Exploitation in clinical research

Exploitation and Developing Countries: The Ethics of Clinical Research

Volumn , Issue , 2008, Pages 63-104

  Wertheimer, Alan ^a  

^a NONE

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EID: 77953464529     PISSN: None     EISSN: None     Source Type: Book    
DOI: None     Document Type: Chapter

References (39)

1. 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, at 561.
2. Ronald Bayer, "The Debate over Maternal-Fetal HIV Transmission Prevention Trials in Africa, Asia, and the Caribbean: Racist Exploitation or Exploitation of Racism?" American Journal of Public Health 88 (1998): 567-70, at 569.
3. Z. Ahmed Bhutta, "Ethics in Internatonal Health Research: A Perspective from the Developing World," CMH Working Papers, Commission on Macroeconomics and Health, 13.
4. Council for International Organizations of Medical Sciences, International Ethical Guidelines for Biomedical Research Involving Human Subjects, (Geneva: CIOMS, 2002).
5. Robert Crouch and John Arras, "AZT Trials and Tribulations," Hastings Center Report 28, no. 6 (1998): 26-34, at 29.
6. 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 33 (1997): 853-56, at 855.
7. Nuffield Council on Bioethics, The Ethics of Research Related to Healthcare in Developing Countries (London: Nuffield Council on Bioethics, 2002).
8. Richard Arneson, "Exploitation," in Encyclopedia of Ethics, ed. Lawrence C. Becker (New York: Garland, 1992), 350.
9. The president of Stanford University claimed that big-time college athletics "reeks of exploitation," because the universities gain a great deal of revenue from the services of the athletes while the athletes (whose graduation rate is much lower than that of nonathletes) gain little from their college experience. Donald Kennedy, "So What If College Players Turn Pro Early?" New York Times, January 19, 1990, B7.
10. USA Today featured an article advocating the legalization of organ sales, whereby a person could be paid cash for a kidney. One reply maintained that such a policy would "open wide the door to exploitation." September 14, 1991.
11. One commentator observed that "one of the most serious charges against surrogate motherhood contracts is that they exploit women." Martha Field, Surrogate Motherhood (Cambridge, MA: Harvard University Press, 1989), 25.
12. The code of the American Psychiatric Association states that "the psychiatrist's ethics and professional responsibilities preclude his/her gratifying his/her own needs by exploiting the patient." From American Psychiatric Association, "Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry," 1985, cited in Ethical Issues in the Professions, ed. Peter Y. Windt et al. (Englewood Cliffs, NJ: Prentice-Hall, 1989), 567.
13. Allen Buchanan, Ethics,Efficiency, and the Market (Totowa, NJ: Rowman and Allanheld, 1985), 87, emphasis added.
14. Nancy Holmstrom, "Exploitation," Canadian Journal of Philosophy 7 (1997): 353-69, at 357, emphasis added.
15. Judith Farr Tormey, "Exploitation, Oppression and Self-Sacrifice," Philosophical Forum 5 (1974): 206-21, at 207-8.
16. Stanley Benn, A Theory of Freedom (Cambridge: Cambridge University Press, 1988), 138.
17. Joel Feinberg, Harmless Wrongdoing (Oxford: Oxford University Press, 1988), 176-79.
18. Stephen Munzer, A Theory of Property (Cambridge: Cambridge University Press, 1990), 171.
19. Andrew Levine, Arguing for Socialism (London: Verso, 1988), 66-67.
20. John Lawrence Hill, "Exploitation," Cornell Law Review 79 (1994): 631-99, at 637.
21. Most consensual transactions are mutually advantageous and vice versa.
22. Allen Buchanan, Marx and Justice (Totowa, NJ: Rowman and Allanheld, 1984), 44.
23. Christine Korsgaard, "The Reasons We Can Share," Social Philosophy and Policy 10 (1993): 24-51, at 40.
24. See Alan Wertheimer, Exploitation (Princeton, NJ: Princeton University Press, 1996), chap. 7.
25. See her introduction to Incommensurability, Incomparability, and Practical Reason, ed.Ruth Chang (Cambridge,MA:Harvard University Press, 1997).
26. For an extended analysis, see my Coercion (Princeton, NJ: Princeton University Press, 1987).
27. Indeed, we can imagine that B makes the identical proposal to A in order to fund her daughter's surgery, in which case B's options would remain the same (no surgery + no sex vs. surgery + sex), but it would be preposterous to claim that A had coerced her into sexual relations.
28. The literature sometimes refers to seductive offers as "undue inducements." I prefer to avoid this phrase because it is unclear whether the inducements are thought to be "undue" because they compromise the rationality of the target's consent or because they are wrongful for other reasons.
29. I set aside the argument that surrogacy harms the children that result from the surrogacy arrangement. Since these children would otherwise not exist, it is difficult to see how they are made worse off as a result of being conceived.
30. As John Rawls puts it, ideal theory "works out the principles that characterize a well-ordered society under favorable circumstances." A Theory of Justice (Cambridge, MA: Harvard University Press, 1971), 245.
31. In studies of HIV maternal-fetal transmission in Thailand, the placebo group had a higher transmission rate than the treated group but a lower transmission rate than the local background transmission rate. See Christine Grady, "Science in the Service of Healing," Hastings Center Report 28 (1998): 34 -38, at 36.
32. World Medical Association, Declaration of Helsinki, as quoted in Ezekiel J. Emanuel, "A World of Research Subjects," Hastings Center Report 28, no. 6 (1998): 25.
33. Needless to say, similar issues arise with respect to the affluent and the poor in developed societies.
34. Even sweatshops may be ethically underrated. As Nicholas Kristof has written, "The American campaign against sweatshops could make [a child's] life much more wretched by inadvertently encouraging mechanization that could cost him his job." "Let Them Sweat," New York Times, June 14, 2002, A25.
35. Charles Weijer, "Protecting Communities in Research: Philosophical and Pragmatic Challenges," Cambridge Quarterly of Healthcare Ethics 8 (1999): 501-13, at 503.
36. "Soft paternalism" refers to cases in which we have reason to question B's competence."Hard paternalism" refers to cases in which we prevent B from doing X even though we have no reason to question the competence of B's decision. Requiring motorcyclists to wear helmets may be a case of hard paternalism.
37. Robert Gilpin, U.S. Power and the Multinational Corporation (New York: Basic Books, 1975), 289.
38. Marcia Angell, "The Ethics of Clinical Research in the Third World," New England Journal of Medicine 337 (1997): 849-51, at 849.
39. Peter Lurie and Sidney Wolfe, letter to Tommy Thompson, Public Citizen, February 22, 2001.