Exploitation and the enterprise of medical research

Exploitation and Developing Countries: The Ethics of Clinical Research

Volumn , Issue , 2008, Pages 206-245

  Carse, Alisa L ^a   Little, Margaret Olivia ^a  

^a NONE

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EID: 69449101052     PISSN: None     EISSN: None     Source Type: Book    
DOI: None     Document Type: Chapter

References (34)

1. For representatives of this view, see, e.g., Robert Nozick, Anarchy, State, and Utopia (New York: Basic Books, 1974);
2. Milton Friedman, Capitalism and Freedom (Chicago: University of Chicago Press, 1962);
3. Ian Maitland, "The Great Non-debate over International Sweatshops," in Ethical Theory and Business, 6th ed., ed. Tom Beauchamp and Norman Bowie (Englewood Cliffs, NJ: Prentice Hall, 2001).
4. See Peter Lurie and Sidney Wolfe, "Unethical Trials of Interventions to Reduce Perinatal Transmission of the Human Immunodeficiency Virus in Developing Countries," New England Journal of Medicine 337 (1997): 853-56;
5. Marcia Angell, "The Ethics of Clinical Research in the Third World," New England Journal of Medicine 337 (1997): 847-49;
6. Marcia Angell, "Ethical Imperialism? Ethics in International Collaborative Clinical Research," New England Journal of Medicine 319 (1988): 1081-83;
7. Kenneth Rothman and Karin Michels, "The Continuing Unethical Use of Placebo Controls," New England Journal of Medicine 331 (1994): 394-98;
8. Troyen Brennan, "Proposed Revisions to the Declaration of Helsinki-Will They Weaken the Ethical Principles Underlying Human Research?" New England Journal of Medicine 341 (1999): 527-31;
9. George Annas and Michael Grodin, "Human Rights and Maternal-Fetal HIV Transmission Prevention Trials in Africa," American Journal of Public Health 88 (1998): 560-63.
10. For a review of the issues, see Harold Varmus and David Satcher, "Ethical Complexities of Conducting Research in Developing Countries,"New England Journal of Medicine 37 (1997): 1003-5.
11. Joel Feinberg, Harmless Wrongdoing (New York:Oxford University Press, 1988), 14.
12. Alan Wertheimer calls this the "historical" version; he gives as an example of such a charge the worry that student athletes receive too little of the benefits they accrue to their universities. See Wertheimer, Exploitation (Princeton, NJ: Princeton University Press, 1996), chap. 3.
13. Denis Arnold and Norman Bowie, "Sweatshops and Respect for Persons," Business Ethics Quarterly 13, no. 2 (2003): 221-42.
14. Onora O'Neill, Constructions of Reason (New York: Cambridge University Press, 1989), 138.
15. Leon Kass, Life, Liberty, and the Defense of Dignity: The Challenge for Bioethics (San Francisco: Encounter Books, 2002).
16. Alan Wood, "Exploitation," Social Philosophy and Policy 12, no. 2 (1995): 145.
17. See Elizabeth Anderson and Richard Pildes, "Expressive Theories of Law: A General Restatement," University of Pennsylvania Law Review 148 (2000): 1503-75, at 1508.
18. Thus, for instance, Tom Hill, in his essay "The Message of Affirmative Action," in Autonomy and Self-Respect (Cambridge: Cambridge University Press, 1991), appeals to the expressivist implications of affirmative action regulations and policies-the "message" they send about our moral priorities.Whatever one thinks about affirmative action, the point we are making here is that policies are important in their expressivist meaning, not just in their concrete implications.
19. For more on the concept of commodification, see Margaret Radin, Contested Commodities (Cambridge, MA: Harvard University Press, 1996).
20. Questions of transactional fairness are central, for instance, to Wertheimer (chapter 3, this volume) and Participants in the 2001 Conference on Ethical Aspects of Research in Developing Countries, "Fair Benefits for Research in Developing Countries," Science 298 (2002): 2133-34.
21. We would define "undue inducement" as positive incentives whose appeal distorts the subjects' practical reasoning in such a way that they trade off future for present goods out of proportion to their own personal futurediscount rate.
22. Both clauses-whose knowledge, and the standard of knowledge-are currently heavily contested.
23. See Debra DeBruin, "Nurses: Research Integrity in Clinical Trials," supported by the Research on Research Integrity Program, an ORI/NIH collaboration, grant 1R01NR08420-01.
24. Barry Bloom, "The Highest Attainable Standard: Ethical Issues in AIDS Vaccines," Science 279 (1998): 186-88;
25. Ruth Faden and Nancy Kass, "HIV Research, Ethics, and the Developing World," American Journal of Public Health 88 (1998): 548-50.
26. See Robert Crouch and John Arras, "AZT Trials and Tribulations," Hastings Center Report 28, no. 6 (1998): 26-34;
27. Salim Karim, "Placebo Controls in HIV Perinatal Transmission Trials: A South African's Viewpoint," American Journal of Public Health 88 (1998): 564-66.
28. See Alex London, "Justice and the Human Development Approach to International Research,"Hastings Center Report 35, no. 1 (2005): 24-37, at 35.
29. See David Wendler, Ezekiel J. Emanuel, and Reidar Lie, "The Standard of Care Debate: Can Research in Developing Countries Be Ethical and Responsive to These Countries'Health Needs?" American Journal of Public Health 94 (2004): 923-28.
30. Participants, "Moral Standards for Research in Developing Countries: From 'Reasonable Availability' to 'Fair Benefits,'" Hastings Center Report 34, no. 3 (2004): 17-27.
31. For discussion, see John Arras, "Fair Benefits in International Medical Research," Hastings Center Report 34, no. 3 (2004): 3.
32. Which does not, of course, rule out the possibility of allowing suitably regulated profit-seeking agents, such as physicians or pharmaceutical companies, to play a designated role in its tasks.
33. Christine Grady, "Science in the Service of Healing," Hastings Center Report 28, no. 6 (1998): 34-38, at 35.
34. See Leonard Glantz et al., "Research in Developing Countries: Taking 'Benefit' Seriously," Hastings Center Report 28, no. 6 (1998): 38-42.