Should social value obligations be local or global?

Bioethics

Volumn 31, Issue 2, 2017, Pages 116-127

  Nayak, Rahul ^a   Shah, Seema K ^b  

^a NATIONAL INSTITUTES OF HEALTH   (United States)

^b UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

Author keywords

Global health; Global justice; International research ethics; Reasonable availability; Social value

Indexed keywords

BENEFICENCE; BIOETHICS; CONCEPTION; CONSENSUS DEVELOPMENT; HEALTH; HUMAN; JUSTICE; RESEARCH ETHICS; RESPONSIBILITY; SCIENTIST; CLINICAL TRIAL (TOPIC); DEVELOPED COUNTRY; DEVELOPING COUNTRY; ETHICS; GLOBAL HEALTH; HEALTH CARE DELIVERY; INTERNATIONAL COOPERATION; MORALITY; PARTICIPATORY RESEARCH; PERSONNEL; PRACTICE GUIDELINE; SOCIAL JUSTICE; SOCIAL PSYCHOLOGY; SOCIAL RESPONSIBILITY; STANDARDS;

BENEFICENCE; CLINICAL TRIALS AS TOPIC; COMMUNITY-BASED PARTICIPATORY RESEARCH; DEVELOPED COUNTRIES; DEVELOPING COUNTRIES; GLOBAL HEALTH; GUIDELINES AS TOPIC; HEALTH SERVICES ACCESSIBILITY; HUMANS; INTERNATIONAL COOPERATION; MORAL OBLIGATIONS; RESEARCH PERSONNEL; SOCIAL JUSTICE; SOCIAL RESPONSIBILITY; SOCIAL VALUES;

EID: 85009115871     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/bioe.12322     Document Type: Note

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46. A related objection is that perhaps researchers should be obligated to pursue certain research projects and not others, based on their duties of beneficence. On this issue, we take the view that people should have discretion to make a wide range of professional choices and then discharge their obligations of beneficence in a variety of ways, including through donating money. Although more discussion on this issue is likely warranted, sacrificing autonomy to this extent seems to go beyondwhat limited duties of beneficence can require, and may also be inefficient if it directs individuals to enter professions that have the potential to do considerable good but perform poorly at them because they are ill-suited for and unhappy to be doing such work.
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51. We thank our reviewers for raising this important objection.
52. Note that, as discussed earlier, we endorse a moderate prioritarian conception to flesh out this duty. An analogy that may be helpful is to the movement behind effective altruism. This movement is based on the premise that one can do more good if one chooses to donate to charities that are cost-effective. See, e.g. GiveWell, your dollar goes further when you fund the right program, at http://www.givewell.org/giving101/Funding- the-Right-Program [Accessed 3 Jun 2016]. Similar logic applies to choices made by individual researchers and sponsors.
53. This move from individual to institutional duties has been nicely defended in the context of the duty to rescue (which is understood to fall under the duty of beneficence) by the following authors: Douglas MacKay and Tina Rulli, ‘The Duty to Rescue and Investigators’ Obligations,’ Kennedy Institute of Ethics Journal (forthcoming)
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73. In theory, it is also possible that some researchers have obligations to promote the social value of their research if they make promises about the intended social value of the research, but we lack the space to address these types of obligations in depth. For instance, researchers may make such promises in the informed consent documents, or in review committees submissions, but these obligations are voluntary and might only apply to a small proportion of researchers.
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77. For example, donating 90% of one’s income to charity could ordinarily be considered supererogatory, however, if one were to pledge to donate 90% of one’s income, we could expect that the individual either uphold that pledge or recant their pledge. It would not be permissible for the individual to make such a pledge and then receive social credit/ acclaim for the supposed generosity if they do not intend to follow through with their commitment.
78. MacKay, op. cit., note 45.
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92. It is worth noting that public-sector research (either publicallyfunded or university-based) contributes to a significant proportion of all new drugs approved by the FDA (9.3-21.2%) and tends to have outsized clinical impact.
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