"But what of other volunteers, those who were neither physically forced nor strongly guided by the prison administration? When they participated, did they offer themselves up voluntarily? The answer hinges upon the meaning of voluntary. Copious evidence exists that coercion was a key element of the supposed consent given by most African American prisoners. Today's clinical medical ethicists tend to define coercion in medical research very narrowly and without much precision, so many would argue that the inmates may have been induced but were not coerced.
However, such critics fail to take into account the coercive features of the prison's special environment. The hell of prison life made the research laboratory, feared and abhorred by African Americans on the outside, an irresistible haven, even a life-support unit, for the African-American prisoner.... But researchers and prison administrators were hardly disinterested observers, and they did not tell everything they knew about prisoners' true motives.
Being admitted to the research unit allowed the inmate to avoid the legion of institutional predators. A stint in the lab offered a respite from the ever-present threat of gang rape, shakedowns, racial strife from prison gangs, and deadly assaults for a thousand petty slights. Taking meals in the laboratory unit allowed the subject to escape the mess hall, the dreaded site of frequent melees and stabbings.
The inmates did speak with relish of the better meals and calmer atmosphere of the research laboratory, and freely acknowledged their need for money. There is no question that men participated for the three hundred to four hundred dollars a month or up to fifteen hundred dollars per experiment they could earn, because the few dollars a week the unskilled could earn in the prison laundry or kitchen offered no competition.
But a cultural dissonance separated the hostile, violent chaos of the inmate's world and the benign, orderly environment of the university researcher or journalist. Money had a very different meaning for inmates than it had for outsiders. Inmates sought not only commissary baubles and delicacies to brighten life but, more important, the price of freedom- or, at least, of safety."
Chapter 10- Medical Apartheid, Harriet A. Washington
