Papers by Renée Llanusa-Cestero
Accountability in Research
In 2010, in an article in this journal, I argued that declassified documents implicated Central I... more In 2010, in an article in this journal, I argued that declassified documents implicated Central Intelligence Agency (CIA) physicians in the conduct of unethical research on enhanced interrogation using detainee subjects. The focus, then as now, is upon physicians at the Office of Medical Services (OMS). The 2010 article highlighted the heavily redacted "Draft OMS Guidelines on Medical and Psychological Support to Detainee Interrogations" (the Draft). This commentary focuses upon the recently declassified final version of that document revealing further culpable evidence of unethical human subject research. The commentary locates that unethical research in historical context and the development of the Nuremberg Code. The commentary also locates enhanced interrogation in contemporary political context and considers how to hold OMS physicians accountable for the conduct of unethical human research using detainee subjects.
Worldview
Paraguay is the least-known nation of the Americas. It comes as no surprise, then, that the thirt... more Paraguay is the least-known nation of the Americas. It comes as no surprise, then, that the thirtieth anniversary of the longest surviving modern-day head of state, General Alfredo Stroessner, should have occurred this past May with a minimum of international media coverage.Stroessner rose to power via a military coup in May, 1954, and by July had been nominated the Colorado party candidate in a one-candidate election. The primary determinant of social and political relations in Paraguay, however, is the state of siege sustained by Stroessner since that time. The “facade of legality which the regime presents”— to borrow from a 1978 Amnesty International report—is achieved by invoking Article 79 of the 1967 Constitution, which, renewed every ninety days, provides for the declaration of a state of emergency and suspends constitutional safeguards against violations of basic civil and human rights.
Substance Use & Misuse, 2006
Because of ongoing resistance in Florida's legislature to interventions involving exchanges of st... more Because of ongoing resistance in Florida's legislature to interventions involving exchanges of sterile syringes for contaminated ones, Miami/Dade County's population of injection drug users (IDUs) reduce risk of HIV and hepatitis C infection by buying illegal syringes, participating in illegal syringe exchanges, or decontaminating their paraphernalia. Although it is completely legal, wherewithal for decontamination of injection paraphernalia, including sodium hypochlorite (laundry bleach), water, and cotton for filtering drugs, only appears sporadically in Miami/Dade's risk locales (called "get-off" houses). To ensure consistent decontamination, our intervention instituted regular delivery of these goods to known risk locales. In addition, personnel in half of the locales received training in techniques for optimal decontamination. RNA polymerase chain reaction measured impact of this intervention in terms of viral load found on harvested paraphernalia. Regular delivery of cleansing paraphernalia provided opportunities for observation and characterization of adaptations among people who run risk locales. These people may lead highly stable lives or highly changeable ones, but in most cases their roles as regular hosts of injection activities continue with only brief hiatuses due to incarceration, eviction, or familial dissolution. Proprietors of risk locales maintain their roles as facilitators of self-injection because they use that role to make money or to obtain opportunities to inject drugs and also because their clientele demands they continue.
Aids Patient Care and Stds, 2006
Accountability in Research, 2010
Declassification of documents has given rise to the allegation that the Central Intelligence Agen... more Declassification of documents has given rise to the allegation that the Central Intelligence Agency may have conducted unethical research targeting detainee subjects. That allegation is examined using document analysis and the development of research goals and roles as defined in the Common Rule. This article sets aside issues as to whether enhanced interrogation techniques described in the declassified documents rise to legal definitions of torture. Instead, it presents a post hoc ethics review raising questions addressed by Institutional Review Boards recommending the filing of a for-cause noncompliance complaint with the Office for Human Research Protection against the Central Intelligence Agency.
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Papers by Renée Llanusa-Cestero