Donald Trump wants to build a ‘great wall’ to keep Mexicans out of America and charge for it. I’ve heard many scientists criticize this plan. But if you think about it, in science we already have our own “great” harmful walls related to money and Trump would probably love them.
One such wall is the paywall that forces Americans and those around the world to pay to get access to read the scientific literature even though almost 100% of such research is funded by taxpayers. Some scientists also must pay or go without reading the literature if their institution doesn’t have an expensive subscription.
Another biomedical paywall is newer, but is potentially growing rapidly and that is the wall between patients and clinical trials. For instance in the stem cell arena patients increasingly have to pay to get into certain clinical trials. This turns history on its head since in the past if payment was involved it was the trial paying the patient, which makes more sense since the patient is taking a risk.
Often today patients are expected to pay anywhere from $10,000 to more than $100,000 to be allowed to be in a stem cell clinical trial.
That price is a wall.
Patients who can’t pay don’t get to be part of the trial and those who do get in are paying to be experimented upon, which take together makes for an ethically very questionable situation.
I believe these walls hurt science as well.
Such “trials” behind walls cannot be properly controlled or have placebos because of their monetary nature. The reasons why include that patients become customers of a clinical trial rather than participants, there may be a stronger placebo effect because of the payment, and those running the trial have even more pressure to spin the results as positive.
Still I expect that The Donald would be enamored of the paywalls of science whether they are charging for access to tax-payer funded research articles or collecting big money from patients to get into a potentially risky clinical trial. The whole concept of “pay-to-play” seems like a perfect fit even for science and medicine in Trump’s worldview.
I asked scientist and artist Jill Howlin if she could put the topic of this article into an illustration and she did a fantastic job. Follow her on Twitter to catch up on her other wonderful work.
Check out this satirical piece I did 3 years ago on the imaginary, but funny conservative push for NIH to become a for-profit enterprise. Trump unfortunately might like these made up ideas too.