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Incidental Findings and Ancillary-Care Obligations

Published online by Cambridge University Press:  01 January 2021

Extract

This paper explores the convergence of two recent and growing streams of bioethical work and concern. Each has originated independently, but each arises from the fact that the Common Rule that has shaped medical research ethics, as institutionalized in the United States and also abroad, is largely silent about what needs to be done in response to researchers’ positive obligations. One stream concerns what to do about the sometimes vast range of findings that may arise incidentally to performing research procedures. The other asks whether medical researchers owe their study participants any “ancillary care” — that is, medical care that their study participants need but that goes beyond what is required to do the science safely.

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2008

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References

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Some readers will deny that there is a moral difference between the cases because they hold that, in effect, that Marvin has a duty-to-rescue sort of duty to warn in both cases. To restore the difference between the cases, I would ask these readers please to adjust downward the urgency and stakes of the warning. I do agree that, when the stakes are high enough and the urgency extreme, the duty to rescue will supersede the difference that the two scenarios are designed to highlight.Google Scholar
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Our analogy to the old common-law idea of bailment in Richardson, and Belsky, , supra note 14, at 28, has the disadvantage that it may suggest this reified interpretation of the scope of entrustment, since bailment is the limited entrustment of some valuable thing, such as an automobile. Our intention, however, was simply to use this analogy to introduce the idea of a limited and partial entrustment. I continue to think the analogy to bailment useful, as it illustrates how obligations can arise from voluntary transactions in a non-promissory way. See my “Special Obligations of Beneficence,” supra note 33.Google Scholar
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“The big muddy,” the unsympathetic reader will nickname it. I cannot claim to have attained ideal clarity about these complex issues. I can only invite this reader to further improve our understanding of how these issues interrelate.Google Scholar