AN ECONOMIC ANALYSIS OF HUMAN SUBJECTS RESEARCH ETHICS;
CHARACTERIZING THE SUBJECTS RIGHTS VS. SOCIAL BENEFITS TRADEOFF

CV Phillips* (Minnesota Center for Philosophy of Science, University of Minnesota, Minneapolis,
MN 55455) 

Economics teaches that it is seldom optimal to do anything perfectly, but rather there is some
optimal middle-ground tradeoff between competing goals. Economics provides conceptual
quantitative tools, particularly the possibility frontier and shadow price, that help clarify
available tradeoffs. We can apply these concepts to the core ethical dilemma of research on
human subjects: the tradeoff between deontological concerns about subjects' rights or clinicians'
obligations vs. the consequentialist value to society of the knowledge from the study. The options
for making this tradeoff, in the form of various health research designs such as observational
studies and randomized trials, are discussed and presented graphically using the possibility
frontier concept. This shows the range for possible fulfillment of the deontological goals and
contributions to health. Within this context, several non-standard methods are considered and
compared, including variations on randomized trials and observation-trial hybrid designs.
Ultimately, the clear comparison provided by the economic approach can help our choices focus
on available options rather than theoretical ideals, contrary to how human subjects ethics is often
discussed. In particular, we need to recognize that experimentation will inevitably infringe upon
rights and obligations, and so we always must ask if the benefit justifies the degree of infringement. 

American Journal of Epidemiology, 153(11):S206, 2001.