Goal-based research ethics | |
Ethics of medical research on humans. Claire Foster. Cambridge: Cambridge University Press, 2001 (xiii + 159 pp). ISBN 0 521 64573 5. |
Why is it
that those who favour the use of embryonic stem cells in medical research and those who oppose it never seem to engage with each other? One reason is that, while the former focus on the goals of such research (the potential therapeutic benefits to people suffering from a range of debilitating conditions), the latter focus on what the research involves (the destruction of human embryos). Clare Foster is interested primarily in the ethics of research conducted by doctors on their patients. She argues that there are three things which must be taken into account if a proper decision is to be made about whether research is ethical: (1) the goals, (2) what the research involves and (3) the rights of the patient-subjects. She calls these three things "science", "best interests" and "autonomy". The assessment of "science" includes a consideration of the importance of the goals, the motives of the researcher, the appropriateness of methods to be used, and the extent to which the researcher has considered how the knowledge gained will translate into practice. An assessment of "best interests" must start from the difference between therapeutic and non-therapeutic research. Ethical research should also include a respect for the "autonomy" of the subject, and needs to grapple with the difficulties of obtaining genuinely informed and genuinely voluntary consent, and also of maintaining patient confidentiality. I would recommend this book to members and prospective members of human research ethics committees — they could learn a lot from it about how best to respond to the challenges that will face them. However, I cannot recommend it to students of moral philosophy. I fear that its discussion of "goal-based" approaches to ethics may add to the conceptual confusion, in the culture generally and in the medical literature, about the "outcomes" of our actions. Goals are not the same kind of "outcomes" as consequences. Often in medicine, as in ordinary life, the distinction between that which I strive for (my goal) and that which I foresee but do not intend (the unintended consequences) is ethically crucial. Bernadette M Tobin
|