Philosophy Ethicals

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Patricia King “The Dangers of Difference”
* The Dilemma of Difference
* Even when a study purports to be helping a disadvantaged group it may cause harm * If the racial difference is ignored harm can result from ignoring factors that may have a correlation with race. Patricia King “The Dangers of Difference”

* Inclusion/Exclusion
* Inclusion: required that vulnerable groups be protected, e.g. equitable selection, cognizant of specific problems with respect to vulnerable groups * Exclusion: Too much protection might result in the underrepresentation of vulnerable groups. Patricia King “The Dangers of Difference”

* Three reasons for increasing representation of African Americans in clinical trials: 1. There may be biological differences between blacks and whites which would affect the applicability of the findings 2. Race can be a reliable index for certain social conditions

e.g. nutrition, access to health care, socioeconomic factors 3. The burdens and benefits of research should be spread among the population regardless of race or ethnicity Patricia King “The Dangers of Difference”

* How can we advocate for increased participation of minorities in clinical research and minimize the harms that may come from this participation? * Start with the presumption that blacks and whites are biologically the same * Priority should be given to exploring social, cultural, and environmental determinants of disease BEFORE biological hypotheses are studied * If there does turn out to be a biological difference this does not necessitate a hierarchical view of race or to discrimination * Mastroianni and Kahn “Swinging on the Pendulum”

* Problems w. “protection”
* E.g. prisoners wanted to participate in clinical trials * $, Access to better/more frequent health care, believed they were making a contribution to society * However, protection policies precluded prisoners from participation in such studies * Mastroianni and Kahn “Swinging on the Pendulum”

* From protection to access
* So…protection policies were limiting access to such treatments to the very people they were trying to protect. * Mastroianni and Kahn “Swinging on the Pendulum”
* Implementation of the NIH guideline requiring inclusion of representative populations of women and minorities unless the research is specific to a particular group (1994) * Why NIH Require Race as a Research Variable: major omissions of racial and ethnic data which may be necessary to address the minority populations' specific health and social services needs * NIH Requirement

* B. 1. The racial and ethnic categories set forth in the standards should not be interpreted as being primarily biological or genetic in reference. Race and ethnicity may be thought of in terms of social and cultural characteristics as well as ancestry. * B. 2. …ideally, respondent self-identification should be facilitated to the greatest extent possible, recognizing that in some data collection systems observer identification is more practical * D. …self-identification is the preferred means of obtaining information about an individual’s race and ethnicity, except in instances where observer identification is more practical (e.g., completing a death certificate) * D. …continue that policy that the categories are NOT to be used for determining the eligibility of population groups for participation in any Federal programs

Chapter 8

Animal Dilemma: Many human beings are suffering from disease, Live animals for research may be the only effective way to develop cures for disease VS. Animals are subjected to suffering and distress, Animals will not benefit

Your Position on Animal Research
* Are your judgments governed by a:
* Consequentialist perspective (the ends justify the means) * Deontological perspective (individual autonomy/animal rights are more important than the...
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