ABSTRACT
This chapter examines the issues which emerge from the structural framework of physician-investigator, patient-subject, and professional and public institutions. It introduces the participants in this sequence in order to first evaluate the problems which arise if total authority were assigned to physician-investigators and to identify their special qualifications and values, then to examine the competence of patient-subjects to collaborate in decisionmaking, and finally to explore the capacity of the professions and the public to play a role in the process of investigating and treating disease. All the participants have unique and conflicting constellations of motivations, capacities, and value preferences by which they chart their courses. To analyze the tensions which arise between the participants over the objectives and conduct of research and therapy, one must not only identify each actor's values but also assess his capacity and willingness to act upon them.
