The experiments that Henry Beecher described could not now occur; even the most ambitious or confident investigator would not today put forward such protocols. Indeed, the transformation in research practices is most dramatic in the area that was once most problematic: research on incompetent and institutionalized subjects. The young, the elderly, the mentally disabled, and the incarcerated are not fair game for the investigator. Researchers no longer get to choose the martyrs for mankind.
In fact, the balance has shifted to such an extent that we now sometimes read news stories not of researchers pressuring individuals to become research subjects but of desperately ill individuals pressuring researchers to accept them as research subjects for experimental treatments. At the same time, the shift toward for-profit drug testing (described in “Contemporary Issues: ‘Guinea Pigging,’”) has raised new concerns not only about the safety of research subjects but also about the credibility of the research enterprise itself.
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