John Harris, Professor of Bioethics at the Institute of Medicine, Law and Bioethics at the University of Manchester, does not advocate making it a legal requirement for people to get involved. But he contends that compulsion is, in principle, justifiable, and in certain circumstances, may be justified.

And he suggests that a change to the Declaration of Helsinki, which sets out the ethical grounds for research, is warranted.

Professor Harris points out that other activities in society, such as vaccination the wearing of seatbelts, and jury service, require the loss of personal autonomy for the public good. "Might medical research be another such case," he asks?

Financial incentives to participate in research are fully justified and preferable to compulsion, he argues.

Everyone in society stands to benefit from research, and indeed has already benefited, so it should be economically, politically, and personally supported, he says.

But he argues that research has "almost universally been treated with suspicion and even hostility" by most of those involved in its regulation. The prevailing assumption is that only the insane, the reckless, or the excessively altruistic would ever dream of taking part in it.

While history has proved that suspicion of doctors and biomedical research is well founded, he says, this does not mean that research is guilty until proven innocent.

"Vigilance against wrongdoing is one thing; the inability to identify wrongdoing, with the result that the good is frustrated and harm caused is quite another," he writes.

He concludes: "The argument concerning the obligation to participate in research should be compelling for anyone who believes there is a moral obligation to help others, and/or a moral obligation to be just an
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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ Specialty Journals
30-Mar-2005