'Fair benefits' accounts of exploitation require a normative principle of fairness: response to Gbadegesin and Wendler, and Emanuel et al.

Full Abstract

In 2004 Emanuel et al. published an influential account of exploitation in international research, which has become known as the 'fair benefits account'. In this paper I argue that the thin definition of fairness presented by Emanuel et al, and subsequently endorsed by Gbadegesin and Wendler, does not provide a notion of fairness that is adequately robust to support a fair benefits account of exploitation. The authors present a procedural notion of fairness--the fair distribution of the benefits of research is to be determined on a case-by-case basis by the parties involved in each study. The fairness of the distribution of benefits is not assessed against an independent normative standard. Emanuel et al.'s account of fairness provides a framework for objecting only to transactions that occur without the fully informed consent of the weaker party. As a result, a debate about exploitation collapses into a debate about consent. This is problematic because, as the proponents of the fair benefits framework acknowledge, neither the trial participants' consent nor the host community's consent preclude exploitation. Attempts to stipulate normative standards of fairness to protect research subjects in developing countries have been controversial and divisive, and it is therefore understandable that bioethicists would be tempted to develop accounts of exploitation that are independent of such prescriptive principles. I conclude, however, that the utility of the fair benefits model of exploitation as a policy tool will ultimately depend on whether a substantive principle of fairness can be developed to underpin it.

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Author information

Author/s: Ballantyne, Angela (A);

Affiliation: Institution for Social and Policy Studies, Interdisciplinary Center for Bioethics, Yale University, New Haven, CT 06520-8029, USA. ball0100(-atsign-)flinders.edu.au

Journal and publication information

Publication Type: Comment; Journal Article

Journal: Bioethics (Bioethics), published in England. (Language: eng)

Reference: 2008-May; vol 22 (issue 4) : pp 239-44

Dates: Created 2008/04/14; Completed 2008/04/24;

PMID: 18405322, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentOn: Bioethics. 2006 Sep;20(5):248-53. (PMID: 17100008)

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