A Relational Account of Exploitation in Clinical Research

Abstract

Exploitation is an important concept in moral and political philosophy. There is an increasing focus on exploitation as an important concept that limits how clinical research is conducted. Yet, there is disagreement at nearly every level regarding the source of wrongness of exploitation, its connection to injustice, and the practical importance of exploitation. This dissertation considers whether the most compelling available theories of exploitation are capable of addressing all of the theoretical and practical problems of exploitation that have been cited in the theoretical and bioethics literature, and finds them wanting. The main approach that I take is to consider exploitation as wrongful advantage taking of relational inequalities. Exploitation is a problem of dynamics between/among people, and is grounded in the instrumentalizing of inequalities for advantage. How exploitation affects and degrades relationships explains its connection to injustice and exploitation’s special importance to clinical research ethics.