Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

Increasingly in the modern world, incentives are becoming the tool we reach for when we wish to bring about change. In government, in education, in health care, between and within institutions of all sorts, incentives are offered to steer people's choices in certain directions. But despite the increasing interest in ethics and economics, the ethics of the use of incentives has raised very little concern. From a certain point of view, this is not surprising. When incentives are viewed from the (...) perspective of market economics, they appear to be entirely unproblematic. An incentive is an offer of something of value, sometimes with a cash equivalent and sometimes not, meant to influence the payoff structure of a utility calculation so as to alter a person's course of action. In other words, the person offering the incentive means to make one choice more attractive to the person responding to the incentive than any other alternative. Both parties stand to gain from the resulting choice. In effect, it is a form of trade, and as such, it meets certain ethical requirements by definition. A trade involves voluntary action by all parties concerned to bring about a result that is beneficial to all parties concerned. If these conditions were not met, the trade would simply not occur. And as inducements in a voluntary transaction, incentives certainly have the moral high ground over coercion as an alternative. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

This anthology represents all of the most important points of view on the most pressing topics in bioethics. Containing current essays and actual medical and legal cases written by outstanding scholars from around the globe, this book provides readers with diverse range of standpoints, including those of medical researchers and practitioners, legal exerts, and philosophers.

A Decent Proposal: Ethical Review of Clinical Research Donald Evans and Martyn Evans Centre for Philosophy and Health Care University of Wales Swansea, UK The investigation and development of modern medicines and medical technology can create numerous ethical dilemmas both for clinical researchers and research ethics committees. A Decent Proposal: Ethical Review of Clinical Research seeks to facilitate and encourage good clinical research by exploring the concerns, responsibilities, general issues and particular pitfalls associated with ethical aspects of research. It provides (...) practical guidelines for researchers on how to improve the quality of research design, while for those appointed to scrutinise research proposals it offers advice on how to apply consistent, careful and critical reasoning to the process of assessing ethical standards. As such, it will provide invaluable assistance to clinical researchers and ethics committees alike in understanding the moral challenges posed by modern health care. (shrink)

Controversial and amusing, this collection of Kennedy's writings illuminates the rights, duties, and liabilities of doctors as well as other aspects of medical law and ethics.

This book, like the practice of medicine itself, is about the value of life. Health care is one of the clearest and most visible expressions of a society's ...

As each week beings more stories of doctors, lawyers and other professionals abusing their powers, while clients demand extra services as at a time of shrinking resources; it is imperative that all practising professionals have an understanding of professional ethics. In _The Ground of Profesional Ethics_, Daryl Koehn discusses the practical issues in depth, such as the level of service clients can justifiably expect from professionals, when service to a client may be legitimately terminated and circumstances in which client confidences (...) can be broken. She argues that, while clients may legitimately expect professionals to promote their interests, professionals are not morally bound to do whatever a client wants. _The Ground of Professional Ethics_ is important reading for all practising professionals, as well as those who study or have an interest in the subject of professional ethics. (shrink)

This new edition of Law and Medical Ethics continues to chart the ever-widening field that the topics cover. The interplay between the health caring professions and the public during the period intervening since the last edition has, perhaps, been mainly dominated by wide-ranging changes in the administration of the National Health Service and of the professions themselves but these have been paralleled by important developments in medical jurisprudence.

This paper argues against paying people to participate in research. Volunteering to participate as a subject in a research program is not like taking a job. The main difference is to do with the risks inherent in research. Experimentation on human beings is, by definition, trying out something with an unknown consequence and exposes people to risks of harm which cannot be known in advance. This is the main reason for independent review by committee of research programs. It is based (...) on a recognition that researchers are not always capable of putting the interests of their subjects ahead of their research objectives. It is not simply a matter of individual autonomy. Society has an obligation, prior to the protection of individual freedom and autonomy, to establish basic safeguards that are equitable in their operation. Any inducement for participating in research would add to the difficulty subjects have in adequately assessing the risks of participating in research. An acceptance of inducement to participate in research would further increase the inequity of research conducted on the impecunious for the benefit of the well‐off. (shrink)

This paper argues against paying people to participate in research. Volunteering to participate as a subject in a research program is not like taking a job. The main difference is to do with the risks inherent in research. Experimentation on human beings is, by definition, trying out something with an unknown consequence and exposes people to risks of harm which cannot be known in advance. This is the main reason for independent review by committee of research programs. It is based (...) on a recognition that researchers are not always capable of putting the interests of their subjects ahead of their research objectives. It is not simply a matter of individual autonomy. Society has an obligation, prior to the protection of individual freedom and autonomy, to establish basic safeguards that are equitable in their operation. Any inducement for participating in research would add to the difficulty subjects have in adequately assessing the risks of participating in research. An acceptance of inducement to participate in research would further increase the inequity of research conducted on the impecunious for the benefit of the well‐off. (shrink)

In a series of articles, I set out my belief that investigators and subjects of research should work together in a partnership based in shared aims. Such a relationship – quite different from what is usual today – would impose duties on both partners. In earlier papers I explored the origin and nature of the duties that would fall on patients; here I examine their limits.

On the basis of critical discussions which have taken place in recent years in the Federal Republic of Germany, certain methodological, ethical and legal problems arising in relation to controlled trials are discussed. Because of methodological inconsistencies inherent in the experimental approach, the efficacy of a drug must in any case be judged by physicians. This leads to major ethical and even--at least in Germany--legal problems which impose considerable limits on the feasibility of controlled trials in Germany. Editor's note: This (...) paper is written at the invitation of the journal, following the considerable controversy on the ethics of clinical trials in the European Journal of Clinical Pharmacology (8-11). A critical commentary follows the paper with a short response from the authors and a further response from the commentator. (shrink)

In a series of articles, I argue for a different relationship between investigators and subjects of clinical research – one that is based on partnership in shared aims. This would require significant behavioural change since any relationship of this nature requires each partner to recognise their duties within it. This third essay examines the duties that would fall on patients in this partnership.