Undue Influence as Coercive Offers in Clinical Trials

  • Joan McGregor
Part of the The Philosophical Foundations of Law and Justice book series (AMIN, volume 2)

Coercion has been conceptually connected with threats. Under the standard account of coercion, threats propose to make the victim “worse off” than his or her baseline, or where he or she was before the proposer intervened in the victim’s causal nexus. This model of coercion that focuses only on the notion of threats does not go far enough to capture cases where the victim’s vulnerability is taken advantage of to accomplish the coercion. In the kinds of cases I have in mind, no threats are used or needed. Clinical trials conducted in developing nations, for example, are at risk of taking advantage of the vulnerabilities of the subjects that can rise to the level of coercion. In this paper, I will consider the question whether in some instances clinical trials with vulnerable populations involve coercion that is accomplished not with threats but rather through offers.


Vulnerable Population Sick Child Common Rule Undue Influence Vulnerable Person 
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  1. 1.
    I would like to thank the participants to the AMINTAPHIL conference on Coercion in St. Louis in October 2006. I would particularly like to thank Kenneth Kipnis who commented on this paper at the conference and the editors of this volume.Google Scholar
  2. 2.
    “Trials of War Criminals Before the Nuremberg Military Tribunals under control Council Law No. 10”, (US Govt. Printing Office 1949) reprinted in Judith Areen et al., Law, Science and Medicine, 2nd ed. (Eagan, MN: Foundation Press, 1996), pp. 996–998, Art. 1 [hereinafter Nuremberg Code].Google Scholar
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    This example comes from Joel Feinberg.Google Scholar
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    Joel Feinberg used the idea of “unwelcome” alternatives. See his Harm to Self (New York: Oxford University Press, 1989), especially chs. 23–24.Google Scholar
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    See Anderson’s and Leiser’s contributions to this volume.Google Scholar
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    See my Is it Rape? (Ashgate Publisher, 2006).Google Scholar
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    See the literature on coercion: Bayles, Michael D., “A Concept of Coercion”, in Pennock and Chapman eds., Coercion (Chicago, IL: Aldene-Atherton, 1972), pp. 16–29; Benditt, Theodore, “Threats and Offers”, The Personalist, v. 58, 1979, pp. 382–384; Feinberg, Joel, Harm to Self. (New York: Oxford University Press, 1989); Frankfurt, Harry, “Coercion and Moral Responsibility”, in The Importance of What We Care About. (New York: Cambridge University Press, 1988); Gorr, Michael, “Toward a Theory of Coercion”, Canadian Journal of Philosophy, v. 16, 1986, pp. 383–406; Gunderson, Martin, “Threats and Coercion”, Canadian Journal of Philosophy, v. 9, 1979, pp. 247–259; Haksar, Vinit, “Coercive Proposals”, Political Theory, v. 4, 1976, pp. 65–79; Held, Virginia, “Coercion and Coercive Offers”, in Pennock and Chapman, supra. McGregor, Joan, “Bargaining Advantages and Coercion in the Market”, Philosophy Research Archives, v. 14, 1988–1989, pp. 23–50; Nozick, Robert, “Coercion”, in Philosophy, Science, and Method: Essays in Honor of Ernest Nagel, Sidney Morgenbesser, Patrick Suppes, and Morton White, eds. (New York: St. Martin’s Press, 1969), pp. 440–472; Wertheimer, Alan, Coercion. (Princeton: Princeton University Press, 1987); Zimmerman, David, “Coercive Wage Offers”, Philosophy and Public Affairs, v. 10, 1981, pp. 121–145.Google Scholar
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    See my “Bargaining Advantages and Coercion in the Market”, supra, pp. 23–50.Google Scholar
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    Ibid. 24.Google Scholar
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    Ibid. 25.Google Scholar
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    Ibid. 34.Google Scholar
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    A group of parents of the children in Nigeria sued Pfizer; Ajuda Ismaila ADAMU et al. v. Pfizer No.04 Civ. 1351(WHP) USDC, S.D. New York, November 8; and see “Pfizer Faces Criminal Charges in Nigeria”, by Joe Stephens, Washington Post, Wednesday, May 30, 2007; p. A10.Google Scholar
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    Joe Stephens, “The Body Hunters: Exporting Human Experiments: Where Profits and lives Hang in the Balance: Finding an abundance of Subjects and Lack of Oversight Aboard, Big Drug Companies Test Offshore to Speed Products to Market”, Washington Post, Dec. 17, 2000, p. A1.Google Scholar
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    It should be noted that the pharmaceutical companies normally provide the drugs without charge for clinical trials.Google Scholar
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    Declaration of Helsinki. October 2000. 52nd World Medical Assembly. Edinburgh. Available at Emphasis added.
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    See Ruth Macklin, “Bioethics, Vulnerability, and Protection”, Bioethics, v.17, n. 5–6, 2003, p. 140.Google Scholar
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    In the United States it is difficult to imagine that a clinical trial during an epidemic with children would ever be approved, particularly when there was an available treatment.Google Scholar
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    David Resnik, “Developing Drugs for the Developing World: An Economic, Legal, Moral, and Political Dilemma”, Developing World Bioethics, v. 1, n. 1, 2001, pp. 11–32; Harold Varmus and David Satcher, “Ethical Complexities of Conducting Research in Developing Countries”, supra.CrossRefGoogle Scholar
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    Sckuklenk, “Protecting the Vulnerable: Testing Times for Clinical Research Ethics”, Social Science and Medicine, v. 51, 2000, pp. 969–977.CrossRefGoogle Scholar

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© Springer Science + Business Media B.V 2008

Authors and Affiliations

  • Joan McGregor
    • 1
  1. 1.Arizona State UniversityUSA

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