The moral philosophy of the first half of the twentieth century, at least in the English-speaking part of the world, has been largely devoted to problems of an ontological or epistemological nature. This concentration of effort by many acute analytical minds has not produced any general agreement with respect to the solution of these problems; it seems likely, on the contrary, that the wealth of proposed solutions, each making some claim to plausibility, has resulted in greater disagreement than ever before, (...) and in some cases disagreement about issues so fundamental that certain schools of thought now find it unrewarding, if not impossible, to communicate with one another. Moral philosophers of almost all schools seem to agree, however, that no major possibility has been neglected during this period, and that every proposed solution which can be adjudged at all plausible has been examined with considerable thoroughness. It is now common practice, for example, for the authors of books on moral philosophy to introduce their own theories by what purports to be a classification and review of all \emph{possible} solutions to the basic problems of analysis; and in many cases, indeed, the primary defense of the author's own position seems to consist in the negative argument that his own position cannot fail to be correct because none of the others which he has mentioned is satisfactory. (shrink)

: Despite its mandate on minimizing harms in clinical trials, the Common Rule provides little guidance as to how IRBs should evaluate risk. The Common Rule and derivative commentaries tend to conceptualize risk review as an expert-based endeavor aimed at an objective and universal evaluation of possible harm; they also have tended to locate risk in the research activity itself rather than in the context of the research. These views of risk conflict with scholarship showing that risk evaluations are socially (...) determined even among experts, that the context of harms can influence how persons evaluate risks, and that forums that approach risk assessment as a technical endeavor bracket from discussion the numerous values that ground risk judgments. Possible reforms are proposed for clinical trial risk review that would render it more inclusive of the different types of risks encountered and more attuned to the priorities of trial subjects. (shrink)

I distinguish between risks in which most people will do badly from those in which few will, though some will do very badly.