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The Ethics of Medical Research

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Medical Research Ethics: Challenges in the 21st Century

Part of the book series: Philosophy and Medicine ((volume 132))

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Abstract

The most basic question any medical researcher should ask oneself is: Why ought I engage in medical research? Like any ethical question, there are valid and invalid answers to it. These answers are the reasons why one should engage in this enterprise. There seem to be three such reasons. (1) Since the subjects of medical research are fellow human beings and it is for their sake medical research is to be conducted, one’s first valid reason for engaging in medical research is that this research is primarily for their good, both individually and collectively. Using human subjects for any purpose other than their good is an immoral practice, hence any reason for it is ethically invalid. (2) Since medical research is science, one’s second valid reason for engaging in medical research is the pursuit of truth. Falsification of data or drawing deceitful conclusions from data is an immoral practice, hence any reason for it is ethically invalid. In order for one’s scientific research to be trusted as true, we have to be convinced that the researchers sharing it with us are truthful. (3) Since medical researchers are members of a scientific community already operating before they entered it, their research is their participation in a public discourse where the questions to which their research is a response have already been raised. As such, medical researchers are responsible for the common good of the scientific community by sharing their research with the community that has enabled researchers to supply answers to common scientific questions through their own research. This is the third valid reason for engaging in medical research. Taking the content of one’s research as one’s private property to be done with however one pleases is an immoral practice, hence any reason for it is ethically invalid. This chapter will explore these three questions more fully and, it is hoped, will supply some ethically convincing arguments for what is outlined above.

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Notes

  1. 1.

    In Nicomachean Ethics, 1.1/1094a1-10, trans. J. A. K. Thomson (London: Penguin Classics, 1955), p. 3, Aristotle writes: “The good has been defined as that at which all things aim. … there is some difference between the ends [telōn] at which they aim: some are activities [energeia] and others results distinct from the actions [ta erga]. When there are ends distinct from the actions, the results are by nature superior to the activities. … the end of medical science is health.” Now health is the result of medicine being done successfully. That is its intrinsic end, the reason for which medicine is practiced. It is also a transaction that is intended to affect somebody else by healing them, i.e., by making them healthy. However, if medicine is practiced (either directly in a clinic or indirectly in a research laboratory) primarily for the sake of its extraneous results (e.g., recognition by others of one’s high social status as a medical researcher), then it is invalid ethically (although not necessarily immoral).

  2. 2.

    Like Aristotle, Kant too is unconcerned with the objective consequences of an ethically valid act, which is obedience to what he calls a “categorical imperative.” The act’s ethical validity, its goodness, is subjective, i.e., “[it] consists in the mental disposition [Gesinnung], let the consequences [der Erfolg] be what they may.” Groundwork of the Metaphysic of Morals, AK4:416, trans. H. J. Paton (New York: Harper and Row, 1964), p. 84.

  3. 3.

    See Novak (2020).

  4. 4.

    See Nicomachean Ethics, 1.5/1095b15-1096a10; also, 5.5/1133b10-20.

  5. 5.

    See Groundwork of the Metaphysic of Morals, AK4:421.

  6. 6.

    See Nicomachean Ethics, 1.8/1099b1-5.

  7. 7.

    The French Catholic philosopher Jacques Maritain (d. 1973) expressed this very well in his Existence and the Existent, trans. L. Gallantiere and G. B. Phelan (Garden City, NY: Doubleday, 1956), p. 21: “Veritas sequitur esse rerum... Truth follows upon the existence of things … Truth is the adequation of the immanence in the act of our thought with that which exists outside our thought … which corresponds to the existence exercised or possessed by that other in the particular field of intelligibility which is its peculiar possession.”

  8. 8.

    The German Jewish philosopher Hermann Cohen (d. 1918) expressed this very well in his Religion of Reason Out of the Sources of Judaism, trans. S. Kaplan (New York: Frederick Ungar, 1972), pp. 421–22: “Truthfulness [die Wahrhaftigkeit] presupposes a foundation of truth [die Wahrheit] upon which it rests... the duty [die Pflicht] of truthfulness is enjoined in the Pentateuch by the prohibition of lying (Exod. 23:7)... it is also said positively: ‘Speak the truth [dabru emet] to one another’ (Zech. 8:16).”.

  9. 9.

    See en.wikipedia.org/primum_non_nocere—Also, the great compendium of Roman law, the Code of Justinian begins with a definition of justice, one of whose three pillars is the norm “not to harm others” (alterum non laedere).

  10. 10.

    See Novak (2007).

  11. 11.

    See Popper (1992).

  12. 12.

    Aristotle, Politics, 1.1/1253a1-20. Ludwig Wittgenstein, Philosophical Investigations, 2nd ed., trans. G. E. M. Anscombe (New York: Macmillan, 1958), 1.256–69.

  13. 13.

    See Habermas (1984).

  14. 14.

    Plato, Republic, 414C–415C. For a powerful philosophical critique of Plato, especially on this point, see Popper (1966).

  15. 15.

    See Habermas (1993).

  16. 16.

    See Plato, Republic, 338C–339A.

  17. 17.

    Nicomachean Ethics, 3.2/1111b20-30.

  18. 18.

    A Treatise of Human Nature, 2.3.1.

  19. 19.

    See Barth (1960).

  20. 20.

    Esther 4:14; Ps. 27:13–14 and 84:6–8; Job 19:25.

  21. 21.

    Babylonian Talmud: Shabbat 88a re Exod. 24:7.

  22. 22.

    See Novak (1995).

  23. 23.

    Babylonian Talmud: Nazir 23b.

  24. 24.

    Maimonides, Mishneh Torah: Blessings, 11.2.

  25. 25.

    Babylonian Talmud: Nedarim 7b-8a re Ps. 119:106.

  26. 26.

    Mishneh Torah: Kings, 8.11.

  27. 27.

    See Palestinian Talmud: Sukkah 3.4/53d.

  28. 28.

    Babylonian Talmud: Baba Batra 12b.

  29. 29.

    Mishneh Torah: Mourning, 14.1.

  30. 30.

    Mishneh Torah: Mourning, 14.4–6.

  31. 31.

    Mishnah: Rosh Hashanah 3.7–8.

  32. 32.

    Commentary on the Torah: Lev. 26:11 re Babylonian Talmud: Baba Kama 85a re Exod. 15:26 and 21:19, quoted in Novak (1992).

  33. 33.

    Sotah 14a re Deut. 13:5 and Gen. 18:1.

  34. 34.

    Babylonian Talmud: Berakhot 34b.

  35. 35.

    Mishnah: Avot 2.1 and 2.16.

  36. 36.

    Babylonian Talmud: Kiddushin 54a.

  37. 37.

    Babylonian Talmud: Rosh Hashanah 4b.

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Correspondence to David Novak .

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Novak, D. (2023). The Ethics of Medical Research. In: Zima, T., Weisstub, D.N. (eds) Medical Research Ethics: Challenges in the 21st Century. Philosophy and Medicine, vol 132. Springer, Cham. https://doi.org/10.1007/978-3-031-12692-5_2

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