edited by Jeffrey P. Kahn, Anna C. Mastroianni, and Jeremy Sugarman.
New York: Oxford University Press, 1998. 208 pp.
a1 Department of Medicine and the Neiswanger Institute
for Bioethics and Health Policy at the Stritch School of Medicine,
Loyola University of Chicago, Maywood, Illinois.
A history of injustices to diverse groups of human
subjects in medical research has resulted in concerted
efforts by U.S. policymakers in the second half of the
twentieth century to provide greater protection for future
subjects. However, in the context of patient populations
demanding better therapies, potential medical advances,
and greater attention to issues of social justice, Kahn,
Mastroianni, and Sugarman set out to reconceptualize the
principle of justice in human subjects research to address
these urgent concerns. In Beyond
and colleagues advance a framework of justice in terms
of access to participation in research, instead of protection.
Their worthy cause, developed out of collaboration on the
White House Advisory Committee on Human Radiation Experiments,
aims to demonstrate how previously unaddressed notions
of justice now require greater consideration in research.
Specifically, they emphasize how fairness requires a greater
distribution of risks and benefits, and that “equals
should be treated equally.” The volume does not report
new research findings but rather draws on multidisciplinary
approaches, including law, medicine, philosophy, history,
and health policy, to argue that justice must go beyond
informed consent. The editors posit that this challenge
to protectionism is necessary given the heightened urgency
for patients to benefit from investigational therapies
although they incur increased risks.