Children in Medical Research: Access versus Protection

Paperback | July 1, 2008

byLainie Friedman Ross

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Lainie Ross presents a rigorous critical investigation of the development of policy governing the involvement of children in medical research. She examines the shift in focus from protection of medical research subjects, enshrined in post-World War II legislation, to the current era in whichaccess is assuming greater precedence. Infamous studies such as Willowbrook (where mentally retarded children were infected with hepatitis) are evidence that before the policy shift protection was not always adequate, even for the most vulnerable groups. Additional safeguards for children were firstimplemented in many countries in the 1970s and 1980s; more recent policies and guidelines are trying to promote greater participation. Ross considers whether the safeguards work, whether they are fair, and how they apply in actual research practice. She goes on to offer specific recommendations tomodify current policies and guidelines. Ross examines the regulatory structures (e.g. federal regulations and institutional review boards), the ad hoc policies (e.g. payment in pediatric research and the role of schools as research venues), the actual practices of researchers (e.g. the race/ethnicity of enrolled research subjects or thedecision to enroll newborns) as well as the decision-making process (both parental permission and the child's assent), in order to provide a broad critique. Some of her recommendations will break down current barriers to the enrolment of children (e.g. permitting the payment of child researchsubjects; allowing healthy children to be exposed to research that entails more than minimal risk without requiring recourse to 407 panels); whereas other recommendations may create new restrictions (e.g., the need for greater protection for research performed in schools; restrictions on whatresearch should be done in the newborn nursery). The goal is to ensure that medical research is done in a way that promotes the health of current and future children without threatening, to use the words of Hans Jonas, 'the erosion of those moral values whose loss . . . would make its most dazzlingtriumphs not worth having'.

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Lainie Ross presents a rigorous critical investigation of the development of policy governing the involvement of children in medical research. She examines the shift in focus from protection of medical research subjects, enshrined in post-World War II legislation, to the current era in whichaccess is assuming greater precedence. Infamo...

Lainie Ross is the Carolyn and Matthew Bucksbaum Professor of Clinical Medical Ethics, an Associate Director of the MacLean Center and co-director of the Ethics Consultation Service that provides both clinical and research ethics consultation. Dr. Ross has published two books on pediatric ethics: iChildren, Families and Health Care De...

other books by Lainie Friedman Ross

Children, Families, and Health Care Decision-Making
Children, Families, and Health Care Decision-Making

Hardcover|Nov 1 1998

$146.77 online$264.00list price(save 44%)
Format:PaperbackDimensions:280 pages, 9.21 × 6.14 × 0.73 inPublished:July 1, 2008Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199230420

ISBN - 13:9780199230426

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Table of Contents

I. Access versus Protection1. From 1966 to 2005: Balancing Protection and Access in Pediatric Research2. Access versus Protection: Minority Representation in Pediatric ResearchII. Challenges to the Regulations3. Overview of the Common Rule and Subpart D4. Should We Provide Healthy Children with Greater Protection in Medical Research?5. Informed Consent in Pediatric Research6. Phase I Research and the Meaning of 'Prospect of Direct Benefit'III. Strengths and Limits of Current Regulations7. Human Subjects Protections in Published Pediatric Research8. Payment in Pediatric Research9. Research in SchoolsIV. Case Studies10. Minimizing Risks: Diabetes Research in Newborns11. Diabetes Prediction and Prevention Research in Childhood12. Lead Abatement Research13. Clinical Asthma Trials14. Research Not Otherwise Approvable: A Look at One Protocol15. Evolution of the 407 ProcessEpilogue