In clinical research, some of the fundamental ethical issues that arise are the issues of exploitation, induced consent and an exposure of a research participant to an unjustifiable risk. If a pharma company deploys researchers from America to Nigeria with the aim of testing a trial drug that would be used to cure cancer, can this be an act of exploitation? What of if the participants were given some incentives before they were involved in the research protocols, could this be interpreted as a kind of inducement? How can these questions be addressed with the principle of equal moral consideration and human rights?
Well, from talking to pharmaceutical people who do this very thing in eastern Europe, I understand that the primary inducement is that you'll get some treatment instead of none! I'm not an expert but the ethics of it are fairly clear. Fully explain the situation. Provide information on probable outcomes. Let the patient decide if they'll go ahead. Whether the actual practices match the ethics is a different question. But the companies will gladly tell you their ethics. It's the other bit that's more interesting.
Good luck
Christopher NOCK
I think Immanuel Kant's principle of humanity is applicable here: always treat others, yourself included, as an end in oneself and not simply as a means. I also think contractarianism furnishes guidance: what are the rules that a community of free, rational, and equal persons would agree to from behind a veil of ignorance? On both Kant's deontology and contractarianism, one could never justify using one group of people as trial subjects to treat another group of people. If there need to be trial subjects at all, they should be evenly distributed among the groups being treated.
The relevance of Kant or the veil of ignorance are both a little hard to fathom. I'm flying of cancer. If I care to live as long as I might, I'm not concerned by too many moral niceties. Just tell me the truth about the drug and ask me if I want it. This isn't likely to be contractarian consent. It's rather more Hobbes, and you "agreeing" with the highwayman if you hand over your purse at the end of his musket! Much better explained in my "On the dissent theory of political obligation" in Polity (Winter, 1995). Check it out, it just might change your world!
Christopher NOCK
Concerning “human rights,” perhaps, the following may help:
http://www.bookdaily.com/book/3341166/scientific-proof-of-our-unalienable-rights-a-road-to-utopia
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