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PHIL 3576 Lecture Two

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York University
PHIL 3576
Duff Waring

Introduction to the History and Ethics of Biomedical Research- Lecture  Voluntary assumption of risk- mentally capable people (or those who believe they are mentally capable) decide to assume their own risks or research with the hope of gaining the benefits  Hard paternalism: standing in the way of a mentally capable persons decision to take the risks of research  Main source of ethical conflict in clinical research- the roles and duties of both the researcher and the patient  Physicians primary obligation should be the well being of your patient  Researchers primary obligation is to produce reliable data o Conflict arises when the two coincide o In a placebo control trial there is no parallel between physicians and researchers. Physicians do not randomize their patients and treatments, but rather take time and deliberate all possible treatments o It would be malpractice in medical practice for prescribing sugar pills for something like depression… but in a clinical trial placebos are legally allowed o Declaration of Helsinki says physicians should treat their patients with the best available proven effective treatment; but this goes against experimental treatment/research trials  Patient centre care aims to cure or ameliorate diseases on a case by case basis, but research aims to help human care not patient care o Research hopes to find cures and treatments to help present and future generations with thus illness, rather than base their efforts specific to the individual  Is it okay to sacrifice the few for the many? o Deontologists say: do not comprise the wellbeing of one for the many o Is the health of citizens at large a kind of social good? o Society will benefit from the knowledge gained from clinical research and developments  Clinical trials asses the efficacy of a unproven intervention; if thus intervention passes all testing it still takes 3-4 years to determine the efficiency and side effects  Some argue clinical research will help us to understand where our healthcare dollars should be allocated  Increasing the information given to possible subjects of a given trial would most likely scare many away o Decreasing the risks of the trial
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