Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making

By David J. Rothman | Go to book overview

CHAPTER 5
New Rules for the Laboratory

EVEN the most sensational exposé will not necessarily spark fundamental alterations in public attitudes or policy. Media attention is fickle and the competition for front-page coverage or a few minutes on the evening news so intense that even egregious scandals may fade from attention. Further, countless ways exist for those in authority to explain problems away, from blaming a few bad apples to assuring everyone that the deficiencies have already been corrected. But not all exposés disappear without a trace. They may affect those so high in power as to generate critical changes (Watergate) or reveal conditions so substandard as to shock the conscience (a hellhole of an institution for the retarded), or describe conditions so frightening in their implications as to rivet attention (images of a silent spring). Human experimentation had elements in common with all of these, helping to ensure that its scandals would produce structural change.

A number of investigators certainly attempted to minimize the problem. Some insisted, as we have seen, that Henry Beecher's cases were aberrations; although no one dared to make the point so bluntly, other researchers undoubtedly believed it proper to trade off the rights of highly marginal groups for the sake of scientific progress, to keep the World War II model operational and out of mothballs. After all, strictly utilitarian principles could justify the experiments of a Saul Krugman; the retarded, it could be argued, did not have all that much to lose

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Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making
Table of contents

Table of contents

  • Title Page *
  • Contents vii
  • Acknowledgments ix
  • Introduction - Making the Invisible Visible 1
  • Chapter 1 - The Nobility of the Material 15
  • Chapter 2 - Research at War 30
  • Chapter 3 - The Gilded Age of Research 51
  • Chapter 4 - The Doctor as Whistle-Blower 70
  • Chapter 5 - New Rules for the Laboratory 85
  • Chapter 6 - Bedside Ethics 101
  • Chapter 7 - The Doctor as Stranger 127
  • Chapter 8 - Life through Death 148
  • Chapter 9 - Commissioning Ethics 168
  • Chapter 10 - No One to Trust 190
  • Chapter 11 - New Rules for the Bedside 222
  • Epilogue 247
  • Appendix A - Citations to Henry Beecher's 1966 Article 263
  • Notes 266
  • Index 293
  • About the Author *
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