Search results

The philosopher Henry Richardson's short book is a defense of a position on a neglected topic in medical research ethics. Clinical research ethics has been a longstanding area of study, dating back to the aftermath of the Nazi death-camp doctors and the Tuskegee syphilis study. Most ethical regulations and institutions (such as Institutiional Review Boards) have developed in response to those past abuses, including the stress on obtaining informed consent from the subject. Richardson points out that that these ethical regulations do not address one of the key dilemmas faced by medical researchers -- whether or not they have obligations towards subjects who need care not directly related to the purpose of the study, termed "ancillary care obligations.".

ABSTRACTDiscussion of medical researcher teams' ancillary‐care obligations has long been dominated by partial‐entrustment theory, developed in 2004 by the author of this article, in collaboration with Leah Belsky. Critics of the limited scope of the special ancillary‐care obligations defended by that theory, however, argue that a better theory would take fuller account of the relationship that develops between individual research participants and members of the research team. Nate W. Olson and Thaddeus Metz have each put forward well worked‐out versions of such a relationship‐based account of ancillary‐care obligations. This article critically evaluates these accounts, concluding that while each of them is vulnerable to various criticisms, each also crucially facilitates understanding of this relationship: Olson brings out well how research participants can find that role not just beneficial but also deeply meaningful, and Metz, drawing on African ethical traditions, emphasizes that when things go well, participants are involved as partners in the research effort. Yet the article closes by arguing that the partial‐entrustment theory, surprisingly, can take on board each of these lessons. As so enhanced, it may actually be the best available relationship‐based theory of this subject.

Philip Pettit's Republicanism: A Theory of Freedom and Government has provided a systematic basis for republican theory in the idea of freedom as non-domination. Can a pure republican view, which confines itself to the normative resources thus afforded, adequately address the full range of issues of social justice? This article argues that while there are many sorts of structural injustice with which a pure republican view can well cope, unfair disparities in political influence, of the kind that Rawls labeled failures of the 'fair value' of the equal political liberties, cannot be well addressed by a pure republican view. In arguing the point, the article assesses the reach not only of the core ideal of freedom as non-domination itself, but also of three further layers in Pettit's republican theory: its suggestion that domination is to be minimized, its account of a set of institutions needed to restrict domination, and its requirement that, to prevent governments from having the power to act arbitrarily and so to dominate, they be made responsive to the common good. Some of these further conceptual resources are shown to be of no help in addressing unfair disparities in political influence, while the ones that are promising are so only because they rely on distinctively liberal ideals, and so depart from a pure republican basis.