The best of the week’s news:

• “Signature strikes” sounds like a brand of cigarettes, but it’s actually a little-known facet of the U.S.’s drone war, the part that involves killing unidentified people who seem to be up to no good.

• While profiling an ex-convict, photojournalist Sara Naomi Lewkowicz captured harrowing images of her subject beating his girlfriend. Her photo essay is a terrifying depiction of an all-too-common problem, one that is rarely glimpsed and only dimly understood by outsiders.

• Andrew Solomon has won the 2013 National Book Critics Circle Award for non-fiction for “Far From the Tree: Parents, Children, and the Search for Identity.“

• Canine murder mystery: Was a prize-winning Samoyed poisoned?

[Photo credit: Wander Mule, Creative Commons.]

Thanks to a 1978 Supreme Court decision, non-Indians who rape on Indian reservations operate with near impunity, Sierra Crane-Murdoch reports:

In 1978, the Supreme Court case Oliphant v. Suquamish stripped tribes of the right to arrest and prosecute non-Indians who commit crimes on Indian land. If both victim and perpetrator are non-Indian, a county or state officer must make the arrest. If the perpetrator is non-Indian and the victim an enrolled member, only a federally certified agent has that right. If the opposite is true, a tribal officer can make the arrest, but the case still goes to federal court.

Even if both parties are tribal members, a U.S. attorney often assumes the case, since tribal courts lack the authority to sentence defendants to more than three years in prison. The harshest enforcement tool a tribal officer can legally wield over a non-Indian is a traffic ticket.

The result has been a jurisdictional tangle that often makes prosecuting crimes committed in Indian Country prohibitively difficult. In 2011, the U.S. Justice Department did not prosecute 65 percent of rape cases reported on reservations. According to department records, one in three Native American women are raped during their lifetimes—two-and-a-half times the likelihood for an average American woman—and in 86 percent of these cases, the assailant is non-Indian.

Indian tribes have their police forces who could be making arrests, were it not for the legal shackles imposed upon them by the court’s decision. The Senate inserted language into the Violence Against Women Act that would have allowed tribal courts to prosecute non-Indians who commit crimes on reservations, but the House Republicans opposed the measure.

Sine 2008, outsiders have been streaming to rural North Dakota to get a piece of the Bakken Shale Oil Boom, and the Fort Berthold reservation is at its epicenter. Federal prosecutors have received additional resources to deal with criminal complaints on the reservation. Case filings on North Dakota reservations rose 70% between 2009 and 2011. The rise crime reporting tracks the influx of non-Indians to the oil patch. The reservation’s population has more than doubled, and the tribal police have little legal control over the new residents. For local women, the newfound prosperity represents an ongoing threat to their safety.

[Photo credit: Hansen.Berlin, Creative Commons.]

• In These Times explores the wage-theft epidemic gripping America.
• Behind the Kitchen Door, a new book by Saru Jayaraman, chronicles the lives of low-wage restaurant workers and exposes the dirty kitchens, unsafe working conditions, and exploited workers behind the so-called sustainable food movement.
• Charter schools are privately-run public schools that promise to serve all students, but these institutions often impose such onerous application requirements that only elite students can hope to be admitted.
• Why did the BBC spike an expose of Jimmy Saville, a beloved TV presenter with a penchant for pedophilia?

 [Photo credit: Wander Mule, Creative Commons.]

Bob Ortega, our February Sidney Award-winner for his expose of a faulty HPV test, has another blockbuster story on women’s health.

U.S.-funded researchers testing a low-tech alternative to pap smears followed thousands of poor Indian woman to see if they developed cervical cancer, but they didn’t screen them to catch the disease early, they just waited to see if they’d get sick:

For more than 12 years, as part of two massive U.S-funded studies in India, researchers tracked a large group of women for cervical cancer but didn’t screen them, instead monitoring them as their cancers progressed. At least 79 of the women died.

One study, funded by the National Cancer Institute, did not adequately inform more than 76,000 women taking part about their alternatives for getting cervical-cancer screening; and those women did not give adequate informed consent, according to the Office of Human Research Protection, part of the U.S. Department of Health and Human Services.

The other study, funded by the Gates Foundation, is under review by the Food and Drug Administration, according to Kristina Borror, the OHRP’s director of compliance oversight. That study has raised similar concerns regarding 31,000 women who were tracked but not routinely screened or treated for cervical cancer.

Both studies continue today, though researchers for both told The Arizona Republic they have begun to offer screening to the women. [AR]

The subjects were uneducated women from the slums of Mumbai. The study was designed to determine whether diluted vinegar douches are an effective, low-tech screening test for cervical cancer. Abnormal tissue turns white in response to the acid.

Basically, women in the experimental groups got the test. Women in the control groups were told they could get HPV screening on their own, but they weren’t screened. Health care workers visited them to ask if they’d developed any symptoms of cervical cancer. Note that cervical cancer doesn’t usually cause symptoms until the disease is far advanced. The more advanced the cancer, the worse the patient’s odds of survival.

By 2009, the researchers had reason to believe the test was working. The vinegar seemed to be revealing abnormal cells, but the researchers felt they needed to keep the study going to show a statistically significant difference in cervical cancer rates between the experimental and control groups.

In 2011, an oversight body found that the National Cancer Institute-funded study had not obtained proper informed consent from their subjects and had not educated them properly about how to seek screening on their own. The researchers argued that the control group subjects were no worse off than they would have been if they hadn’t participated in the trial because most poor women in Mumbai don’t get cervical cancer screenings anyway.

It’s irrelevant whether the women in the control groups were worse off than they would have been. Control groups of this type were probably unnecessary in the first place. Cervical cancer researchers in many other developing countries reject the unscreened control group design. They have other ways to measure the efficacy of their tests.

At this point, the medical consensus is that any reliable form of cervical cancer screening is better than nothing. If the vinegar test accurately identifies cancers that would have otherwise gone unnoticed until much later, that’s proof that it works better than no screening. We don’t have to wait for unscreened women to get sick and die to prove the point.

A cancer screening trial with an unscreened control arm would never be allowed in the United States. Ortega quotes researchers who attempt to justify their laissez-faire approach by claiming that Western principles of research ethics, like informed consent, don’t apply to women in the slums of Mumbai. No doubt it’s more difficult to obtain informed consent for medical care from subjects who have little formal education, but that doesn’t imply that it’s any less important. Ortega’s reporting shows that the researchers didn’t even do the bare minimum.

It’s a twisted logic that says it’s okay to treat someone worse because they’re already so badly off.

[Photo credit: A slide from an HPV test, euthman, Creative Commons.]