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- Genre: Doctoral Dissertation
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With the number of internationally-run clinical drug trials increasing, the double standards between those in developed nations and those in developing nations are being scrutinized under the ethical microscope. Many argue that several pharmaceutical companies and researchers are exploiting developing nation participants. Two issues of concern are the use of a placebo control when an effective alternative treatment exists and the lack of drug availability to the country that hosted the clinical trial should the experimental drug prove effective. Though intuitively this seems like an instance of exploitation, philosophically, exploitation theories cannot adequately account for the wrongdoing in these cases. My project has two parts. First, after explaining why the theories of Alan Wertheimer, John Lawrence Hill, and Ruth Sample fail to explain the exploitation in clinical drug research, I provide an alternative account of exploitation that can explain why the double standard in clinical research is harmful. Rather than craft a single theory encompassing all instances of exploitation, I offer an account of a type, or subset, of exploitation that I refer to as comparative exploitation. The double standards in clinical research fall under the category of comparative exploitation. Furthermore, while many critics maintain that cases of comparative exploitation, including clinical research, are mutually beneficial, they are actually harmful to its victims. I explain the harm of comparative exploitation using Ben Bradley's counterfactual account of harm and Larry May's theory of sharing responsibility. The second part of my project focuses on the "standard of care" argument, which most defenders use to justify the double standard in clinical research. I elaborate on Ruth Macklin's position that advocates of the "standard of care" position make three faulty assumptions: placebo-controlled trials are the gold standard, the only relevant question responsive to the host country's health needs is "Is the experimental product being studied better than the 'nothing' now available to the population?", and the only way of obtaining affordable products is to test cheap alternatives to replace the expensive ones. In the end, I advocate moving towards a universalizing of standards in order to avoid exploitation.
ContributorsFundora, Danielle (Author) / McGregor, Joan (Thesis advisor) / Brake, Elizabeth (Committee member) / Portmore, Douglas (Committee member) / Arizona State University (Publisher)
Created2013
Description
This work has two major goals. The first is to reframe the problem of political authority from its Conservative framing to a Reformist framing. This change creates a new benchmark for the success of a theory. Rather than justifying a pre-existing intuition, a theory can be successful if it could establish political authority whenever the state itself or an individual’s relationship to it changes. This change also shifts the focus from the state’s right to rule to moral housekeeping. In other words, the main goal is not to see when the state can use coercion against its citizens but rather to determine what political obligations citizens could have under different scenarios so that citizens can more accurately keep track of their moral reasons for action. The second major goal is to call into question epistemic theories of democratic authority through a critical examination of David Estlund’s theory of normative consent. Normative consent cannot establish political authority. Even granting that it could, normative consent would bind individuals to epistemic procedures rather than democratic procedures given that epistemic procedures better solve the moral problems that generate normative consent. However, this then raises worries from the public reason perspective that epistemic procedures would impose a procedure on some citizens which they could reject from a qualified position. To overcome this worry, it is shown that epistemic procedures based on reducing the power of the ignorant rather than raising the power of the experts are not open to such qualified rejection, and democratic procedures in the real world will do no better than a coin flip at selecting correct policies. In the end, one branch of epistemic conceptions of democratic authority are proven untenable.
ContributorsHall, James Michael (Author) / de Marneffe, Peter (Thesis advisor) / Portmore, Douglas (Committee member) / Huemer, Michael (Committee member) / Arizona State University (Publisher)
Created2024