David J. Rothman is an American author and professor of Social Medicine at Columbia University College of Physicians and Surgeons. Rothman's work has focused on the American history of social medicine and the current health care practices with respect to professionalism in medicine. Topics of his published works have includes mental hospitals, prisons, and almshouses, organ trafficking, AIDS among Romanian orphans, and the ethics of research in third-world countries.
The Shame of Medical Research
In an article titled "'The Shame of Medical Research'" that was published in November 2000, Rothman wrote:
- Until the 1990s American medical researchers performed most of their experiments on other Americans—frequently choosing subjects who were poor and vulnerable. Now, however, they are increasingly likely to conduct their investigations in third world countries on subjects who are even poorer and more vulnerable. Part of the reason is AIDS—the first modern infectious disease to strike the developed and developing world simultaneously and to give both a large stake in finding a cure. Part of the reason, too, is the mounting financial and regulatory burdens of research in the rich nations, which cause investigators, both from universities and drug companies, to go to the poorer countries to test new treatments.
- Whatever the reason, practice has overwhelmed ethics. The major international codes on human experimentation, including the principles proclaimed at Nuremberg in 1947 and the World Medical Association’s Declaration of Helsinki in 1964, all say that the well-being of the subject always should take precedence over the needs of science or the interests of society, and that doctors must obtain “the subject’s freely informed consent.” But neither these codes nor the Western groups concerned with medical ethics have had the developing countries in mind. Countries in which clinical trials are now conducted are often too poor to pay for the medicines that are successfully tested. And the people recruited for those trials very seldom get the kind of medical care the participants in trials in prosperous countries can expect. Whether Western principles covering the treatment of people who are the subjects of research can and should be applied in Africa and Asia has become a bitterly debated question.
- The Discovery of the Asylum (1971)
- Conscience and Convenience: The Asylum and Its Alternatives in Progressive America (1980)
- The Willowbrook Wars (1984, co-authored with Sheila M. Rothman)
- Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision-making (1991)
- Medicine and Western Civilization (1995, co-edited with S. Marcus and S. Kiceluk)
- Beginnings Count: The Technological Imperative in American Health Care (1997)
- The Pursuit of Perfection: The Promise and Perils of Medical Enhancement (2003)
- Trust Is Not Enough (2006, co-authored with Sheila M. Rothman)
- Medical Professionalism in the New Information Age (2010, co-edited with David Blumenthal)
- The Hastings Center Hastings Center Fellows. Accessed November 6, 2010
- Rothman DJ (November 2000). "The shame of medical research". The New York Review of Books 47 (19): 60–4. PMID 11808621.