Larry Udell

This essay explores some concerns about the quality of informed consent in patients whose autonomy is diminished by fatal illness. It argues that patients with diminished autonomy cannot give free and voluntary consent, and that recruitment of such patients as subjects in human experimentation exploits their vulnerability in a morally objectionable way. Two options are given to overcome this objection: (i) recruit only those patients who desire to contribute to medical knowledge, rather than gain access to experimental treatment, or (ii) provide prospective subjects the choice to participate in standard doubleblind study or receive the experimental treatment. Either option would guarantee that patients in desperate conditions are given a more meaningful choice and a richer freedom, and thus a higher quality of informed consent, than under standard randomized trials

Barbara Fried described John Rawls’s response to libertarianism as “the unwritten theory of justice.” This paper argues that while there is no need for a new theory of justice to address the libertarian challenge, there is a need for an additional chapter. Taking up Fried’s suggestion that the Rawlsian response would benefit from a revised list of primary goods, I propose to add employment to the list, thus leading to adoption of a full employment principle in the original position that ensures that anyone who wants to work will be able to do so. I argue that although Rawls famously proposed government as employer of last resort, he never integrated that comment into his theory, which lacks a full employment principle and says nothing about the injustice of involuntary unemployment in its ideal theory. I first refute the received view of Rawls’s treatment of employment as required by its importance for citizens’ self-respect, then show that in fact, the full employment assumption is the result of the role of general equilibrium theory in Rawls’s model of a well-ordered society, and indicate why developments in economic theory and economic policy support the proposed revision.