Jennifer Hawkins

This book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of "use" are morally permissible? What is it to exploit people? Suppose that a trial conducted in a developing country would not be ethically permissible in the developed world. Can we automatically conclude from this that the trial is unethical, that some sort of morally problematic double standard is in operation? Or might the differences in the two settings justify differences in trial design? This collection of philosophical essays examines these important questions about what exploitation is and when clinical research counts as exploitative. "This is an outstanding contribution to the growing literature on the ethics of research with human subjects and a fine example of what bioethics can offer at its best. Anyone with a serious interest in these issues will need to read this book from start to finish." -Daniel Wikler, Harvard School of Public Health "This book contributes significantly to the literature on exploitation in clinical research conducted in the developing world."--Patricia Marshall, Case Western Reserve University

Desire satisfaction theorists and attitudinal-happiness theorists of well-being are committed to correcting the psychological attitudes upon which their theories are built. However, it is not often recognized that some of the attitudes in need of correction are evaluative attitudes. Moreover, it is hard to know how to correct for poor evaluative attitudes in ways that respect the traditional commitment to the authority of the individual subject's evaluative perspective. L. W. Sumner has proposed an autonomy-as-authenticity requirement to perform this task, but this article argues that it cannot do the job. Sumner's proposal focuses on the social origins of our values and overlooks the deep psychological roots of other evaluative attitudes that are just as problematic for welfare. If subjective theories of welfare are to be at all plausible they may need to abandon or modify their traditional commitment to the authority of the individual subject

Philosophers concerned with what would be good for a person sometimes consider a person’s past desires. Indeed, some theorists have argued by appeal to past desires that it is in the best interests of certain dementia patients to die. I reject this conclusion. I consider three different ways one might appeal to a person’s past desires in arguing for conclusions about the good of such patients, finding flaws with each. Of the views I reject, the most interesting one is the view that prudential value is, at least partly, concerned with the shape of a life as a whole