ABSTRACT
Scientific medicine has produced many great advances in human well-being and the relief of suffering. As it has developed, scientific medicine has grown dramatically in parallel with the growth of the pharmaceutical industry. One cause and consequence of this parallel growth is the development of medical research into a large industry in its own right-in both its academic and industry contexts. Medical research depends crucially on the participation of human subjects, both healthy volunteers and patients. Many authors have commented on the apparent tension between the clinical research coordinator’s clinical obligations to the patient as a patient and his or her scientific obligations to the study, sponsor, scientific community, and future patients. We can also consider more widely the tensions between the interests of the scientific community, the business interests of the sponsor, the public policy interests of the state, the financial and professional interests of participating clinicians, and the short-and longterm interests of the host population. Resolving these tensions can become a complex matter of law, politics, and ethical debates on justice. Over all of these debates looms an awareness of the profound immorality of the human rights violations sometimes perpetrated by human experimenters.
