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Page 2 - The Michigan Daily -- Wednesday, October 12, 1988
Doctor questions AIDS drug testing
BY THE PACIFIC NEWS SERVICE
SAN FRANCISCO - Peter LaRiviere is
upset.
LaRiviere is a doctor and a lawyer and he is
part of a group medical practice specializing in
the care of AIDS patients. He is upset because he
says one of the nation's foremost AIDS research
projects is misleading and possibly mistreating
people who are infected with the deadly AIDS
virus.
"We had a patient who was in this study and
didn't know what he was receiving," LaRiviere
explained. By the time the patient arrived at
LaRiviere's office, his immune system was
severely compromised.
' "We asked him if he had been advised (by the
study's directors) of any treatment that might be
indicated, and he said that he had not." As far as
LaRiviere was concerned, the investigator's fail-
ure to counsel the patient about his steadily
worsening condition constituted a severe derelic-
tion of medical duty.
Dr. LaRiviere's complaint cuts to a critical
ethical issue that pits the procedures of scientific
research against the treatment of individual pa-
tients. Dr. LaRiviere's patient is involved in
Protocol 19, one of the most extensive AIDS
prevention therapy studies ever conducted. The
ethical issue is straightforward: should 1,000 of
the study's volunteers get a worthless placebo, or
dummy treatment, in order that millions of oth-
ers might have a chance at long-term survival?
The study works like this. Doctors want to
know the effect of giving the anti-AIDS drug
AZT to people who are infected with the virus
but who don't yet show any symptoms. Of 3,200
study participants, a third receive high doses of
AZT, another third get low doses, and the final
third receive placebos. Medical researchers say
that such use of placebos is a standard and neces-
sary scientific technique, but AIDS activists like
Martin Delaney denounce it as "Murder by
Placebo" because the 1000 people getting place-
bos will almost certainly get AIDS and die.
"The medical establishment has become so
accustomed to placebo control, so used to
justifying and rationalizing it on the basis of
science, that we've simply stopped thinking
about the safety of patients," Delaney says.
Delaney accepts and supports the objectives of
Protocol 19 and other studies like it. But, he and
other activists ask, in a global epidemic where
death is certain, how much data is necessary to
demonstrate that a drug is effective?
At the heart of the debate is the basic proce-
dure of government drug licensing and the
certification that is necessary to induce the insur-
ance industry to pay for drugs. Unless a drug has
met certain conventional testing standards, the
FDA has hesitated to certify it as a prescription.
For Delaney and the AIDS activists, that concern
for insurance industry standards is the only reason
Protocol 19 has required placebo controls.
"I don't think that under the current system
we'll ever be able to convince the insurance
companies to pay for (AZT as a preventive drug).
They've got nice little (laws) out here, that until
you've met the traditional standard of proof,
they'll say you've never proved anything, so I
don't have to pay for the bill. That what this
study's all about. It's about proving the value of
AZT to the extent that the insurance companies
will have to accept it."
IN BRIEF
Compiled from Associated Press and staff reports
Serbians demand local
party leaders' resignation
BELGRADE, Yugoslavia - Serbian Communists demanded
yesterday that three senior party leaders be fired in Kosovo, an
autonomous province whose Slavic residents claim to be victimized by
the huge majority of ethnic Albanians.
The demand is the latest development in weeks of strikes, public
protest, and political maneuvering over ethnic rivalries and economic
crisis in Yugoslavia.
The nation is $21 billion in debt to the West and has been forced to
adopt unpopular austerity measures. Inflation has been more than 200 per
cent for the past 12 months, and there are about one million unemployed.
Civilians make weapons
WASHINGTON - U.S. nuclear weapons are made in an industrial
labyrinth spreading over 13 states and occupying 90,000 people in 16
major planets, three laboratories and a test range, spending about $7.6
billion a year.
All of the weapons are produced by a civilian agency, the Energy
Department, and have always been. No administration or Congress has
wanted to give the job to the military.
It wasn't until the 1950s, in fact, that the armed forced were even
allowed to keep weapons on hand. If they had wanted one, they would
have had to get it from the Atomic Energy Commission, one of the
department's predecessors.
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Mich. plane crash kills
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DAILY PERSONALS 764-0557
OSCODA, Mich. - Six people were killed and 10 others injured
yesterday at Wurtsmith Air Force Base when an Air Force tanker plane
crashed, authorities said. The Pentagon indicated the plane was carrying
only16 people, said Lt. Col. Rick O'Born, a spokeperson in Washington,
D.C.
A KC-135 stratotanker, a four-engine plane used to refuel other
planes, went down at 2:20 p.m. as it was returning to the base from a
mission to K .I. Sawyer Airforce Base in Michigan's Upper Peninsula,
said Staff Sgt. Donald Lawber, spokesperson at Wurtsmith.
The plane's mission was unknown at the time of the crash, Senior
Airperson Michael Blair said.
A mechanic at a shop near the Air base said the fire had been
extinguished at 3:45 p.m.
Candidates talk about
trade issues in pres. race
Michael Dukakis and George Bush sparred at a distance yesterday over
trade issues. In a speech in Boston, the Democrat vowed to stand up for
American companies and jobs while his rival charged him guilty of
"protectionist demagoguery."
"My opponent needs an issue and he's willing to scare people to find
it," said Bush, campaigning in Seattle. He coupled his attack with a
pledge to "throw the book" at inside stock traders and other white-collar
criminals.
Dukakis replied a few hours later. "I'm for more trade not less trade,"
he said. "I want to export American products, not American jobs. I want
us to begin selling cars and computers and compact discs to the Germans
and the Japanese and the Koreans, not arms to the Ayatollah," Dukakis
said.
The Democratic candidate said that the U.S. might need to protect
some firms struggling against foreign competition.
EXTRAS
Canadian gardener grows
gargantuan, 633 lb gourd
SAN FRANCISCO - A Nova Scotia gourd grower pounded the
competition with a super-heavyweight pumpkin that tipped the scales at a
near-record 633 pounds - an international victory he says came without
steriods.
Keith Chapel gleefully denied a mischievous suggestion that he may
have used anabolic steriods on his entry to win Monday's International
Pumpkin Association World Weight-Off.
"Oh, no!" said Chapel, responding to the allegation.
The question came in light of drug scandals that plagued the Summer
Olympics at Seoul, including the case of Canadian sprinter Ben Johnson,
who was stripped of his gold medal when officials found he'd used the
banned drug that bolsters muscle building but has many harmful side ef-
fects.
Chapel's entry, which competed with plump pumpkins from the
United States, England and Japan, won him $2,000 and a trip to San
Francisco.
England's 317-pound entry, grown by Ron Butcher, was weighed in a
pub, where cries of encouragement echoed across the City Hall steps
some 5,000 miles away.
~iie II ioiga n Iati1
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