intemporels sont admis comme des droits élémentaires pour toute personne humaine. Pourtant, en milieu carcéral, ces principes s’y perdent facilement. De plus, l’étendue de cette problématique éthique dépasse de loin les murs du pénitencier pour toucher à des questions conflictuelles intéressant la publication scientifique, la discrimination sociale et même les décisions politiques. Cette note d’histoire, la cinquième d’une série sur l’expérimentation médicale sur les prisonniers, se propose de discuter les principales considérations éthiques relatives aux prisonniers, et de souligner la difficulté de leurs mises en œuvre.

1. Gaddas M, Jedidi M, Ben Khelil M, Ben Saad H. Medical experimentation on prisoners (part 3): the main milestones of the evolving ethical’ texts and codes. Tunis Med 2022 ; Vol 100 (07) : 572-577.
2. Gaddas M, Jedidi M, Ben Khelil M, Bel Hadj M, Masmoudi T, Ben Saad H. Medical experimentation on prisoners (part 4): the dilemma of ‘pros’ and ‘cons’. Tunis Med 2022 ; Vol 100 (10) : 659 – 663 .
3. Gaddas M, Jedidi M, Masmoudi T, Ben Saad H. Medical experimentation on prisoners (part 1): historical milestones. Tunis Med 2022;100 (06):423-7.
4. Gaddas M, Ben Dhiab M, Ben Saad H. Medical experimentation on prisoners (part 2): role of doctors in research abuses Tunis Med 2022; 100 (07): 497-501.
5. Institute of Medicine (US) Committee on Ethical Considerations for Revisions to DHHS Regulations for Protection of Prisoners Involved in Research. Ethical Considerations for Research Involving Prisoners. Gostin LO, Vanchieri C, Pope A, editors. Washington (DC): National Academies Press (US); 2007.
6. Appendix IV. Ethics references. Téléchargeable via ce lien: https:// portal.abuad.edu.ng/lecturer/documents/1610026743Nuremberg,_ Helsinki.pdf (dernière viste: premier octobre 2022)
7. Amiel, P. Code de Nuremberg: texte original en anglais, traductions et adaptations en français, in Des cobayes et des hommes: expérimentation sur l’être humain et justice, Paris, Belles Lettres, 2011. Telechargeable via ce lien: https://www.inserm.fr/wp-content/ uploads/2017-11/inserm-codenuremberg-tradamiel.pdf (dernière visite: premier octobre 2022).
8. Declaration d’Helsinki de l’association medicale mondiale Principes éthiques applicables aux recherches médicales sur des sujets humains. Telechargeable via ce lien: https://www.fhi360.org/sites/ default/files/webpages/fr/RETC-CR/nr/rdonlyres/
9. del Carmen MG, Joffe S. Informed consent for medical treatment and research: a review. Oncologist. 2005;10(8):636-41.
10. Pont J. Ethics in research involving prisoners. Int J Prison Health. 2008;4(4):184-97.
11. Valapour M, Paulson KM, Hilde A. Strengthening protections for human subjects: proposed restrictions on the publication of transplant research involving prisoners. Liver Transpl. 2013;19(4):362-8.
12. Neher TL, Udochi AL, Wilson KA, Guillory DM, Zaller ND, Zielinski MJ. Conducting health research in carceral systems: Considerations and recommendations. Am J Public Health. 2020;110(S1):S52-S5.
13. Rubenstein LS, Amon JJ, McLemore M, Eba P, Dolan K, Lines R, et al. HIV, prisoners, and human rights. Lancet. 2016;388(10050):1202-14.
14. Weisz GM, Gal A. Research on tuberculosis in Nazi Germany and the cruelest medical experiments on Jewish children: An observational review. Isr Med Assoc J. 2021;23(3):160-4.
15. Dober G. Cheaper than Chimpanzees: Expanding the use of prisoners in medical experiments. prison Legal News2008 [updated 21/11/2021. Telechargeable via ce lien: https://www.prisonlegalnews.org/news/2008/ mar/15/cheaper-than-chimpanzees-expanding-the-use-of-prisoners-inmedical-experiments/ (dernière visite: premier octobre 2022).
16. Weindling PJ. Nazi Medicine and the Nuremberg Trials: Palgrave Macmillan London; 2004.
17. Horwitz S. Race, Kidney Transplants, Immunosuppression Research, and White Supremacy under Apartheid, 1960-80. Can Bull Med Hist. 2020;37(2):461-89.
18. Mostow P. “Like building on top of Auschwitz”: On the symbolic meaning of using data from the Nazi experiments, and on nonuse as a form of memorial. J Law Relig. 1993;10(2):403-31.
19. Goldstein CE, Peterson A. Is it unethical to publish data from Chinese transplant research? J Med Ethics. 2020;46(10):689-90.
20. Reiter K. Experimentation on prisoners: persistent dilemmas in rights and regulations. Calif Law Rev. 2009;97(2):501-66.
21. Meyer CR. Unwitting consent: “Acres of skin: Human experiments at Holmesburg prison” tells the story of medical researchers who sacrificed the rights of their subjects for personal profit. Minn Med. 1999;82(7):53-4.
22. Gellene D. Dr. Albert M. Kligman, Dermatologist, Dies at 93. The New York Times. 2010. Telechargeable via ce lien: https://www.nytimes. com/2010/02/23/us/23kligman.html (dernière visite: premier octobre 2022).
23. Kligman AM. The pathogenesis of Tinea capitis due to Microsporum audouini and Microsporum canis. I. Gross observations following the inoculation of humans. J Invest Dermatol. 1952;18(3):231-46.
24. Goldschmidt H, Kligman AM. Experimental inoculation of humans with ectodermotropic viruses. J Invest Dermatol. 1958;31(3):175-82.
25. Diflo T. Use of organs from executed Chinese prisoners. Lancet. 2004;364 Suppl 1:s30-1.
26. Wise J. Transplantation: researchers urge retraction of 400 papers amid fears that organs were from Chinese prisoners. BMJ. 2019;364:l596.
27. Dyer O. Journals retract 15 Chinese transplantation studies over executed prisoner concerns. BMJ. 2019;366:l5220.
28. Shuster E. Fifty years later: the significance of the Nuremberg code. N Engl J Med. 1997;337(20):1436-40.
29. Jacobsen A. Operation paperclip: The secret intelligence program that brought Nazi scientists to America: Little, Brown; 2014.
30. Hanauske-Abel HM. From Nazi holocaust to nuclear holocaust: a lesson to learn? Lancet. 1986;2(8501):271-3.
31. Hanauske-Abel HM. Not a slippery slope or sudden subversion: German medicine and national socialism in 1933. BMJ. 1996;313(7070):1453-63.
32. Pross C. Breaking through the postwar coverup of Nazi doctors in Germany. J Med Ethics. 1991;17:13-6.