PrintPart 2 - Treatment of Subjects and Stakeholders
How eager would you be to take a medicine for an ailment if you were not at all sure if either the medicine would work on your ailment – or if the side-effects of the medication were worse than the disease? How confident would you be in someone you never met saying that they "have your best interests" in mind when making decisions for you, such as ? On one hand, new medicines could not be brought to market if no one was willing to take part in early trials of the medicine. On the other hand, not many people would be eager to be among the first to test out a new drug for an ailment or life-threatening disease, unless the alternatives were definitively worse. Research is often conducted on humans, animals, living systems, and environments in ways that could impact the well-being (positively and negatively) of those subjects of research. Important ethical questions arise when we begin to ask how much those subjects know about the risks of partaking in specific research or how a specific intervention may impact their health. Further, ethical problems are compounded when the subject(s) of research or decision-making cannot speak or make decisions for themselves, such as for an unconscious patient on life support, or even for non-human subjects, like animals, plants, and ecosystems. The main ethical question that arises is whether a subject or stakeholder is able to consent to participating in research and/or decision-making, or what is referred to as "informed consent."
Having the capacity to give consent to being part of research, receiving a medical treatment with known risks (like surgery), and/or having decisions (including policies) about your welfare made on your behalf requires the ability to consent and be informed (and understand that information) well enough to make a well-grounded decision. The idea of informed consent, however, is only applied to humans who can consent. While consent cannot be given by animals, ecosystems, and other non-human subjects, the idea of consent is implicit in trying to come to a decision about the minimization of harms. This consideration of the well-being of non-human subjects unable to consent would widely apply, from animals in a laboratory setting to aquifers in a hydraulic fracturing (fracking) zone, and are typically taken into consideration through existing regulatory processes (such as the Institutional Review Board or Environmental Impact Assessments.)
The main concept to keep in mind here is the idea of consent, whether it be informed consent of a patient or research subject, or a form of representative consent, where a person or organization stands in for the concerns of the non-human subject(s) undergoing research or significant changes.