Rethinking the Ethics of Clinical Research: Widening the Lens
Clinical research requires that some people be used and possibly harmed for the benefit of others. What justifies such use of people? This book provides an in-depth philosophical analysis of several crucial issues raised by that question. Much writing on the ethics of research with human subjects assumes that participation in research is a distinctive activity that requires distinctive moral principles. In most contexts, we allow people to choose the activities in which they engage. By contrast, people are permitted to participate in research only after Institutional Review Boards determine that it is appropriate for them to do so. Although we assume that consent to participate in research must be preceded by an elaborate disclosure of information, we make no such assumption in many other areas of life. Although it is thought to be morally problematic to provide financial inducements to prospective subjects, we make no such assumptions when we hire people as loggers, fishermen, and fire fighters. Although we readily accept the "off-shoring" of manufacturing, many regard the off-shoring of medical research with great skepticism. This book seeks to widen the lens through which we consider such issues. When we do so, we will find that many standard principles of research ethics are difficult to defend. The book first argues that because respect for "autonomy" has been a central tenet of research ethics, many have failed to recognize that the structure of the regulation of research is deeply paternalistic and have therefore failed to justify such paternalism. The book then rejects "the autonomous authorization" model that characterizes most writing in bioethics and argues for a "fair transaction" model. Although many worry that the use of financial payment to recruit research subjects is coercive or constitutes an undue inducement, the book argues that most of those worries are misplaced. Shifting its attention to research in developing societies, the book considers the claim that international researchers exploit research abroad often exploits its subjects. Finally, the book considers the claim that because researchers benefit from their use of research subjects, they acquire special obligations to them or their communities.
What people are saying - Write a review
We haven't found any reviews in the usual places.
Other editions - View all
A’s proposal accept arguably argued argument assume autonomy B’s consent believe Belmont Report bioethics burdens choice claim clinical research coerced coercion compensation consent to participate consent transactions contexts decision Declaration of Helsinki developing countries effect ex ante exploitation fair financial incentives financial payment give morally transformative given harm human subjects informed consent interaction interests intervention investigators IRBs justified lawn blower LDCs LK/AA lumpectomies medical research morally transformative consent mutually advantageous Nike Nuremberg Code obligations offer one’s otherwise participate in research paternalistic patients permissible person physicians placebo post-trial treatment principle prospective subjects protect protocol question reason receive regard reject require Rescue research ethics research participants research subjects respect risks social society soft paternalism standard super-contractual surfactant surgery surrogacy T.M. Scanlon theory theory of consent things considered tion treat undue inducement unfair University Press valid consent worry worse wrong