Avoiding Justice: Research at the Auction Block

Although the principle of justice plays a peripheral role in domestic research in high-income countries, it grounds a series of requirements in international research relating to responsiveness to host community health needs, the standard of care, and assurances of post-trial access. This chapter reviews a proposal to eliminate what is seen as a cumbersome mix of requirements on international research in favor of a framework of procedures that render considerations of fairness more manageable within the confines of orthodox research ethics. This might appear to be an alternative to the approach defended in this book because it would avoid having to engage with difficult issues of justice that reach beyond the confines of the field as it is currently configured. This chapter argues that efforts to avoid substantive conceptions of justice wind up tacitly enforcing a particular conception of justice, and it is shown that the proposal to streamline the ethics of international research cannot satisfy some of the requirements that its proponents advocate.