Distributive Justice and the New Medicine
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Distributive Justice and the New Medicine

George P. Smith II

The author begins by examining various economic constructs as aids for achieving a fair and equitable delivery of health care services. He then assesses their level of practical application and evaluates the costs and benefits to society of pursuing the development and use of the ‘New Medicine’. The book ends with a case study of organ and tissue transplantation that illustrates the implementation of distributive justice. The author concludes that as long as clinical medicine maintains its focus on healing and alleviating suffering among patients, a point of equilibrium will be reached that advances the common good.
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Chapter 4: Human Experimentation: Conflicts and Confluences

George P. Smith II


4. Human experimentation: conflicts and confluences INTRODUCTION Medical research has been central to America’s vision of a good society— for, through its use, biological knowledge is enhanced which, in turn, allows for its application to the development of various technologies to cure disease.1 Indeed, the abiding goal of medicine has always been to relieve pain and suffering; and medical research aims to implement that very goal2 by not only promoting health, but, whenever possible, preventing disease in the first instance from ever occurring.3 The size and complexity of contemporary medical research is seen dramatically when it is realized that approximately 16 000 to 20 000 investigations are conducted annually. It is estimated, further, that more than 19 million individuals have enrolled in medical experiments—with more than 2 million participating each year.4 Within each investigation undertaken, a significant risk of pain, disability and death is ever present for the experimental subjects.5 This proliferation of biomedical research studies has led to significant concerns regarding the adequacy of present federal regulatory schemes to ensure safety for study participants.6 Recent litigation against institutional review boards (IRBs) and IRB members as defendants may indicate new levels of responsibility will be imposed in order to safeguard those who participate.7 Fundamental to the whole research process and the human experimentation component of it is the need to assure that subject-participants have a level of information which, in turn, allows them to understand fully both the level of potential benefits and...

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