Justice

The Belmont Report uses the term ''justice'' to refer to ''fairness in distribution.'' This is different from the word's common association with enforceable rights and penalties within a legal system but consistent with general usage in the field of bioethics. Justice in this context involves the ethical allocation of a fair share of risks or possible harms incurred in research and the allocation of benefits expected to result from the research. Research risks can range from minor inconvenience, to discomfort, to actual harm. For an individual or group to carry a large share of risks of research without getting a proportionate share of the benefits seems unfair, even if it is difficult to say exactly what constitutes a fair and equitable distribution. The early history of human subject research is replete with examples of disadvantaged or vulnerable populations (prisoners, disabled elderly, devel-opmentally disabled persons, etc.) serving as research subjects and risking harm in the quest for knowledge expected to benefit some other population. Study design and subject selection distribute potential harm among subjects. The knowledge acquired in research and the research activity itself (particularly in therapeutic clinical research) can be a source of tremendous benefits; the nature of the study itself and its subject recruitment and selection determine who will get those benefits.

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