Rethinking the Ethics of Clinical Research: Widening the Lens

Hardcover | October 14, 2010

byAlan Wertheimer

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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 inresearch 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 tobe 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 greatskepticism. 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 autonomousauthorization" 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 acquirespecial obligations to them or their communities.

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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 ...

Alan Wertheimer is Senior Research Scholar in the Department of Bioethics at The National Institutes of Health, and Professor Emeritus at the University of Vermont.

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Format:HardcoverDimensions:352 pages, 9.25 × 6.12 × 0.98 inPublished:October 14, 2010Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199743517

ISBN - 13:9780199743513

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Table of Contents

Preface1. Introduction2. Facing Up to Paternalism in Research Ethics3. Preface to a Theory of Consent Transactions in Research: Beyond Valid Consent4. Should We Worry About Money?5. Exploitation in Clinical Research6. The Interaction PrincipleNotesIndex