Title: Philosophical Reflections on Experimenting with Human Subjects

Author: Hans Jonas

Publication Information:  This essay is included, on pp.105-131, in a 1980 re-edition of Jonas' Philosophical Essays: From Current Creed to
Technological Man, published by the University of Chicago Press available here https://www.sfu.ca/~andrewf/jonas.pdf

Contrary to general notion that approves the use of human subjects by medical professionals and researchers in experiments, Hans Jonas argues
that such experiments expose individuals to dangers for the common good. He further stresses that progress is an optional goal and we are not obligated to participate in any medical experiment for the sake of progress. In his opinion, we can accept slower progress than erosion of our moral values – loss of individual rights and dignity. Health, as many believe, is a national resource or public good. Jonas reminds us that it is so but not in the first place. The services that physicians provide by curing a disease or the 67researchers provide by finding knowledge about a new cure are indeed great service to the “society”.
However, the social good does not have greater value than the individual good. Society in general flourishes at a pace given the number of deaths in general. Jonas is against improving the health condition of the whole society, especially if that means using some individuals as the guinea pigs.

Some of us think that we are indebted to society for the past experiments it conducted and the benefits we are enjoying from them. Jonas says that we are not indebted to the society but the society itself is indebted to the past “martyrs”.  Hence, the society has no right to call upon individuals for more sacrifice. The call for volunteers to participate in medical experiments involves some solicitation.  The researchers or physicians making such calls may not fully explain the objectives and consequences of an experiment. Ideally, a volunteer should have a complete “freedom” and knowledge about an experiment before participating in it. Jonas suggests that the physicians, research scientists themselves and the scientific community at large can be such ideal candidates and they should be the first ones to participate in the medical experiments. In this case, Jonas believes that “almost all of the associated legal, ethical, and metaphysical
problems vanish.”

By extending the general criteria for selection as we discussed for researchers above, we can look for additional subjects where “a maximum of identification, understanding, and spontaneity can be expected.” Jonas suggests that the next desirable (ethically) batch of human subjects would be among “the most highly motivated, highly educated, and the least captive members of the society.” Selecting subjects from such an affluent batch would satisfy the cause of both the subject and the researcher. The subjects in this case are “willed” to participate and have a clear understanding of the purpose and technique of the experiment that makes them valid candidates. This is essentially a “descending order” of selecting subjects in a society i.e. the most informed, educated, and free are considered before the “captive”, ill informed, and poor mass. This might result in researchers not finding enough subjects but Jonas things it is ethically a better trade-off.

The most available subjects are patients since they are already under treatment and observation. The physicians may have to use their patients as subjects to experiment a new drug or treatment. However, they should never forget that a physician is obligated to the patient and to no one else. A physician while attending a patient should not worry about the interest or benefits of society, medical science, patient’s friends or family, or the future patients suffering from the same disease. Hence, the physician’s only focus should be on curing the patient on hand. The physical and mental condition of a patient may make it more vulnerable to accept a physician’s suggestion to participate in an experiment. This means that the physician has even higher responsibility to keep the
persuasion to the minimum and avoid all conflicts of interests. Jonas suggests that among the patients also, we can use the “descending order” in selecting subjects. The medical professionals who are patients should be considered first, then the highly motivated, educated, and least dependent patients. However, we should not do any experiment on the patients unrelated to their own disease.

Summary: Hita Gurung  (QCC,2003)

Outline by  Don Berkich,  University of Texas, Corpus Christi (by permission)

Jonas presents an extended contractarian analysis of human experimentation. He grants that human experimentation has led to and can lead to long-term improvements in health, but the rights individual members have in society cannot be ignored in the process of seeking these improvements.

Jonas argues for two principles to guide human experimentation:

• The Principle of Identification: The most educated and motivated members of society should be the candidates for research, and their agreement must be autonomous and informed to be valid.
• The Rule of Descending Order: The pool of candidates should begin with with the most valuable and least expendable members of society.

It is fairly easy to see how a contractarian "Veil of Ignorance"-style argument can be used to justify these principles.

The Peculiarity of Human Experimentation

• Substitution: Given the limitations of animal models for humans, human experimentation requires humans. Thus human experimentation has the problem of being on humans, who might forever suffer the effects of the experiment.
• Obligation: Can the purpose of human experimentation be met while meeting our obligations to individual persons?

Health as a Public Good

• The good aimed at by human experimentation is health.
• But whose health is the goal?
• Society's? Can a society be healthy?

What Society Can Afford

• Society can afford to lose members through death.
• Society can not afford to have a great imbalance of births to deaths.
• Society can not afford a single miscarriage of justice or violation of rights.

Society and the Cause of Progress

• Do we "owe" society the pursuit of more progress?
• Do our descendents have a right to a cure?

The Melioristic Goal

• One is not obligated by the social contract to "surrender" one's body.
• Gratitude does not require emulation.

The "Conscription" of Consent

• Soliciting consent amounts to conscripting consent.

Self-Recruitment of the Community

• The first candidate for research should be the researcher him/herself.

"Identification" as the Principle of Recruitment

• Primary pool of candidates should be the most educated and motivated--i.e., the least "captured".
• Consent must be autonomous and informed to be valid.

The Rule of "Descending Order"

• Begin with the most valuable and least expendable members of society.

Experimentation on Patients

• The last to be asked to be subjects are the patients themselves.

The Fundamental Privilege of the Sick

• Physicians' obligation is to the patient alone.
• Of course, the contagious sick must be quarantined.

The Principle of "Identification" Applied to Patients

• Same principle applies to patients as to general population.

Nondisclosure as a Borderline Case

• Placebo experiments are wrong for patients, even when they are not harmed.

No Experimentation on Patients Unrelated to Their Own Diseases

• Patients may be experimented on, if at all, only with respect to their own diseases.

Conclusion

• Progress is an optional goal, not an unconditional commitment.
• A slower rate of progress would not threaten society.

• Erosion of values threatens society.

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The Case for the Use of Animals in Biomedical Research by   Carl Cohen, New England Journal of Medicine, Vol. 315, no. 14(1986), pp. 865-870.

READ:  SUMMARY

Outline by  Don Berkich,  University of Texas, Corpus Christi (by permission)

Cohen's article is very simple. He seeks to argue that animal experimentation is perfectly morally permissible because animals have no rights.

Although Cohen certainly comes out of a lengthy tradition in ethics which places human animals in a unique moral position over other animals--a tradition which begins with DCT and NLT--his argument does not explicitly assume any such ethical theory. Rather, Cohen's argument cleverly turns on what it is for an agent to have moral rights in the first place.

For Cohen, to have moral rights is to be a moral agent, but to be a moral agent is to be an agent with free will. Since non-human animals do not enjoy free will, non-human animals have no moral rights.

Objection to Premise (1):

• The brain-damaged, the comatose, and the senile have rights but cannot make claims.

Response to the Objection to Premise (1):

• What matters is the species. Thus we should replace (1) with

1.* If X has rights, then X belongs to a species, S, such that many members of S can make claims against other members of a moral community.

But then why is Speciesism not morally wrong?

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Opposed to Animal Experimentation by Peter Singer, author Animal Experimentation

READ: Summary

http://www.cariboo.bc.ca/ae/php/phil/mclaughl/students/phil433/singer1.htm

Outline by  Don Berkich,  University of Texas, Corpus Christi (by permission)

It is important to appreciate that Singer does not rule out animal experimentation. Rather, what Singer's argument shows is that animal experimentation--particularly experimentation on adult mammals of other species--is morally permissible when, and only when, human infant experimentation is morally permissible.

Justification for premise (1):

• The premise may usefully be restated as

EITHER i) human infants are morally on a par with adult mammals of other species OR ii) human infants are not morally on a par with to adult mammals of other species.

• One might think that (ii) is true if one held that human infants have the morally relevant characteristic of the potentiality of later on becoming more aware of what is happening to them, more self-directing, etc.

• Whatever the case, premise (1) is true since it has the form

P or not-P

and every statement of this form is true.

Justification for premise (2):

• Under the supposition that human infants are morally on a par with adult mammals of other species--i.e., there is no moral difference between them--the claim that it is wrong to experiment on human infants but permissible to experiment on adult mammals of other species amounts to blatant speciesism. But speciesism is as morally indefensible as racism. Hence either one claims that it is wrong to experiment on human infants and it is wrong to experiment on adult mammals of other species or one claims that it is permissible to experiment on human infants and it is permissible to experiment on adult mammals of other species.

Justification for premise (3):

• Presumably, the only moral difference between human infants and adult mammals of other species is the potentiality of the human infant. Under the hypothesis that there is this difference, it follows that abortion is morally wrong since the human embryo has the same potentiality as the human infant.

Justification for premise (4):

• Consider our discussion of the arguments over abortion--Noonan, Thomson, etc.

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