A major US government report has recommended that prisoners be allowed to participate in clinical trials. This is a practice that has been under a cloud for 30 years after it was found that Pennsylvania inmates were being used as guinea pigs for cosmetic toxicity testing. The Institutes of Medicine says that prisoners might actually benefit from clinical trials if these were in the final phase of Food and Drug Administration approval, did not involve any cosmetic toxicity testing, and ensured that half the subjects were non-inmates. There should be no compensation and no special treatment which might entice prisoners into cooperating.

The proposal is controversial. On the one hand, some doctors, like dermatologist A. Bernard Ackerman, says that "There has to be experimentation in medicine, but populations that are aged, vulnerable or defective mentally should not be used." Others question whether prisoners can truly give informed consent. On the other hand, government officials wonder if they might be doing more harm than good by keeping trials out as the health of the prison population becomes more problematic because of the growing prison population and larger proportion of inmates with HIV and hepatitis C.