9780199730087

The Ethics of Pediatric Research

by
  • ISBN13:

    9780199730087

  • ISBN10:

    0199730083

  • Format: Hardcover
  • Copyright: 2010-03-01
  • Publisher: Oxford University Press

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Summary

Millions of children suffer from diseases and illnesses that do not have adequate treatment, and many other children are harmed by medicines intended to help them. In order to protect and help these children, society must conduct pediatric research to identify safer and more effective medical treatments. This research requires exposing some children to risks for the benefit of others. Yet, critics and courts have argued that it is unethical to expose children to research risks for the benefit of others, and this practice seems to violate our obligation to protect children from harm and exploitation. In this way, clinical research with children presents us with what appears to be an irresolvable dilemma: either we can protect pediatric subjects from exploitation, or we can protect pediatric patients from dangerous medicines, but not both. The Ethics of Pediatric Research is the first work to systematically evaluate this dilemma, and David Wendler offers an original justification for pediatric research based on an in-depth analysis of when it is in our interests to help others. It will be of interest primarily to scholars in pediatric ethics and clinical research ethics.

Author Biography


Head, Unit on Vulnerable Populations, Department of Bioethics, National Institutes of Health

Table of Contents

Preface
A Vaccine for Rotavirus
The Prevalence of non-Beneficial Pediatric Research
Questioning the Acceptability of non-Beneficial Pediatric Research
Method of the Book
Lessons Learned
An Initial Example
Outline of the Argument
Background
Scope of the Debate
Terms of the Debate
History of Abuses, Early Guidelines
Current Regulations
Efforts to Increase Pediatric Research
The Legal Landscape
The (Few) Pediatric Research Cases
Evaluating The Worry
Ramsey's Argument
The Value of Consent
When is Consent Necessary?
Why is Consent Valuable?
Clarifying the Worry
McCormick's Response
The Negligible Risks Threshold
The Risks of Daily Life Threshold
The Routine Examinations Threshold
Appeal to Long Term Benefits
Helping Children as a Group
Proposed Justifications
The Argument thus Far
Utilitarianism as an Epithet
The Scope of Parental Authority
Teaching Children to Be Moral
Children's Moral Obligations
The View from Behind the Veil of Ignorance
Human Interests And Human Causes
Brief Recapitulation
Three Conditions on an Acceptable Account
Brief (and Prospective) Summary
Three Questions on Our Interests
Five Categories of Interests
All Things Considered Interests
Interested in Versus in One's Interests
The Causal Nexus of Our Lives
The Personal Significance of Making a Contribution: 5 Factors
Our Connection To Our Contributions
The Present Chapter
Our (Tenuous?) Connection to Childhood
The Value of Youthful Contributions
Saying Something Positive
Are Contributions Necessarily Active?
Striving versus Contributing
The Influence and Importance of Causal Inputs
In the Valley of Kings
The Value Of Passive Contributions
The Virtuous KKK Member
Nazi Era Children
The Reluctant Propagandist
The Normative Asymmetry Thesis
Contributing without Trying
Children in Operas, Infants at Political Rallies
The Calamitous Discovery
The Ubiquity of Competing Considerations
Making Decisions for Children
The Value of Making a Contribution
Implications For Non-Beneficial Pediatric Research
Limits on the Personal Value of Passive Contributions
Moral Claims on 3rd Parties
The Necessity of Value
Minimal Risks and Sliding Scales
Exceptional Cases
Adults and Older Children First
Children Helping Adults
Objections And The Potential For Abuse
You Will Eat Your Spinach
The Unfairness of it All
What Happened to Autonomy?
Giving Comfort to Scoundrels?
The Potential for Abuse
Worries about Distribution
Conclusion
Notes
Index
Table of Contents provided by Publisher. All Rights Reserved.

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