The use of human beings as research subjects poses distinctive ethical issues. Subjects of medical research are exposed to risks of harm for the sake of generating scientific knowledge that can benefit future patients and society. Ethical analysis of the challenges posed by research involving human subjects requires careful attention to the contextual details of scientific experimentation. This book contains 22 essays by Franklin G. Miller on research ethics written over a 15-year period. With the exception of the first essay, all have been previously published in bioethics and medical journals. The book is arranged into four parts. Part One addresses a general ethical perspective on the protection of human subjects in clinical research, including paternalism in research regulation and acceptable limits to research risks. The essays in Part Two examine ethical issues in study design. It includes ethical analyses of controversial types of medical experimentation-studies that provoke psychiatric symptoms, induce infections, provide patients with placebos that withhold proven effective treatments or administer fake invasive procedures, test experimental treatments in cancer patients who have exhausted all standard treatment options, and employ the use of deception to generate scientifically valid data. Part Three offers a systematic critique of "the therapeutic orientation" to clinical trials and the principle of clinical equipoise, which is widely regarded as a fundamental norm for randomized treatment studies. Part Four takes up a range of ethical issues relating to informed consent for research participation, including examination of "the therapeutic misconception" and presentation of a novel approach to the validity of consent: "the fair transaction model." An abiding theme, developed in many of the essays is that the ethics of clinical research is importantly different from the ethics of medical care.

"The articles in this book are seminal contributions to research ethics thought, especially since they challenge numerous prevailing assumptions in research ethics scholarship." -- DOODY'S "Of the three main areas of research in applied ethics -- medical ethics, business ethics, and environmental ethics -- medical ethics has received the most sustained philosophical attention. But not all issues in medical ethics have received the same degree of philosophical scrutiny, and while much attention has been paid to ethical issues that concern the provision of medical care, comparatively little attention has been paid to ethical issues that arise in the course of clinical research... There is thus much of value in The Ethical Challenges of Human Research, and it serves as a welcome corrective to the more usual bioethical focus on medical care." -- James Stacey Taylor, The College of New Jersey, Notre Dame Philosophical Reviews

Department of Bioethics, National Institutes of Health. Co-editor of The Oxford textbook of Clinical Research Ethics, and The Ethics of Consent