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Rethinking the Ethics of Clinical Research - Widening the Lens (Hardcover)
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Rethinking the Ethics of Clinical Research - Widening the Lens (Hardcover)
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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 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.
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