Discussion of manipulation as a form of undermining the consent of participants in clinical reserach, and specifically pregnant women who are HIV positive.. / I will argue that the relationship between the clinician scientist and the participant in the ACTG 076 trials involved unethically manipulative elements. My question of unethical manipulation examines the relationship between the clinician scientist and the participant. My first chapter establishes manipulation as follows, ‘A manipulates B if and only if A motivates B to make a decision or perform an action that bypasses B’s rational capacities by means of deception, emotional pressure, or exploitation of B’s ego depleted state.’ I argue that manipulation is prima facie unethical because it violates one’s autonomy. In the second chapter I examine the concerns of illness, gender roles, pregnancy, and HIV status, which can cause ego depletion and increase the participants’ vulnerability to manipulation. After analysis, I conclude that, although none of these elements can be eliminated as concerns for the clinician scientist, if they are not adequately accounted for, the clinician scientist has unethically manipulated the participant to enter and remain a part of the trial. I suggest that an adequate account would involve special consideration of how these vulnerabilities interact within the specific context of the trial. My third and final chapter will relate my conclusions to the current and upcoming research that is actively incorporating pregnant women as participants. / Thesis / Master of Arts (MA) / This thesis will examine the need to include the term “manipulation” into current ethical guidelines for Western bioethics because manipulation is a concept that is separate from concepts such as “coercion,” “force,” “exploitation,” or “undue influence” which appear in current Western bioethical guidelines. Manipulation is an unethical influence of another’s decision-making that undermines their autonomy, whereas autonomy is a key feature of Western bioethics and must be fostered rather than undermined or hindered. This thesis will discuss a clinical case in which pregnant women with HIV were enrolled in a clinical trial and I will discuss how illness, gender, pregnancy, and HIV status can cause one’s ego to be depleted so that they are more vulnerable to manipulation than other clinical participants. Finally, I will recommend that states, ethics boards, and researchers are the primary actors responsible for ensuring that participants are not manipulated in clinical research settings.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/24566 |
| Date | January 2019 |
| Creators | Woodward, Leanne |
| Contributors | Emerson, Claudia, Gedge, Elisabeth, Philosophy |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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