Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

Volume 20, Issue 2, February 2020, Page 20-22.

Volume 20, Issue 2, February 2020, Page 38-41.

Volume 20, Issue 2, February 2020, Page 35-38.

My paper explores the question of when it is wrong for a state’s immigration criteria to discriminate against people with disabilities, focusing on the idea that discrimination is wrong when it demeans a group, rather than when it disadvantages them. I argue that selecting against people with disabilities often demeans them but might not always do so even when immigration criteria explicitly exclude people on the basis of having disabilities – that is, in cases of direct discrimination. Moreover, I demonstrate (...) that certain cases of less direct forms of discrimination that select against people with disabilities – in particular, when states apply health-cost limits on admissions – can function as proxies designed to exclude people with disabilities and thereby demean them. Finally, I explain why my analysis of discrimination’s wrong does not typically apply to health conditions in general, such as heart, liver, or lung disease or cancer, setting my view apart from a prominent view in the literature. (shrink)