The outsourcing of medical research has become a strategic imperative in the global pharmaceutical industry. Spurred by the challenges of competition, the need for speed in drug development, and increasing domestic costs, pharmaceutical companies across the globe continue to outsource critical parts of their value chain activities, namely contract clinical research and drug testing, to sponsors across the globe, typically into emerging markets. While it is clear that important ethical issues arise with this practice, unraveling moral responsibility and the allocation (...) of responsibility is not so clear, considering that contracts, by their very definition transfer responsibility from the principal to the agent. This research provides a framework for exploring some of the ethical issues, including attributions of moral responsibility associated with Contract Medical Research. Using a theory of strategic and moral behavior, the research shows that both clients and sponsors in contract research have individual and collective responsibility to ensure that due care and diligence is exercised in the performance of clinical research. The research suggests some guidelines for stakeholder action. (shrink)

Some philosophers worry that if modal realism is true, you have no reason to prevent evils. For if you prevent an evil, you’ll have a counterpart somewhere that allows a similar evil. And if you refrain, your counterpart will end up preventing the relevant evil. Either way one evil is prevented and one is allowed. Your act makes no difference. I argue that this is mistaken. If modal realism is true, you are in a variant of Newcomb’s Problem. And if (...) Lewis’ view about Newcomb’s Problem is true, then your act does make a difference and you should prevent the evil. (shrink)

There is, no doubt, a temptation to treat preventions, such as ‘the father’s grabbing the child prevented the accident’, and cases of ‘causation’ by omission, such as ‘the father’s inattention was the cause of the child’s accident’, as cases of genuine causation. I think they are not, and in this paper I defend a theory of what they are. More specifically, the counterfactual theory defended here is that a claim about prevention or ‘causation’ by omission should be understood not as (...) being directly about actual genuine causation but primarily as a counterfactual claim about genuine causation.1 The relation between actual causation and the mere possibility of causation allows my theory to explain both the difference and the similarity between the two notions (causation and prevention/omission). Further, the difference explains certain intuitions we have and the similarity justifies and explains the fact that for practical purposes we usually treat preventions and omissions as if they were genuine causation. Finally, the fact that this counterfactual theory of prevention and omission takes causation as primitive suggests that it is consistent with any theory of causation. This allows us to construct two arguments against what I will call genuinism, the view that cases of prevention and ‘causation’ by omission really are cases of genuine causation. In section II I show that genuinism does not account for the so-called intuition of difference. In section III I outline a number of problems that various theories of causation have with preventions and ‘causation’ by omission. These problems are ipso facto problems for genuinism, whereas I show in section V how the counterfactual theory solves those problems. Further, I answer a genuinist argument based on another type of intuition—the genuinist intuition—by showing why we have that intuition and how it should be handled (section VI). (shrink)

It is intuitively attractive to think that it makes a difference in Newcomb’s problem whether or not the predictor is infallible, in the sense of being certainly actually correct. This paper argues that that view is irrational and manifests a well-documented cognitive illusion.