Abstract

THE PARAMOUNT ETHICAL questions posed by any clinical trial include the following: Should it be done at all? What information will be elicited that is not now available? Is seeking to obtain this information justifiable in terms of the risks to the subjects that may be involved? In the view of John Fletcher, PhD, these questions override all other considerations in the protection of human subjects, including the much-publicized one of informed consent. Before going to the University of Virginia School of Medicine, Charlottesville, where he is professor of biomedical ethics, Fletcher was the resident bioethicist at the Clinical Center of the National Institutes of Health (NIH), Bethesda, Md—the first person to hold the post. Fletcher became interested in the ethical aspects of medical research when he was a student at Union Theological Seminary in New York City, where he received his doctorate. During that period, he worked as a

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