It has long been taken for granted that clinical research involving human subjects is ethical only if it holds out the prospect of producing socially valuable knowledge. Recently, this social value requirement has come under scrutiny, with prominent ethicists arguing that the social value requirement cannot be substantiated as an ethical limit on clinical research, and others attempting to offer new support. In this paper, I argue that both criticisms and existing defenses of the social value requirement are predicated on (...) what I call the “transactional model of stakeholder obligations”. I go on to problematize this framework, and to introduce an alternative framework for conceptualizing ethical obligations within clinical research. In defending this framework, which I call the “basic structure model of stakeholder obligations”, I also demonstrate how it provides a stronger grounding for the social value requirement that is not vulnerable to critiques grounded in the transactional model. (shrink)

Pratt, Zion, and Loff (2012) correctly point out that most international clinical research (ICR) is not intended to address the vast inequities in access to health care between developed and develo...

Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value (...) judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call “deliberative pathologies,” or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research. (shrink)

What are the effects of deliberation about political issues by likeminded people? An experimental investigation involving two deliberative exercises, one among self-identified liberals and another among self-identified conservatives, showed that participants' views became more extreme after deliberation. Deliberation also increased consensus and significantly reduced diversity of opinion within the two groups. Even anonymous statements of personal opinion became more extreme and homogeneous after deliberation.

Philosophers who have written about implicit bias have claimed or implied that individuals are not responsible, and therefore not blameworthy, for their implicit biases, and that this is a function of the nature of implicit bias as implicit: below the radar of conscious reflection, out of the control of the deliberating agent, and not rationally revisable in the way many of our reflective beliefs are. I argue that close attention to the findings of empirical psychology, and to the conditions for (...) blameworthiness, does not support these claims. I suggest that the arguments for the claim that individuals are not liable for blame are invalid, and that there is some reason to suppose that individuals are, at least sometimes, liable to blame for the extent to which they are influenced in behaviour and judgment by implicit biases. I also argue against the claim that it is counter-productive to see bias as something for which individuals are blameworthy; rather, understanding implicit bias as something for which we are liable to blame could be constructive. (shrink)

Sunstein argues that democratic theory has recently rested its normative claims on a vast but empirically uninformed optimism about the ability of collective deliberation to lead to morally and rationally better decisions. Once that question is considered empirically, he argues, deliberation turns out to be mixed at best, and a disaster at worst. I want to suggest that Sunstein exaggerates the claims of the deliberative democrats, and interprets the empirical literature against deliberation in a way that appears, even based on (...) his own descriptions of the studies, to be unfairly biased against the value of deliberation. (shrink)

Deliberative democracy is now an influential approach to the study of democracy and political behaviour. Its key proposition is that, in politics, it is not only power that counts, but good discussions and arguments too. This book examines the interplay between the normative and empirical aspects of the deliberative model of democracy. Jürg Steiner presents the main normative controversies in the literature on deliberation, including self-interest, civility and truthfulness. He then summarizes the empirical literature on deliberation and proposes methods by (...) which the level of deliberation can be measured rather than just assumed. Steiner's empirical research is based in the work of various research groups, including experiments with ordinary citizens in the deeply divided societies of Colombia, Bosnia-Herzegovina and Belgium, as well as Finland and the European Union. Steiner draws normative implications from a combination of both normative controversies and empirical findings. (shrink)

The maze and the masses -- Democracy as the rule of the dumb many? -- A selective genealogy of the epistemic argument for democracy -- First mechanism of democratic reason: inclusive deliberation -- Epistemic failures of deliberation -- Second mechanism of democratic reason: majority rule.

Khader offers a deliberative perfectionist approach to identifying and responding to adaptive preferences-- deprived people's preferences that perpetuate their deprivation.

Revisioning macro-democratic processes in light of the processes and promise of micro-deliberation, Innovating Democracy provides an integrated perspective on democratic theory and practice after the deliberative turn.

This book describes a new method of consulting the public that has been tried successfully around the world. The book combines the theory of democracy with actual practice. Fishkin lays out a theory of "deliberative democracy" and shows with practical examples, how it can be realized.