Friday, November 26, 2004
From the Austin Chronicle
When Austin's homeless shelter moved from Fourth and Nueces to the new Austin Resource Center for the Homeless at Seventh and Neches, shelter director Robert Petersen and his colleagues hoped to leave several old problems behind, including the ubiquitous street drug salesmen. Unfortunately, the shelter staff now fear that at least one high-priced pusher has made the move with them: the local human-subject clinical drug-trial testers.
According to Petersen, about a year and a half ago "recruiters" from a local drug-testing company called FutureSearch began hanging around the old shelter, looking for subjects to participate for pay in clinical trials designed to test new schizophrenia medications. After shelter officials confronted the reps, telling them to stay out of the building, Petersen said, the recruiters simply took their clipboards and moved to the sidewalk across the street. At press time, J. David Morrison, general partner of FutureSearch, had not returned a call requesting comment.
For a while the activity appeared to slack off, Petersen said, and the truce continued when the shelter moved to the new Seventh Street ARCH. Then several months ago, Petersen and other shelter officials noticed a billboard across the street from the new facility. "Diagnosed with Schizophrenia?" reads a billboard for Community Clinical Research Inc., the text layered over a background scene of an arid desert. FutureSearch may have taken a break Downtown, but its absence had been abruptly filled by another pharmaceutical trial recruiter.
"This is an ethical issue," Petersen said. While at least 30% of the shelter's clientele have some form of mental illness, said Helen Varty, executive director of Front Steps (the nonprofit that manages the ARCH), it is not the only issue the clients struggle with. Many, for example, also have substance abuse and/or addiction problems, and all are financially strapped. In other words, says Varty, the drug testers have found a vulnerable population to prey upon – which has produced, on occasion, disastrous results.
"Changing medications when you're schizophrenic is a big deal; it's not like other meds," said Varty. "Healthy people who are schizophrenic would never go through the physiological changes just to have to change [medicines] back again," which often happens since trial meds are generally unavailable outside the trial. In fact, Varty said, the shelter has had several clients who had "never acted up before" return from clinical trials acting "so wild that we had to kick them out of the shelter." Petersen agrees. "We know people by name who've not been able to follow through [with after-trial follow up] and are out on the street in a bad way."
Kris Brown, president and director of CCR Inc., says that she was unaware that ARCH officials were upset about their schizophrenia billboard and that she "didn't realize" the ad had been placed across the street from the ARCH. "We've not heard anything about it," she said. "We have no intention of offending anybody." Brown said that every potential trial subject is questioned and counseled for three hours and that participation in the test is based on "informed consent." That doesn't satisfy Varty or Petersen, nor resolve the ethical concerns shared by others in the mental-health community.
"It's been a long[time], potentially sore point with us," said Jim Van Norman, medical director of the Austin/Travis County Mental Health and Mental Retardation Center. There's an obvious need for clinical research, he acknowledged. "The upside potential is that we get a new medication that works wonders," he said, but when the "enticement of reimbursement is too easy to go for," the methods of recruiting become ethically questionable. "You don't want to make the offer so good, so much money, that it sways someone. That's way outside ethical bounds. So, I think with the homeless, [these types of recruiting methods] get shaky." When the compensation is relatively high for the potential subjects, it is more difficult "to make a relatively dispassionate choice" about participation.
Varty is less generous: "What they're doing may be legal," she said, "but it is sleazy and real, real creepy." Still, Brown insists that her company does not want to offend anyone. "We're trying to be sensitive," she said. CCR does more research at their Austin clinic than is done at the UT med school in San Antonio – people with schizophrenia, she said, "deserve" the best treatment available. However, she said in a Nov. 18 interview that the company would be happy to remove the billboard. According to ARCH officials, the billboard was removed on Nov. 19.
Posted by cuddlefish at 7:34 AM
Wednesday, November 24, 2004
Tuesday, November 23, 2004
It is a rare day when members of the United States Congress try to read the minds of the members of a grand jury in Travis County, Tex. Apparently Tom DeLay's colleagues expect him to be indicted.
Last week Congressional Republicans voted to change their rule that required an indicted leader to relinquish his post. They were responding to an investigation by the Travis County grand jury into political contributions by corporations that has already resulted in the indictments of three associates of Mr. DeLay, the House majority leader.
Yet no member of Congress has been indicted in the investigation, and none is a target unless he or she has committed a crime. The grand jury will continue its work, abiding by the rule of law. That law requires a grand jury of citizens, not the prosecutor, to determine whether probable cause exists to hold an accused person to answer for the accusation against him or her.
Politicians in Congress are responsible for the leaders they choose. Their choices reflect their moral values.
There is no limit to what you can do if you have the power to change the rules. Congress may make its own rules, but the public makes the rule of law, and depends for its peace on the enforcement of the law. Hypocrisy at the highest levels of government is toxic to the moral fiber that holds our communities together.
The open contempt for moral values by our elected officials has a corrosive effect. It is a sad day for law enforcement when Congress offers such poor leadership on moral values and ethical behavior. We are a moral people, and the first lesson of democracy is not to hold the public in contempt.
Posted by cuddlefish at 9:01 AM
US Ukraine election fraud. From today's WaPo editorial
UKRAINE FACED a fateful choice on Sunday: not just between two sharply opposed candidates in a presidential election runoff, but between two political systems. Opposition leader Viktor Yushchenko promised a genuine liberal democracy along Western lines, while Prime Minister Viktor Yanukovych represented those forces that, backed by a neo-imperial Russia, would rule this large European nation through force and fraud. The outcome of the vote has brought this confrontation to a head. According to exit polls, the democratic opposition won handily, by 54 to 43 percent in one survey. But yesterday the government revealed its intent to steal the election, announcing that Mr. Yanukovych had a decisive lead in the vote count. Tens of thousands of outraged citizens filled the center of Kiev last night to oppose this authoritarian coup. The United States and other Western governments must do everything possible to support them.
For the Bush administration, the responsibility starts with stating the unvarnished truth about what has happened in an election that some -- including those employed by a large Ukrainian lobbying operation in Washington -- have falsely portrayed as flawed but free. Sen. Richard G. Lugar (R-Ind.), who traveled to Kiev to observe the elections with the endorsement of President Bush, made an excellent start: "It is now apparent," he said in Kiev, "that a concerted and forceful program of election-day fraud and abuse was enacted with either the leadership or cooperation of governmental authorities." That judgment was backed by the European Union, the Organization for Security and Cooperation in Europe, and several nongovernmental organizations that sent observers to Ukraine. Appropriately, the State Department called yesterday for "quick action on the part of the government of Ukraine" to "ensure an outcome that reflects the will of the Ukrainian people."
The United States should do everything possible to help those who seek to reverse the fraud. [emphasis mine] If that proves impossible in the short term, the United States at least can demonstrate to Ukrainians that it supports their desire for genuine democracy -- and it can oppose any use of force by the government to suppress popular demonstrations.
Crazy Ruskies. That would never happen here.
Posted by cuddlefish at 8:23 AM