Bioethics Lecture 4: Research Ethics part 1
The basic issue is that to use medicine responsibly and effectively, you need information
about the dangers and benefits of treatments (drugs, surgical techniques, devices, other
treatments such as radiation, etc.). But to gather this information, you have to try the
, without fully knowing the dangers and benefits. (testing on non-
human animals is helpful but not definitive). This always means subjecting participants in
studies to some risk.
There are clear bad cases, such as the Nazi concentration camp experiments, in which
peoples bodies were damaged intentionally to test the effectiveness of medical
treatments. (Other experiments included testing poisons and weapons on people to see
how effective these were at killing). (Background: systematic extermination by Nazi
Germany of 11-17 million ethnic, religious and political prisoners)
What was bad about these experiments? At least the following:
-These people clearly had no choice in the matter; their autonomy was not
-Their suffering and danger was treated as if it had no importance.
-The value of the information was not worth the suffering caused by the
-Harm was inflicted intentionally.
Violates: Principle of non-maleficence, principle of utility, and principle of autonomy.
To be ethical, experiments must be done responsibly: minimizing risk, balancing risk
against beneficial information gained, and respecting autonomy of patients. These ideas
are simple in principle, but there are tricky issues applying them.
First Face Transplant:
Isabelle Denoire took sleeping pills (suicide attempt?), passed out, and a dog chewed off
her face, to the point where not only was she horribly disfigured, but couldn’t speak or
eat normally. Doctors decided reconstructive surgery could not fix the problem, so they
would try a partial face transplant, which had never been done.
The doctors told her that there was a %33 chance the surgery would work, %33 the