The Hippocratic maxim ''First, do no harm'' is important but not sufficient to guide the ethics of research. The risk of harm must be compared with the potential benefits, through a form of cost-benefit analysis which takes place on three levels: for the sake of the individual research subject, for all those affected by the protocol, and for society-at-large. Good research design and execution are ethical, insofar as they minimize harm and maximize benefit. The metaphor of ''balancing'' risks with benefits may, however, disguise some of the complexity and ambiguity involved in such a calculus (Weijer, 2000). Older adults have fewer remaining years than their younger counterparts to experience either the benefits or harm related to research participation. They may be more inclined to altruistic behavior than younger persons (Midlarsky et al., 1994). While cost-benefit analysis provides an analytic technique, it does not itself resolve some of the underlying questions in ethics.
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