Abstract

The lead article in this issue discusses a potentially free metaphorical space—that of decision-making—within the confines, tangible and intangible, of life in jail or prison. By interviewing prisoner-participants from six clinical studies, Paul Christopher and colleagues sought to find out how these men and women would answer open-ended questions about their decision to enroll in the research. What the interviewers heard was that none saw themselves as having been inappropriately pressured to do so. In fact, a significant percentage of the prisoners described being dissuaded from participating in the studies. The authors therefore advise that unfair exploitation poses the more relevant research risk to contemporary prisoners in the United States than does coercion, and they encourage investigations into whether prisoners are unfairly restricted or discouraged from joining clinical studies. Although Keramet Reiter makes no reference to etymology in her commentary responding to the article, her argument suggests that the roots of “coerce”—the Latin for “shut up” or “enclose”—remain relevant. Reiter argues that, under current conditions, the people shut up in prisons in the United States cannot make an unfettered choice to join a clinical trial.