ABSTRACT
Medical research is thought to involve the objective or unbiased pursuit of knowledge. This is often expressed by saying that research is, or at least ought to be, value-free. In this chapter, I aim to draw attention to some of the problems with this ideal. I begin by developing a thought experiment aimed at demonstrating the signifi cant challenges of controlling for values in the design, execution, and reporting of medical research. Following this, I outline the implications of pervasive unacknowledged values in medical research, from direct harm to research subjects to the indirect harms that arise as a result of loss of public trust in the research enterprise. Given the undesirability of these potential harms, I clarify what is meant by values in this context and then turn to recent work in philosophy of science, on two questions: “Is value-free medical research possible?” and “Is value-free medical research desirable?” In both cases, the answer is no. In light of these answers, I present a different way of thinking about the role of values in medical research, and trace the practical implications of this approach. Rather than pretending that medical research is more objective than it really is, we ought to improve the social mechanisms that allow for the exposure and critical evaluation of the values that necessarily persist in medical research.
