PHI2396 Lecture 10 October 10 2013
• Medical research on human subjects is one of the foundational issues of bioethics. This
o Conflict arises between Kantians and Utilitarians where Kantians argue in favor
of duty and respect of the subjects while the utilitarians would argue that the
sufferings of the few can benefit the many.
• Research on human subjects was not an object of concern because
o The victims of these researches belonged to disadvantaged classes.
o The patients would place trust in the actions and abilities of their doctors.
• The terms of medical research were recently abused;
o The Tuskegee experiment where the government sponsored experiments on
syphilis on under-educated Southern black Americans.
o McGill’s Allan Memorial Institute where a doctor worked with the CIA on
brainwashing mildly-depressed patients as MK-ULTRA experiments.
• What are the goals of research?
o Is it healing or accumulation of knowledge?
o According to Hans Jonas, medical progress is not necessary for the good of the
society. He also says that urgent research which gives benefits in times of war,
epidemic or disaster is different from expansive research which is ‘melioristic’ in
that it target what is viewed as important for the future. He argues that present
needs are of higher priority than future needs.
o According to Harris, we all have an obligation to participate in medical research
because the benefits of the past researches should encourage the participation
of present researches in financial and social ways. This stresses his utilitarian
view where participation in research by competent adults is necessary in spite of
Harris’ view (melioristic care) is justified by the utilitarian view of creating
a greater good for a greater number of people where the greater number
of people refers to future humans.
Assume that Harris is right, and we have an obligation to participate in
medical research for the public good.
If research, however, benefits only a company that holds (or would hold)
the patent, then it doesn’t benefit the public good, only the company. (At
best, perhaps, the public benefits only indirectly).
Thus corporate driven research undermines our obligation to participate
in medical research. o A Kantian would put the dignity of the individual over the benefits of the society.
The Kantian would argue that melioristic goals;
Treat patients as means to an end and not as ends. For example, even
prisoners or children cannot be used.
Responds to future goals.
o The Informed Consent as part of medical research involves;
Potential subjects cannot make competent choices unless they have all
the necessary information.
• This does not help the patient better since the researchers are
better informed about the procedures.
The consent must not be coerced.
Some situations where the patients fear negative consequences health-
wise if they do not participate.
Consent from total institutions cannot be relied upon since the institution
determines the state of the individual.
Depends on global concerns.
• Clinical trials have 4 phases:
o Test the toxicity of a drug.