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DOI

International clinical research and the problem of benefiting from injustice

01 Jan 2014-pp 169-184
TL;DR: In this paper, the authors argue that participants in clinical trials can plausibly be regarded as victims of deep structural injustices, e.g. severe avoidable pov games, etc.
Abstract: Clinical trials are increasingly “offshored” to developing countries. Many participants in these trials can plausibly be regarded as victims of deep structural injustices, e.g. severe avoidable pov ...

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Citations
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Journal Article
TL;DR: Pogge as mentioned in this paper argued that the role that benefiting from injustice plays in determining our duty to work toward reforming unjust practices and mitigating their harmful effects is best understood in terms of compensation.
Abstract: Contrasting his own position with that of those who conceive the moral challenge of global poverty in terms of a positive duty to help, Thomas Pogge suggests that “we may be failing to fulfill our stringent negative duty not to uphold injustice, not to contribute to or profit from [emphasis added] the unjust impoverishment of others” (p. 197). We should conceive of our individual donations and of possible institutionalized initiatives to eradicate poverty not as helping the poor but “as protecting them from the effects of global rules whose injustice benefits us and is our responsibility” (p. 23, emphasis added). Pogge also claims that such activities should be understood in terms of compensation: “The word ‘compensate’ is meant to indicate that how much one should be willing to contribute toward reforming unjust institutions and toward mitigating the harms they cause depends on how much one is contributing to, and benefiting from, their maintenance” (p. 50, emphasis added). In characterizing wrongful involvement in an unjust social order and the compensatory duties that arise from it, Pogge refers to the terms contribution/responsibility as well as to benefit/profit (the latter are used interchangeably). The first of these factors is unobjectionable: we can take it for granted that there is a negative duty not to contribute to injustice and that those who are responsible for harmful institutions should compensate their victims. I want to raise doubts, however, about the role that Pogge assigns to benefiting from injustice in the determination of our duties toward the victims of injustice. I shall do so by challenging his claim that there is a negative duty not to benefit from injustice, and that the role that benefiting from injustice plays in determining our duties to work toward reforming unjust practices and mitigating their harmful effects is best understood in terms of compensation.

5 citations

Journal ArticleDOI
TL;DR: In this paper, the authors distinguish between different types of cases corresponding to different kinds of involvement in exploitation by the third party, and argue that these different types have different moral implications.
Abstract: Recent years have seen a growing philosophical interest in the concept of exploitation as well as in putatively exploitative practices, such as commercial surrogacy, sweatshop labor, and medical research in the developing world. This article contributes to the philosophical debate in this area by focusing on a problem about exploitation that has remained largely unexamined until now. The debate has concentrated on the kind of situation where one party to a transaction or relationship, A, exploits another party, B, and A benefits himself/herself. At the same time, philosophers have for the most part ignored cases where A exploits B, but the gains A extracts from B accrue not (only) to A but (also) to a third party, C . This omission is striking because such cases are easily found in the real world. Clinical researchers and their sponsors may exploit research subjects to advance the interests of future patients. Sweatshops may exploit workers in poor countries on behalf of multinational firms and for the benefit of their customers. In fact, it is plausible to claim that, more often than not, several parties stand to gain from putatively exploitative practices in today’s globalized economy. For example, Iris Marion Young (2011, ch. 5) paints a vivid picture of the complex and multilayered network of actors (i.e., sweatshops, multinationals, intermediaries, distributors, retail and wholesale companies, individual and group customers, and so on) who make up one prominent such practice, the global apparel industry. Therefore, in order to be genuinely practically relevant, exploitation theory needs a better grasp of how third parties can be involved in exploitative transactions and arrangements and of the normative significance of such involvement. Young herself, while emphasizing that the circle of those bearing some (mostly forward-looking) responsibility in connection with such transactions and arrangements is much broader than commonly thought, does not systematically distinguish among different kinds of third-party involvement. Our work undertakes such an analysis. We distinguish between different types of cases corresponding to different kinds of involvement in exploitation by the third party. We also argue that these different types of involvement have different moral implications—especially as regards the remedial duties incurred by the third parties. Our main claim is that in many cases third-party beneficiaries can be properly construed as acting together with exploiters in bringing about and/or maintaining the exploitative relationship or transaction. Establishing joint action in such cases is important because, first,

4 citations


Cites background from "International clinical research and..."

  • ...Some hold that the essential wrong of exploitation consists in the violation of some norm of fairness (Wertheimer 1996, 2011; Mayer 2007; Valdman 2009)....

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Journal ArticleDOI
TL;DR: In this paper , the authors highlight important ethical and practical limitations with applying PPP in this context: PPP gives ambiguous and arbitrary guidance due to difficulties in identifying the salient polluter, and when PPP does identify responsible actors, these may be unable or mitigate their contribution to the pollution, only able to avoid/mitigate it at excessive cost to themselves or others, or excusably ignorant of contributing.
Abstract: Human consumption of pharmaceuticals often leads to environmental release of residues via urine and faeces, creating environmental and public health risks. Policy responses must consider the normative question how responsibilities for managing such risks, and costs and burdens associated with that management, should be distributed between actors. Recently, the Polluter Pays Principle (PPP) has been advanced as rationale for such distribution. While recognizing some advantages of PPP, we highlight important ethical and practical limitations with applying it in this context: PPP gives ambiguous and arbitrary guidance due to difficulties in identifying the salient polluter. Moreover, when PPP does identify responsible actors, these may be unable to avoid or mitigate their contribution to the pollution, only able to avoid/mitigate it at excessive cost to themselves or others, or excusably ignorant of contributing. These limitations motivate a hybrid framework where PPP, which emphasizes holding those causing large-scale problems accountable, is balanced by the Ability to Pay Principle (APP), which emphasizes efficiently managing such problems. In this framework, improving wastewater treatment and distributing associated financial costs across water consumers or taxpayers stand out as promising responses to pharmaceutical pollution from human use. However, sound policy depends on empirical considerations requiring further study.
References
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Book
01 Jan 1984

528 citations


"International clinical research and..." refers background in this paper

  • ...See, in particular, Jonas (1984) and Young (2011)....

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Book
27 Apr 2009
TL;DR: In this article, anthropologist Adriana Petryna takes us deep into the clinical trials industry as it brings together players separated by vast economic and cultural differences, showing that neither the language of coercion nor that of rational choice fully captures the range of situations and value systems at work in medical experiments today.
Abstract: The phenomenal growth of global pharmaceutical sales and the quest for innovation are driving an unprecedented search for human test subjects, particularly in middle- and low-income countries. Our hope for medical progress increasingly depends on the willingness of the world's poor to participate in clinical drug trials. While these experiments often provide those in need with vital and previously unattainable medical resources, the outsourcing and offshoring of trials also create new problems. In this groundbreaking book, anthropologist Adriana Petryna takes us deep into the clinical trials industry as it brings together players separated by vast economic and cultural differences. Moving between corporate and scientific offices in the United States and research and public health sites in Poland and Brazil, When Experiments Travel documents the complex ways that commercial medical science, with all its benefits and risks, is being integrated into local health systems and emerging drug markets. Providing a unique perspective on globalized clinical trials, When Experiments Travel raises central questions: Are such trials exploitative or are they social goods? How are experiments controlled and how is drug safety ensured? And do these experiments help or harm public health in the countries where they are conducted? Empirically rich and theoretically innovative, the book shows that neither the language of coercion nor that of rational choice fully captures the range of situations and value systems at work in medical experiments today. When Experiments Travel challenges conventional understandings of the ethics and politics of transnational science and changes the way we think about global medicine and the new infrastructures of our lives.

428 citations


"International clinical research and..." refers background in this paper

  • ...Typical participants in Phase 1 trials appear to be students, unemployed and contingent labourers trying to supplement their income, while those who enrol in Phase 2 and 3 trials are commonly patients seeking treatments that they cannot otherwise afford or access (Sunder Rajan 2007; Petryna 2009; Wemos 2010; Cooper and Waldby 2014)....

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  • ...Developing countries themselves are often eager to host foreign research sponsors (Sunder Rajan 2007; Petryna 2009; Cooper and Waldby 2014)....

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  • ...…appear to be students, unemployed and contingent labourers trying to supplement their income, while those who enrol in Phase 2 and 3 trials are commonly patients seeking treatments that they cannot otherwise afford or access (Sunder Rajan 2007; Petryna 2009; Wemos 2010; Cooper and Waldby 2014)....

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  • ...In some countries trials run by the pharmaceutical industry appear to be increasingly counted on to provide the healthcare that a shrinking public sector can no longer offer (Petryna 2009)....

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  • ...Different considerations motivate pharmaceutical firms and other sponsors to “offshore” their research to developing countries (Macklin 2004; Sunder Rajan 2007; Petryna 2009; Cooper and Waldby 2014)....

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Journal ArticleDOI
Thomas Pogge1
TL;DR: In this paper, the authors focus on the present situation, on the radical inequality between the bottom half of humankind, suffering severe poverty, and those in the top seven, whose per capita share of the global product is 180 times greater than theirs (at market exchange rates).
Abstract: Mathias Risse discusses whether the global system of territorial sovereignty that emerged in the fifteenth century can be said to harm the poorer societies. This question is distinct from the question I raise in my book—namely, whether present citizens of the affluent countries, in collusion with the ruling elites of most poor countries, are harming the global poor. These questions are different, because present citizens of the affluent countries bear responsibility only for the recent design of the global institutional order. The effects of the states system as it was shaped before 1980, say, is thus of little relevance to the question I have raised. A further difference is that whereas Risse's discussion focuses on the well-being of societies, typically assessed by their GNP per capita, my discussion focuses on the well-being of individual human beings. This difference is significant because what enriches a poor country (in terms of GNP per capita) all too often impoverishes the vast majority of its inhabitants, as I discuss with the example of Nigeria's oil revenues (pp. 112–14).My focus is then on the present situation, on the radical inequality between the bottom half of humankind, suffering severe poverty, and those in the top seventh, whose per capita share of the global product is 180 times greater than theirs (at market exchange rates). This radical inequality and the continuous misery and death toll it engenders are foreseeably reproduced under the present global institutional order as we have shaped it. And most of it could be avoided, I hold, if this global order had been, or were to be, designed differently. The feasibility of a more poverty-avoiding alternative design of the global institutional order shows, I argue, that the present design is unjust and that, by imposing it, we are harming the global poor by foreseeably subjecting them to avoidable severe poverty.

217 citations


"International clinical research and..." refers background in this paper

  • ...More specifically, they have argued that benefiting from injustice (or wrongdoing) may give rise to responsibilities towards its victims (Gosseries 2004; Anwander 2005 and 2009; Pogge 2005 and 2008; Butt 2007 and 2014; Goodin and Barry 2014)....

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  • ...Different versions of this view have been advanced to attribute special responsibilities to the beneficiaries of human-induced climate change (Gosseries 2004), global poverty (Anwander 2005 and 2008; Pogge 2005 and 2008) and historic injustices such as slavery (Butt 2007)....

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Journal ArticleDOI
TL;DR: In this paper, the authors argue that the previous generation of polluters may not have been morally responsible for the harms they caused, but a suitably defined notion of moral free-riding may still account for the moral obligation of the polluters' descendants to compensate the current victims of their ancestors' actions.
Abstract: Should the current members of a community compensate the victims of their ancestor’s emissions of greenhouse gases? I argue that the previous generation of polluters may not have been morally responsible for the harms they caused. I also accept the view that the polluters’ descendants cannot be morally responsible for their ancestor’s harmful emissions. However, I show that, while granting this, a suitably defined notion of moral free-riding may still account for the moral obligation of the polluters’ descendants to compensate the current victims of their ancestors’ actions. A concept of trans- generational free-riding is defined. Objections to the idea of using free-riding as part of a theory of justice are rejected. Two different views of moral free-riding are contrasted, with consequences for the amount of compensation to be exigible from the polluters’ descendants. Some final considerations are devoted to the possible relevance of this free-riding-based view for other issues of historical injustice.

124 citations


"International clinical research and..." refers background in this paper

  • ...More specifically, they have argued that benefiting from injustice (or wrongdoing) may give rise to responsibilities towards its victims (Gosseries 2004; Anwander 2005 and 2009; Pogge 2005 and 2008; Butt 2007 and 2014; Goodin and Barry 2014)....

    [...]

  • ...Some invoke the notion of free riding to justify remedial responsibilities on the part of innocent beneficiaries of injustice (Gosseries 2004; Anwander 2009)....

    [...]

  • ...Different versions of this view have been advanced to attribute special responsibilities to the beneficiaries of human-induced climate change (Gosseries 2004), global poverty (Anwander 2005 and 2008; Pogge 2005 and 2008) and historic injustices such as slavery (Butt 2007)....

    [...]

Journal ArticleDOI
Daniel Butt1
TL;DR: The most straightforward cases are those where we acquire obligations as the result of particular actions which we voluntarily perform as mentioned in this paper, i.e. if I promise you that I will trim your hedge, I face a moral obligation to uphold my promise, and in the absence of some morally significant countervailing reason, I should indeed cut your hedge.
Abstract: How do we acquire moral obligations to others? The most straightforward cases are those where we acquire obligations as the result of particular actions which we voluntarily perform. If I promise you that I will trim your hedge, I face a moral Obligation to uphold my promise, and in the absence of some morally significant countervailing reason, I should indeed cut your hedge. Moral obligations which arise as a result of wrongdoing, as a function of corrective justice, are typically thought to be of a similar nature.

100 citations


"International clinical research and..." refers background in this paper

  • ...More specifically, they have argued that benefiting from injustice (or wrongdoing) may give rise to responsibilities towards its victims (Gosseries 2004; Anwander 2005 and 2009; Pogge 2005 and 2008; Butt 2007 and 2014; Goodin and Barry 2014)....

    [...]

  • ...Daniel Butt (2007) offers a more fanciful but structurally similar case....

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  • ...(Butt 2007, 143) In a later paper, Butt restates this claim as follows: [T]here is an inconsistency in our moral outlook if we condemn actions which harm others as wrong, and so maintain that they should not have taken place, but then refuse to perform actions within our power which would make the…...

    [...]

  • ...Different versions of this view have been advanced to attribute special responsibilities to the beneficiaries of human-induced climate change (Gosseries 2004), global poverty (Anwander 2005 and 2008; Pogge 2005 and 2008) and historic injustices such as slavery (Butt 2007)....

    [...]