EXAMPLE 3 Minorities in clinical trials

Refusal to participate is a serious problem for medical experiments on treatments for major diseases such as cancer. As in the case of samples, bias can result if those who refuse are systematically different from those who cooperate.

Clinical trials are medical experiments involving human subjects. Minorities, women, the poor, and the elderly have long been underrepresented in clinical trials. In many cases, they weren’t asked. The law now requires representation of women and minorities, and data show that most clinical trials now have fair representation. But refusals remain a problem. Minorities, especially blacks, are more likely to refuse to participate. The government’s Office of Minority Health says, “Though recent studies have shown that African Americans have increasingly positive attitudes toward cancer medical research, several studies corroborate that they are still cynical about clinical trials. A major impediment for lack of participation is a lack of trust in the medical establishment.” Some remedies for lack of trust are complete and clear information about the experiment, insurance coverage for experimental treatments, participation of black researchers, and cooperation with doctors and health organizations in black communities.