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Contractualist reasoning, HIV cure clinical trials, and the moral (ir)relevance of the risk/benefit ratio
  1. Rahul Kumar
  1. Correspondence to Dr Rahul Kumar, Department of Philosophy, Queen's University, Kingston, Ontario, Canada K7L 3N6; rahul.kumar{at}queensu.ca

Abstract

Institutional review boards (IRB) normally require of a morally defensible clinical trial that any trial participant will benefit from the inquiry, or at least not be exposed to a significant risk of having their prospects worsened by participating. Stage 1 HIV cure trials tend not to meet this requirement. Does that show them to be morally indefensible? Utilitarian thinking about this question supports a negative answer. But one might reasonably expect a Kantian moral theory to support the conclusion that exposing trial participants to a significant risk of their prospects being worsened by their participation to be morally indefensible, on grounds that this would be a clear case of using a person as a mere means. In this paper, I argue, drawing on Kantian contractualist thinking, that requiring the risk/benefit ratio for participants be positive if a trial is to be morally defensible does not in fact gain any support from Kantian thinking about morality.

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Footnotes

  • Funding National Institute of Allergy and Infectious Diseases (grant no. 1 R01 AI114617-01A1; 1 R56 AI114617-01).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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