Manson, Neil Campbell (2017) Misleading by omission : rethinking the obligation to inform research subjects about funding sources. Journal of Medicine and Philosophy, 42 (6). 720–739. ISSN 0360-5310
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Abstract
Informed consent requirements for medical research have expanded over the past half-century. The focus here is upon one aspect of this expansion: the introduction of explicit obligations to inform subjects about funding sources, in the Declaration of Helsinki. Whilst it is agreed from the outset that a failure to inform about funding sources can wrong a research subject, a general obligation is problematic in a number of ways: including, determining the scope of the norm; plus problems with subjects’ comprehension of complex funding information, and, most importantly, that such a norm seems to oblige researchers to disclose too much, including information irrelevant to most consent decisions. We ask whether the general obligation in Helsinki might be justified by appeal to respect for autonomy and informed consent, but find that it cannot be. The general obligation seems to rest upon an “informational fallacy”. We then note that this orthodox justification of research ethics—by appeal to respect for autonomy and informed consent—has been subject to various critiques. The aim in the second part of the paper is to provide a better approach to making sense of how a failure to inform about funding sources wrongs subjects: making appeal to obligations to refrain from misleading by omission. This alternative approach—grounded in obligations to refrain from misleading—provides a basis for a norm that protects subjects interests without being hostage to the orthodox justification, that avoids the informational fallacy, and that—by and large—avoids the problems noted above about the scope of the obligation, and its implications for subjects’ comprehension.