The surge in genetic research and technology, fuelled in large part by the Human Genome Project, has resulted in the continuing expansion of the range of genetic tests and other genetic information available to physicians, insurance companies, employers, and the general public.’ Genetic tests can provide presymptomatic medical information about an individual, including information about an individual's increased risk of future disease, disability, or early death. These tests can reveal information about an individual's carrier status, that is, the likelihood of (...) parents passing on to their children a genetic condition, and about the health of the individual's family members. Although genetic information provides the promise of early detection and treatment of certain illnesses and disorders, it also poses risks. As a result of the increase in genetic testing and information, legal issues regarding employment discrimination on the basis of genetic information are emerging. (shrink)

The surge in genetic research and technology, fuelled in large part by the Human Genome Project, has resulted in the continuing expansion of the range of genetic tests and other genetic information available to physicians, insurance companies, employers, and the general public.’ Genetic tests can provide presymptomatic medical information about an individual, including information about an individual's increased risk of future disease, disability, or early death. These tests can reveal information about an individual's carrier status, that is, the likelihood of (...) parents passing on to their children a genetic condition, and about the health of the individual's family members. Although genetic information provides the promise of early detection and treatment of certain illnesses and disorders, it also poses risks. As a result of the increase in genetic testing and information, legal issues regarding employment discrimination on the basis of genetic information are emerging. (shrink)

A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

This article considers the future of genetic testing and disiblity insurance, and explores the potential for discrimination when using genetic information.

As we enter the new century, humanity wields increasing power to understand, alter, and control the world in which we live. The mysteries of our genetic code provide remarkable new insights into our unique human characteristics. Rapid developments in information technology provide instant access to limitless data. The information age has taken hold, and the genetic revolution is in full swing. With apologies to Aldous Huxley, we stand at the precipice of a brave new world.It has been just 50 years (...) since James Watson and Francis Crick's groundbreaking discovery of the double helix. Since then, profound developments in the science of genetics have been staggering. More staggering still are the potential benefits, the boundless horizons, the promised and unimagined applications of their work, and the work of the many scientists involved in the sequencing of the human genome. There can be no doubt that a firm and unwavering commitment to the betterment of humankind has fueled this tireless effort. (shrink)

Despite the importance of extrapair copulation (EPC) in human evolution, almost nothing is known about the design features of EPC detection mechanisms. We tested for sex differences in EPC inference-making mechanisms in a sample of 203 young couples. Men made more accurate inferences (φmen = 0.66, φwomen = 0.46), and the ratio of positive errors to negative errors was higher for men than for women (1.22 vs. 0.18). Since some may have been reluctant to admit EPC behavior, we modeled how (...) underreporting could have influenced these results. These analyses indicated that it would take highly sex-differentiated levels of underreporting by subjects with trusting partners for there to be no real sex difference. Further analyses indicated that men may be less willing to harbor unresolved suspicions about their partners’ EPC behavior, which may explain the sex difference in accuracy. Finally, we estimated that women underreported their own EPC behavior (10%) more than men (0%). (shrink)

: The "therapeutic misconception," described by Paul Appelbaum and colleagues more than 20 years ago, refers to the tendency of participants in clinical trials to confuse the design and conduct of research with personalized medical care. Although the "therapeutic misconception" has become a term of art in research ethics, little systematic attention has been devoted to the ethical significance of this phenomenon. This article examines critically the way in which Appelbaum and colleagues formulate what is at stake in the (...) therapeutic misconception, paying particular attention to assumptions and implications that clinical trial participation disadvantages research participants as compared with receiving standard medical care. After clarifying the ethical significance of the therapeutic misconception with respect to the decision making of patients, we offer policy recommendations for obtaining informed consent to participation in clinical trials. (shrink)

Classics of Political and Moral Philosophy provides in one volume the major writings from nearly 2,500 years of political and moral philosophy. The most comprehensive collection of its kind, it moves from classical thought (Plato, Aristotle, Epicurus, Cicero) through medieval views (Augustine, Aquinas) to modern perspectives (Machiavelli, Hobbes, Spinoza, Locke, Rousseau, Hume, Adam Smith, Kant). It includes major nineteenth-century thinkers (Hegel, Bentham, Mill, Nietzsche) as well as twentieth-century theorists (Rawls, Nozick, Nagel, Foucault, Habermas, Nussbaum). Also included are numerous essays from (...) The Federalist Papers and a variety of notable documents and addresses, among them Pericles' Funeral Oration, the Declaration of Independence, the Constitution of the United States, and speeches by Edmund Burke, Abraham Lincoln, Elizabeth Cady Stanton, John Dewey, and Martin Luther King, Jr. The readings are substantial or complete texts, not fragments. An especially valuable feature of this volume is that the works of each author are introduced with a substantive and engaging essay by a leading contemporary authority. These introductions include Richard Kraut on Plato, Aristotle, Epicurus, and Cicero; Paul J. Weithman on Augustine and Aquinas; Roger D. Masters on Machiavelli; Jean Hampton on Hobbes; Steven B. Smith on Spinoza and Hegel; A. John Simmons on Locke; Joshua Cohen on Rousseau and Rawls; Donald W. Livingston on Hume; Charles L. Griswold, Jr., on Smith; Bernard E. Brown on Hamilton and Madison; Jeremy Waldron on Bentham and Mill; Paul Guyer on Kant; Richard Miller on Marx and Engels; Richard Schacht on Nietzsche; Thomas Christiano on Nozick; John Deigh on Nagel; Thomas A. McCarthy on Foucault and Habermas; and Eva Feder Kittay on Nussbaum. Offering unprecedented breadth of coverage, Classics of Political and Moral Philosophy is an ideal text for courses in social and political philosophy, moral philosophy, or surveys in Western civilization. (shrink)

Ideal for survey courses in social and political philosophy, this volume is a substantially abridged and slightly altered version of Steven M. Cahn's Classics of Political and Moral Philosophy (OUP, 2001). Offering coverage from antiquity to the present, Political Philosophy: The Essential Texts is a historically organized collection of the most significant works from nearly 2,500 years of political philosophy. It moves from classical thought (Plato, Aristotle) through the medieval period (Aquinas) to modern perspectives (Machiavelli, Hobbes, Locke, Rousseau, Hume, (...) Adam Smith, Hamilton and Madison, Kant). The book includes work from major nineteenth-century thinkers (Hegel, Marx and Engels, Mill) and twentieth-century theorists (Rawls, Nozick, Foucault, Habermas, Nussbaum) and also presents a variety of notable documents and addresses, including the Declaration of Independence, the Bill of Rights, and speeches by Abraham Lincoln and Martin Luther King, Jr. The readings are substantial or complete texts, not fragments. An especially valuable feature of this volume is that the works of each author are introduced with an engaging essay by a leading contemporary authority. These introductions include Richard Kraut on Plato and Aristotle; Paul J. Weithman on Aquinas; Roger D. Masters on Machiavelli; Jean Hampton on Hobbes; A. John Simmons on Locke; Joshua Cohen on Rousseau and Rawls; Donald W. Livingston on Hume; Charles L. Griswold, Jr., on Adam Smith; Bernard E. Brown on Hamilton and Madison; Paul Guyer on Kant; Steven B. Smith on Hegel; Richard Miller on Marx and Engels; Jeremy Waldron on Mill; Thomas Christiano on Nozick; Thomas A. McCarthy on Foucault and Habermas; and Eva Feder Kittay on Nussbaum. (shrink)

: Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor-patient relationship.

Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor‐patient relationship.

Classics of Political and Moral Philosophy provides in one volume the major writings from nearly 2,500 years of political and moral philosophy, from Plato through the twentieth century. The most comprehensive collection of its kind, it moves from classical thought through medieval views to modern perspectives. It includes major nineteenth-century thinkers and considerably more twentieth-century theorists than are found in competing volumes. Also included are numerous essays from The Federalist Papers and a variety of notable documents and addresses, among them (...) Pericles' Funeral Oration, The Declaration of Independence, The Constitution of the United States, The Declaration of the Rights of Man and of the Citizen, and speeches by Edmund Burke, Abraham Lincoln, Elizabeth Cady Stanton, John Dewey, and Martin Luther King, Jr. The readings are substantial or complete texts, not fragments. The second edition contains two new readings--by Charles Taylor and Virginia Held--and adds The Universal Declaration of Human Rights. It also presents two works by John Locke in their entirety and includes a new translation of Kant's Groundwork for the Metaphysics of Morals.An especially valuable feature of this volume is that the writings of each author are introduced with a substantive and engaging essay by a leading contemporary authority. These introductions include Richard Kraut on Plato, Aristotle, Epicurus, and Cicero; Paul J. Weithman on Augustine and Aquinas; Roger D. Masters on Machiavelli; Jean Hampton on Hobbes; Steven B. Smith on Spinoza and Hegel; A. John Simmons on Locke; Joshua Cohen on Rousseau and Rawls; Donald W. Livingston on Hume; Charles L. Griswold, Jr., on Smith; Bernard E. Brown on Hamilton and Madison; Jeremy Waldron on Bentham and Mill; Paul Guyer on Kant; Richard Miller on Marx and Engels; Thomas Christiano on Nozick; Robert B. Talisse on Charles Taylor; Thomas A. McCarthy on Foucault and Habermas; Cheshire Calhoun on Held; and Eva Feder Kittay on Nussbaum.Offering unprecedented breadth of coverage, Classics of Political and Moral Philosophy, Second Edition, is an ideal text for courses in political philosophy, social and political philosophy, moral philosophy, or surveys in Western civilization. (shrink)

Now greatly expanded in its second edition, Political Philosophy: The Essential Texts is ideal for survey courses in social and political philosophy. Offering coverage from antiquity to the present, this historically organized collection presents the most significant works from nearly 2,500 years of political philosophy. It moves from classical thought through the medieval period to modern perspectives. The book includes work from major nineteenth-century thinkers and twentieth-century theorists and also presents a variety of notable documents and addresses, including The Declaration (...) of Independence, The Constitution of the United States, The Declaration of the Rights of Man and of the Citizen, The Universal Declaration of Human Rights, and speeches by Pericles, Edmund Burke, Abraham Lincoln, Elizabeth Cady Stanton, and Martin Luther King, Jr. The readings are substantial or complete texts, not fragments. In addition to the new selections noted above in bold, the second edition also includes more essays from Aristotle, Locke, Hume, Smith, Hamilton and Madison, Kant, and Mill. An especially valuable feature of this volume is that the works of each author are introduced with an engaging essay by a leading contemporary authority. These introductions include Richard Kraut on Plato and Aristotle; Paul J. Weithman on Augustine and Aquinas; Roger D. Masters on Machiavelli; Jean Hampton on Hobbes; A. John Simmons on Locke; Joshua Cohen on Rousseau and Rawls; Donald W. Livingston on Hume; Charles L. Griswold, Jr., on Smith; Bernard E. Brown on Hamilton and Madison; Paul Guyer on Kant; Steven B. Smith on Hegel; Richard Miller on Marx and Engels; Jeremy Waldron on Mill; Thomas Christiano on Nozick; Robert B. Talisse on Taylor; Thomas A. McCarthy on Foucault and Habermas; and Cheshire Calhoun on Held. (shrink)

Medical ethics assumes a clear boundary between clinical research and clinical medicine: one produces knowledge for the benefit of future patients, while the other provides optimal care to individuals right now. It also assumes that the two cannot be integrated without sacrificing the needs of the current patient to those of future patients. But integration could allow us to provide better care to everyone, now and in the future.

Drawing the line on physician assistance in physician-assisted death continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill that (...) can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)

In the midst of the recent Ebola outbreak, scientific developments involving infection challenge experiments on nonhuman primates (NHPs) sparked hope that successful treatments and vaccines may soon become available. Yet these studies pose a stark ethical quandary. On the one hand, they represent an important step in developing novel therapies and vaccines for Ebola and the Marburg virus, with the potential to save thousands of human lives and to protect whole communities from devastation; on the other hand, they intentionally expose (...) sophisticated animals to severe suffering and a high risk of death. Other studies that infect NHPs with a lethal disease in order to test interventions that may prove beneficial for humans pose the same ethical difficulty. Some advocates have argued that all research on primates should be phased out, and ethicists have questioned whether a moral justification of primate research is possible. A 2010 European Union directive banned virtually all research on great apes, and 2013 guidelines from the National Institutes of Health (NIH), based upon recommendations in an influential 2011 Institute of Medicine (IOM) report, eliminated most biomedical research with chimpanzees in the United States. But studies involving other NHPs face no comparable restrictions.Should research on NHPs other than great apes be subject to tighter restrictions than it currently is? In this article, we explore this general question in the context of one particular type of biomedical research: infection challenge studies. We advocate a presumptive prohibition on infection challenge experiments in NHPs, but we also argue that exceptions to this prohibition are permissible, subject to strict substantive and procedural safeguards, when necessary to avert substantial loss of human life or severe morbidity for a substantial number of people. (shrink)

The essays in this collection investigate two political traditions and their critical interactions. The first series of essays deals with the development of natural rights individualism, some examining its origins in the thought of the seminal political theorist, John Locke, and the influential constitutional theorist, Montesquieu, others the impact of their theories on intellectual leaders during the American Revolution and the Founding era, and still others the culmination of this tradition in the writings of nineteenth-century individualists such as Lysander Spooner. (...) The second series of essays focuses on the Progressive repudiation of natural rights individualism and its far-reaching effect on American politics and public policy. (shrink)

Psychologists and neuroscientists often struggle to integrate findings in their respective domains, a problem due partly to implicitly and explicitly held philosophical positions on issues of reduction and autonomy across these domains. The present article reviews how reduction and autonomy have been used in philosophical arguments regarding how macro-scale findings relate to micro-scale findings across various scientific disciplines. The present article demonstrates how macro findings are indispensable to explanations of phenomena of interest by (a) providing information regarding higher levels of (...) organization in mechanisms, (b) including information not contained within certain micro explanations that (c) provides more general and stable causal explanations relative to micro explanations in certain situations. The purpose of presenting these analyses and recommendations is to disabuse psychologists and neuroscientists of pervasive assumptions that psychology is reducible to biology and that lower level phenomena (molecular) should be prioritized as somehow more explanatory than higher level phenomena (behavioral). The article concludes with 3 hypothetical scenarios from clinical psychology and psychiatry illustrating this critique and providing a pragmatic approach to clarify the relative roles, and importance, of biological and psychological data in service of general and stable explanations that are tailored to the kind of intervention desired. (shrink)

Examines interrelated topics in Medieval and Renaissance Latin literature: the status of women as writers, the status of women as rhetorical figures, and the status of women in society from the fifth to the early seventeenth century.

In early March 2014, some of the members of Culture on the Edge—a scholarly research collaboration of seven scholars of religion, interested in more theoretically sophisticated studies of identity, and all of whom are at different career stages and at a variety of North American institutions—had a conversation online on the use of the terms “critique” and “critical,” terms widely used in the field today but employed in such a variety of ways that the members of the group thought it (...) worthwhile to focus some attention on them. What follows is the transcript of their conversation. (shrink)

The first full treatment of truth as a core philosophical concept in the late Foucault, this volume examines his work on the ancient world and the early church. Each essay features a deep examination as to how the topics of truth and sexuality intersect with and focus on Foucault's engagement with ancient philosophy and thought. Truth in the Late Foucault offers readings on Plato, Artemidorus, Cicero, Sophocles and the Stoics, and pays close attention to Cassian, Paulinus of Nola, and early (...) Christian practices of confession. (shrink)

Statues also die -- Open letter to the enemy : Jean Genet, war, and the exact measure of man -- Mayhem : symbolic violence and the culture of the death drive -- War, word, worst : reading Samuel Beckett's worstward ho -- Translation of a system in deconstruction : Derrida and the war of language against itself.

In 1980, Michel Foucault's work makes two decisive turns. On the one hand, as announced at the start of his course at the Collège de France for that year, Le Gouvernement des vivants, his topic will be the modalities through which power constitutes itself in relation to truth. On the other hand, the texts on which he will concentrate will no longer be those of the early modern period. Rather, he begins with one by Dio Cassius on the emperor Septimius (...) Severus and then proceeds to spend the next two sessions offering a reading of Oedipus Tyrannus. He will concentrate on works from antiquity for the rest of his life. This book will offer the first detailed account of these lectures, examining both the development of their philosophical argument and the ancient texts on which that argument is based. This is the period during which Foucault also began work on Volumes 2 and 3 of the History of Sexuality. Yet, while there are clear overlaps between the work he was presenting in his course and the last books he published before his death, nonetheless the seminars are anything but rough drafts for the published work. Instead they offer a sustained encounter with the texts of the classical and early Christian era while seeking to trace a genealogy of the western subject as a speaker of truth. (shrink)

Since publication of the 1986 Carnegie Commission report, A Nation Prepared: Teachers for the 21st Century, the professional teaching standards movement has gained noticeable momentum. The professional standards movement in teaching has been fueled by national organizations such as the National Council for Accreditation of Teacher Education, the Interstate New Teachers Assessment and Support Consortium, the National Board for Professional Teaching Standards, the National Commission on Teaching and America's Future, and by close collaboration among these four entities. Further, nearly all (...) of the fifty states are embracing the professional standards movement through formal participation in the work of one or more of these organizations. Although the professional standards movement in teaching is strong and growing stronger, its implications are not clear for instructional programs in social foundations of education, either at the teacher preparation or the advanced graduate levels. In response to the standards movement, social foundations educators have a number of options before them, three of which are to (1) largely ignore these developments, as "this too shall pass"; (2) critically interpret and resist these developments through scholarship and collective professional action, as social foundations scholars did with Competency Based Teacher Education in the 1970s; and (3) critically interpret these developments while working to strengthen the potential of the professional teaching standards movement to achieve its stated goal of providing caring and qualified teachers for every classroom in the nation. Of these three options, the last is most advisable, but it presents a considerable challenge to social foundations educators. Although the absence of social foundations skills, perspectives, and understanding should make it very difficult for teacher candidates and teachers to perform well on standards-based teaching assessments, there is no guarantee that these assessments will hold candidates accountable for social foundations learning. Implications for social foundations educators and activists are significant. (shrink)

Many people have argued that the evolution of the human language faculty cannot be explained by Darwinian natural selection. Chomsky and Gould have suggested that language may have evolved as the by-product of selection for other abilities or as a consequence of as-yet unknown laws of growth and form. Others have argued that a biological specialization for grammar is incompatible with every tenet of Darwinian theory – that it shows no genetic variation, could not exist in any intermediate forms, confers (...) no selective advantage, and would require more evolutionary time and genomic space than is available. We examine these arguments and show that they depend on inaccurate assumptions about biology or language or both. Evolutionary theory offers clear criteria for when a trait should be attributed to natural selection: complex design for some function, and the absence of alternative processes capable of explaining such complexity. Human language meets these criteria: Grammar is a complex mechanism tailored to the transmission of propositional structures through a serial interface. Autonomous and arbitrary grammatical phenomena have been offered as counterexamples to the position that language is an adaptation, but this reasoning is unsound: Communication protocols depend on arbitrary conventions that are adaptive as long as they are shared. Consequently, language acquisition in the child should systematically differ from language evolution in the species, and attempts to analogize them are misleading. Reviewing other arguments and data, we conclude that there is every reason to believe that a specialization for grammar evolved by a conventional neo-Darwinian process. (shrink)

1 Adaptationism is a research strategy that seeks to identify adaptations and the specific selective forces that drove their evolution in past environments. Since the mid-1970s, paleontologist Stephen J. Gould and geneticist Richard Lewontin have been critical of adaptationism, especially as applied toward understanding human behavior and cognition. Perhaps the most prominent criticism they made was that adaptationist explanations were analogous to Rudyard Kipling's Just So Stories. Since storytelling is an inherent part of science, the criticism refers to the acceptance (...) of stories without sufficient empirical evidence. In particular, Gould, Lewontin, and their colleagues argue that adaptationists often use inappropriate evidentiary standards for identifying adaptations and their functions, and that they often fail to consider alternative hypotheses to adaptation. Playing prominently in both of these criticisms are the concepts of constraint, spandrel, and exaptation. In this article we discuss the standards of evidence that could be used to identify adaptations and when and how they may be appropriately used. Moreover, building an empirical case that certain features of a trait are best explained by exaptation, spandrel, or constraint requires demonstrating that the trait's features cannot be better accounted for by adaptationist hypotheses. Thus, we argue that the testing of alternatives requires the consideration, testing, and systematic rejection of adaptationist hypotheses. Where possible, we illustrate our points with examples taken from human behavior and cognition. Key Words: adaptation; ADHD; brain allometry; constraint; epistemology; evolutionary psychology; exaptation; female orgasm ; optimization; special design; waist-hip ratio. Footnotes1 The authors contributed equally to this paper. Order of authorship was determined alphabetically. Correspondence may be addressed to any of the authors. (shrink)

Many people have argued that the evolution of the human language faculty cannot be explained by Darwinian natural selection. Chomsky and Gould have suggested that language may have evolved as the by-product of selection for other abilities or as a consequence of as-yet unknown laws of growth and form. Others have argued that a biological specialization for grammar is incompatible with every tenet of Darwinian theory – that it shows no genetic variation, could not exist in any intermediate forms, confers (...) no selective advantage, and would require more evolutionary time and genomic space than is available. We examine these arguments and show that they depend on inaccurate assumptions about biology or language or both. Evolutionary theory offers clear criteria for when a trait should be attributed to natural selection: complex design for some function, and the absence of alternative processes capable of explaining such complexity. Human language meets these criteria: Grammar is a complex mechanism tailored to the transmission of propositional structures through a serial interface. Autonomous and arbitrary grammatical phenomena have been offered as counterexamples to the position that language is an adaptation, but this reasoning is unsound: Communication protocols depend on arbitrary conventions that are adaptive as long as they are shared. Consequently, language acquisition in the child should systematically differ from language evolution in the species, and attempts to analogize them are misleading. Reviewing other arguments and data, we conclude that there is every reason to believe that a specialization for grammar evolved by a conventional neo-Darwinian process. (shrink)

In this paper, we argue that deliberative democrats have too narrow a conception of the political, but that 'activism' as it is normally understood is not sufficiently broad, either. Politics is not reducible to coercion and contestation, but rather to the constitution of our shared world. We contend that active citizenship more often takes the form of working in a rape crisis center or a domestic violence clinic than participating in marches or town meetings.

In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects.Some commentators and ethics documents claim that physicians, whether acting as care givers (...) or researchers, have the same duty of beneficence towards their patients and subjects: namely, that they must provide optimal medical care. In discussing placebo surgery in research on refractory Parkinson's disease, Peter Clark succinctly states this view: “The researcher has an ethical responsibility to act in the best interest of subjects.”. (shrink)

In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects.Some commentators and ethics documents claim that physicians, whether acting as care givers (...) or researchers, have the same duty of beneficence towards their patients and subjects: namely, that they must provide optimal medical care. In discussing placebo surgery in research on refractory Parkinson's disease, Peter Clark succinctly states this view: “The researcher has an ethical responsibility to act in the best interest of subjects.”. (shrink)