- Conducting Biomedical Research in Extreme Scarcity:What Theory of Justice Should Apply when the Sponsor is an Industry or a Rich Country?
Allen Andrew A. Alvarez is Assistant Professor of Philosophy at the University of the Philippines in Diliman. He has published research papers on preintrinsic necessity, vital needs, and an encyclopaedia entry on rationing. He has also published articles on empirical ethics, Filipino concepts of disease and illness, and research ethics. His current research interests include human enhancement ethics and the dynamics of cross-cultural deliberation on the ethical implications of new technologies.
1. Macklin, R. (2004) Double standards in medical research in developing countries, Cambridge University Press, Cambridge, 82-6. This work is a key reference in the discussion of research ethics in developing countries. Chapter 3 addresses, in detail, the concept of distributive justice in the context of international research and examines how international guidelines deal with questions of justice. Chapter 4 examines the related concept of exploitation in research and grounds for having justice-related worries. Chapter 7 analyses related obligations from the point of view of human rights, including a discussion on what international human rights instruments say about distributive justice.
2. A more detailed discussion of the egalitarian view as applied to a broader discussion of distributive justice in health beyond the context of biomedical research can be found in A.A.A. Alvarez (2009) Threshold Considerations: The Ethics of Healthcare Rationing in Extreme Scarcity. In Department of Philosophy, University of Bergen, Bergen, xiv, 302. An article length discussion of this also appeared in A.A.A. Alvarez (2007) Threshold considerations in fair allocation of health resources: justice beyond scarcity, Bioethics, 21, 426-38.
3. Parfit, D. (1997) Equality and Priority, Ratio, 10, 202-21.
4. Alvarez, A.A.A. (2007) Threshold considerations in fair allocation of health resources: justice beyond scarcity, Bioethics, 21, 426-38.
5. This mainly refers to what can be considered as compensation. Any payment for participation could pose the danger of undue inducement or making participation too attractive as to undermine its voluntariness and/or cause the participant to take too much risk that she would otherwise avoid if not for the undue attraction afforded by the prospect of compensation. What is normally acceptable is providing for expenses related to participation in a trial, e.g. transportation, food, etc. This does not mean that it is absolutely prohibited to provide benefits beyond enabling participation. Of course, such benefits could be provided when appropriate. The relevant point made here is that such benefits may not be imposed as obligation and should not be given if it undermines the voluntariness of participation.
6. Lucero, M.G., H. Nohynek, G. Williams, V. Tallo, E.A.F. Simões, S. Lupisan, D. Sanvictores, S. Forsyth, T. Puumalainen, J. Ugpo, M. Lechago, M. de Campo, E. Abucejo-Ladesma, L. Sombrero, A. Nissinen, A. Soininen, P. Ruutu, I. Riley, and H.P. Mäkelä (2009) Efficacy of an 11-Valent Pneumococcal Conjugate Vaccine Against Radiologically Confirmed Pneumonia Among Children Less Than 2 Years of Age in the Philippines: A Randomized, Double-Blind, Placebo-Controlled Trial, The Pediatric Infectious Disease Journal, 28, 455-62, 410.1097/INF.1090b1013e31819637af.
10. Despite some isolated claims that children are in some sense competent to make moral decisions (for example, see Mayall, B.  Towards a sociology for childhood: thinking from children's lives, Open University Press, Buckingham, UK., as cited in Frankel, S.  Researching Children's Morality: developing research methods that allow children's involvement in discourses relevant to their everyday lives, Childhoods Today: An online journal for childhood studies, 1, 4, Mayall, B.  The Sociology of Childhood in Relation to Children's Rights, Int'l J Child Rts, 8, 243-59), it is widely accepted that very young children are not yet able to make their own decisions or give consent, and are thus, not yet fully competent to be considered moral agents in the usual sense (see Gert, B.  Morality: Its nature and justification, Oxford University Press, New York, 142-3). Nevertheless, even if we assume that very...