Christopher Lewis

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies

Racial justice is widely seen as a central moral and political ideal of our time, especially on the liberal-egalitarian left. And racial justice goes hand in hand with racial equality. The centrality of these ideals would be hard to justify if they had no bearing on material or economic inequality, or applied solely to semiotic and cultural issues. But we argue that, at present, the only plausible basis for understanding racial equality as a distinctive aim for the economic domain—rather than a mere implication of more general egalitarian or progressive principles—rests on minimal state, right-libertarian foundations. As such, racial equality is a strange focus for the left.