I want to argue for two propositions. First, I suggest that what some researchers may take to be a simple trade-off between minor violations of the truth for the sake of access to far greater truths represents a profound miscalculation with far-reaching and cumulative reverberations. Second, I submit that today's research environment, as demanding, competitive, and sometimes bewildering as it is, offers genuine scope for what Murdoch calls truth-seeking, for imagining and questioning, and for relating to facts through both truth (...) and truthfulness; but that, in so doing, it presents hard choices with respect to methods, and, in turn, to personal integrity—not only in particular research projects but also with respect to that fragile research environment in its own right. (shrink)

A thoughtful addition to the growing debate over public and private morality. Looks at lying and deception in law, family, medicine, government.

This is a major work in moral philosophy, the long-awaited follow-up to Parfit's 1984 classic Reasons and Persons, a landmark of twentieth-century philosophy. Parfit now presents a powerful new treatment of reasons and a critical examination of the most prominent systematic moral theories, leading to his own ground-breaking conclusion.

A summary of the philosophical literature on trust.

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 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 obligation'. (shrink)

According to the standard view of informed consent, a prospective subject's consent to participate in a research study is invalid if the individual fails to comprehend the information about the study standardly disclosed to him. I argue that this involves three mistakes. First, the standard view confuses an ethical aspiration with a minimum ethical standard. Second, it assigns the entire responsibility for producing comprehension in study participants to the investigators. Most importantly, the standard view requires the termination of many otherwise (...) perfectly ethical research studies. This last conclusion follows from appreciating a pervasive phenomenon that is known as the "therapeutic misconception." I argue that a prospective subject's consent to participate in research can be perfectly valid even if he or she does not comprehend the information that investigators are required to disclose. Furthermore, I explain that this alternative view does not in the least compromise the vital goal of ensuring the protection of subjects in research. (shrink)

A lively exchange sparked by Ortmann and Hertwig's call to outlaw deception in psychological research was intensified by underlying differences in the meaning of deception. The conception held by Broder, who defended deception, would restrict research more than Ortmann and Hertwig's conception. Historically, a similar difference in conceptions has been embedded in the controversy over deception in research. The distinction between informational and relational views of deception elucidates this difference. In an informational view, giving false information, allowing false assumptions, and (...) withholding information are deceptive. In a relational view these failures to inform are not necessarily deceptive. Rather, relational criteria, including denial of right to the truth, betrayal of trust, and impairment of commerce with reality finally determine what is deceptive. Analyses reveal that fewer research procedures are deceptive on a relational view than on an informational view. Surveys of the Journal of Personality and Social Psychology correspondingly show that a lower percentage of studies are deceptive on the relational view applied in this analysis than on the informational view applied by Sieber, Iannuzzo, and Rodriguez. If restrictions on deception keep increasing, more studies will be vetoed on the currently salient informational view than would be vetoed on a relational view. (shrink)

The requirement of informed consent (IC) to medical treatments is almost invariably justified with appeal to patient autonomy. Indeed, it is common to assume that there is a conceptual link between the principle of respect for autonomy and the requirement of IC, as in the influential work of Beauchamp and Childress. In this paper I will argue that the possible relation between the norm of respecting (or promoting) patient autonomy and IC is much weaker than conventionally conceived. One consequence of (...) this is that it is possible to exercise your autonomy without having the amount of and the kind of information that are assumed in the standard requirement of IC to medical treatments. In particular, I will argue that with a plausible conception of patient autonomy, the respect for and the promotion of patient autonomy are in certain circumstances better protected by giving patients the right to give their negatively informed consent to medical treatments. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

In this essay, I argue that prescription drug laws violate patients' rights to self-medication. Patients have rights to self-medication for the same reasons they have rights to refuse medical treatment according to the doctrine of informed consent (DIC). Since we should accept the DIC, we ought to reject paternalistic prohibitions of prescription drugs and respect the right of self-medication. In section 1, I frame the puzzle of self-medication; why don't the same considerations that tell in favour of informed consent also (...) justify a right of self-medication? In section 2, I show that the prescription drug system was historically motivated by paternalism. In section 3, I outline the justifications for the DIC in more detail. I show that consequentialist, epistemic, and deontic considerations justify the DIC. In sections 4–6, I argue that these considerations also justify rights of self-medication. I then propose that rights of self-medication require non-prohibitive prescription policies in section 7. I consider two objections in sections 8 and 9: that patients ought not to make medically risky or deadly decisions, and that unrestricted access to prescription-grade pharmaceuticals would result in widespread misuse and abuse. Section 10 concludes. (shrink)

Coercive Care: The Ethics of Choice in Health and Medicine asks probing and challenging questions regarding the use of coercion in health care and social services. This book combines philosophical analysis with comparative studies of social policy and law in a large number of industrialized countries and proposes an ideal of judicial security on a global scale.

Coercive Care asks probing and challenging questions regarding the use of coercion in health care and the social services. The book combines philosophical analysis with comparative studies of social policy and law in a large number of industrialized countries.

Introduction: making the invisible visible -- The nobility of the material -- Research at war -- The guilded age of research -- The doctor as whistle-blower -- New rules for the laboratory -- Bedside ethics -- The doctor as stranger -- Life through death -- Commissioning ethics -- No one to trust -- New rules for the bedside -- Epilogue: The price of success.

Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while also explaining why (...) trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines. (shrink)

Truth, Trust and Medicine investigates the notion of trust and honesty in medicine, and questions whether honesty and openness are of equal importance in maintaining the trust necessary in doctor-patient relationships. Jackson begins with the premise that those in the medical profession have a basic duty to be worthy of the trust their patients place in them. Yet questions of the ethics of withholding information and consent and covert surveillance in care units persist. This book boldly addresses these questions which (...) disturb our very modern notions of a patient's autonomy, self-determination and informed consent. (shrink)

Is it ethical to deceive the individuals who participate in psychological experiments for methodological reasons? We argue against an absolute ban on the use of deception in psychological research. The potential benefits of many psychological experiments involving deception consist in allowing individuals and society to gain morally significant self-knowledge that they could not otherwise gain. Research participants gain individual self-knowledge which can help them improve their autonomous decision-making. The community gains collective self-knowledge that, once shared, can play a role in (...) shaping education, informing policies and in general creating a more efficient and just society. (shrink)