A commentary titled "Toward Improved Understanding of the Ethical and Clinical Issues Surrounding Mandatory Research Biopsies" published in the January 1, 2013 issue of the Journal of Clinical Oncology alerted me to a bioethics debate regarding "mandatory research biopsies versus the rights of prospective trial participants to freely consider consent to a research biopsy separately from consent to a clinical trial."
Opponents of the practice of mandatory research biopsies cite the following issues: linking consent to a biopsy to participation in a clinical trial is coercive, mistaken assumption by patients that biopsy provides a clinical benefit, technical scientific problems limit the usefulness of the biopsies, and optional biopsies can achieve the same results as mandatory biopsies.
The optional biopsies option makes no damn sense to me. After enrolling in a study a patient can always refuse to complete any portion of the trial he/she wishes, so "mandatory" research biopsies are in reality always "optional biopsies". Problem solved.
The coercion complaint is the issue most interesting to a libertarian bioethicist. What does coercion mean? That is the crux of the matter. The Dictionary.com app on my iPhone defines coercion as the "use of force or intimidation to obtain compliance." A plumbline libertarian obviously opposes coercion if this is the definition. This is not the definition of coercion, however, that the opponents of mandatory research biopsies are apparently utilizing. The commentary author states the following: "It is clear that patients in some settings feel that they will be harmed, through loss of access to the experimental intervention, if they fail to pursue trial care. This arguably creates a sense of coercion ... " So another non-libertarian incorrectly defines coercion as harm. Plumbline libertarians do not oppose harm, for one is harmed if someone steals your girlfriend, but stealing someone's girlfriend is not coercive and not unethical and not a libertarian crime. Case closed.
In summary, the LIBERTARIAN BIOETHICS BLOGger supports mandatory research biopsies.
Opponents of the practice of mandatory research biopsies cite the following issues: linking consent to a biopsy to participation in a clinical trial is coercive, mistaken assumption by patients that biopsy provides a clinical benefit, technical scientific problems limit the usefulness of the biopsies, and optional biopsies can achieve the same results as mandatory biopsies.
The optional biopsies option makes no damn sense to me. After enrolling in a study a patient can always refuse to complete any portion of the trial he/she wishes, so "mandatory" research biopsies are in reality always "optional biopsies". Problem solved.
The coercion complaint is the issue most interesting to a libertarian bioethicist. What does coercion mean? That is the crux of the matter. The Dictionary.com app on my iPhone defines coercion as the "use of force or intimidation to obtain compliance." A plumbline libertarian obviously opposes coercion if this is the definition. This is not the definition of coercion, however, that the opponents of mandatory research biopsies are apparently utilizing. The commentary author states the following: "It is clear that patients in some settings feel that they will be harmed, through loss of access to the experimental intervention, if they fail to pursue trial care. This arguably creates a sense of coercion ... " So another non-libertarian incorrectly defines coercion as harm. Plumbline libertarians do not oppose harm, for one is harmed if someone steals your girlfriend, but stealing someone's girlfriend is not coercive and not unethical and not a libertarian crime. Case closed.
In summary, the LIBERTARIAN BIOETHICS BLOGger supports mandatory research biopsies.
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