Journal of Medical Ethics:medethics-2019-106034 (forthcoming)

Robert C. Hughes
University of Pennsylvania
Many ethicists maintain that medical research on human subjects that presents no prospect of direct medical benefit must have a prospect of social benefit to be ethical. Payment is not the sort of benefit that justifies exposing subjects to risk. Alan Wertheimer has raised a serious challenge to this view, pointing out that in industry, social value is not considered necessary to make dangerous jobs ethical. This article argues that Wertheimer was correct to think that the ethics of hazard pay should be the same in medical research and in business. Nevertheless, a qualified social benefit requirement should apply in both fields. For a study or a job with significant net physical risk to be ethical, it must have social value beyond the satisfaction of ordinary preferences, including the preference for money. The requirement derives from a non-absolutist version of the doctrine of double effect. If a risky study or a dangerous job has no distinctive social value, and hazard pay is subjects' or workers’ only reason to undergo risks, the very fact that they undergo risk is intended as a means to a financial end. Inviting people to enrol in such a study or to take such a job wrongfully treats people as mere means. By contrast, if a study or a job has social value, people can participate with a primary end other than money, even if they accept compensation. Researchers or employers do not intend but merely foresee risks to subjects or workers.
Keywords doctrine of double effect  exploitation  human subjects research  research ethics  social value requirement
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DOI 10.1136/medethics-2019-106034
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References found in this work BETA

Moral Dimensions: Permissibility, Meaning, Blame.Thomas Scanlon - 2008 - Belknap Press of Harvard University Press.
How Payment For Research Participation Can Be Coercive.Joseph Millum & Michael Garnett - 2019 - American Journal of Bioethics 19 (9):21-31.
Defending Double Effect.Ralph Wedgwood - 2011 - Ratio 24 (4):384-401.
Paying People to Risk Life or Limb.Robert C. Hughes - 2019 - Business Ethics Quarterly 29 (3):295-316.

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