Does someone who participates in a clinical trial make as big a contribution as an organ donor?

In 2006 the Center for Information & Study on Clinical Research surveyed 900 people, asking:

Which one of the following do you think makes a greater contribution to mankind?

The results were as follows:

1. A person who donates an organ (40%)
2. A person who gives blood (29%)
3. Not sure/refused (13%)
4. A person who raises money for charity by running in a race (10%)
5. A person who volunteers to take part in a clinical trial (9%)

The Center's founder, Ken Getz, would like to see #5 rise to the top. From Monday's Boston Globe (There's virtue in volunteering, he says)

"Participating in a clinical trial can be profound," he said. "But I don't think the public understands the magnitude, the impact that volunteering can have, its essential role in every medicine that sits in our medicine cabinets."If they did, they'd put it on par with organ donation," he said, referring to the survey where organ donors finished on top. "My mission is to move us out of last place."

Actually, I think the public has these choices in about the right order and that if everyone were well educated on the topic the results might come out about the same. Here's how I think about it:

• When a person donates an organ they make a direct, profound difference to someone. In many cases it's the difference between life and death for a specific, identifiable individual. When organs are harvested from a cadaver it can save several people and provide solace to the donor's survivors.
• A blood donor is like an organ donor on a smaller scale. Their blood helps one or more people live.
• "Not sure/refused" is a pretty good response, too. Who really knows the answer anyway and why is the surveyor asking the question?
• A person who raises money for charity by running a race is certainly making a noble effort, but who knows how the donation will be used? It's pretty likely to be wasted in whole or part.
• A clinical trial volunteer might be contributing to mankind, but it depends a lot on the trial. Sure, other people --possibly many others-- may benefit. But only a minority of clinical trial participants are in studies of novel agents. Many are taking part in trials of me-too drugs or extended release versions of products that the manufacturer is trying to get on the market to blunt generic competition. And here's a dirty little secret: Some trial sponsors enroll patients in unnecessary trials of already-marketed drugs in order to keep competitors from recruiting patients for trials of possibly superior new products.

I don't mean to be harsh on clinical trial participants and I'm not bothered by the work of the Center. However, if I were Getz I wouldn't hold my breath waiting for attitudes to undergo a dramatic change anytime soon.