Suspended judgment. AIDS and the ethics of clinical trials: learning the right lessons.
There is a tribe of thinkers who believe that new technological advances and scientific discoveries raise new ethical issues. And it is the case, of course, that scientific and technological change--change in knowledge and power--implies a new realm for choice and, therefore, moral reflection. In the case presently concerning us, they see the AIDS social and scientific crisis as requiring the adoption of new ethical principles. I believe to the contrary. AIDS--more broadly, the entire spectrum of HIV disease--does not in itself present radically new issues at the level of principle. For example, the questions associated with confidentiality and HIV disease that have to this point dominated public discourse about morality and AIDS simply resurrect old questions raised by potentially deadly infectious disease. Recent discussions of the ethical issues associated with HIV-infectious health care workers fail to recognize that HIV is simply a new garb for the old question of the impaired or unsafe practitioner. HIV disease does have this effect on ethical reflection, however: It rubs our noses in issues that may have received insufficient attention to date. The urgency and poignancy associated with moral conflict and HIV disease forces us to face up to questions hitherto ignored. But this may be a good or a bd thing. In the heat of crisis, being human, we are likely to call for change without adequate consideration of the need for and effects of that change.(ABSTRACT TRUNCATED AT 250 WORDS)
Freedman
B
B
Jewish General Hospital, McGill Centre for Medicine, Ethics and Law, Montreal, Quebec, Canada.
D000163:Acquired Immunodeficiency Syndrome / Q000628:therapy*; D026686:Beneficence; D002986:Clinical Trials as Topic / Q000379:methods*; D004992:Ethics, Medical; D015658:HIV Infections / Q000628:therapy*; D006805:Human Experimentation; D006801:Humans; D018579:Patient Selection; D026684:Personal Autonomy; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D035842:Research Subjects; D018570:Risk Assessment; D036302:Therapeutic Human Experimentation