6.4.3 Justice

Justice is about ensuring that the risks and benefits of research are distributed fairly.

The Belmont Report argues that the principle of Justice addresses the distribution of the burdens and benefits of research. That is, it should not be the case that one group in society bears the costs of research while another group reaps its benefits. For example, in the 19th and early 20th century, the burdens of serving as research subjects in medical trials fell largely on the poor, and the benefits of improved medical care flowed primarily to the rich.

In practice, the principle of Justice was initially interpreted around the idea that vulnerable people should be protected from researchers. In other words, researchers should not be allowed to intentionally prey on the powerless. It is a troubling pattern that in the past, a large number of ethically problematic studies have involved extremely vulnerable participants including poorly educated and disenfranchised citizens (Jones 1993); prisoners (Spitz 2005); institutionalized, mentally disabled children (Robinson and Unruh 2008); and old and debilitated hospital patients (Arras 2008).

Around 1990, however, views of Justice began to swing from protection to access (Mastroianni and Kahn 2001). For example, activists argued that children, women, and ethnic minorities needed to be explicitly included in clinical trials so that these groups could benefit from the knowledge gained by these trials.

In addition to questions about protection and access, the principle of Justice is often interpreted to raise questions about appropriate compensation for participants—questions which are subject to intense debate in medical ethics (Dickert and Grady 2008).

Applying the principle of Justice to the three examples offers yet another way to evaluate them. Participants in none of the studies were compensated financially. Encore raises the most complex questions about the principle of Justice. While the principle of Beneficence might suggest excluding participants from countries with repressive governments, the principle of Justice could argue against denying these people the possibility to participant in–and benefit from—accurate measurements of Internet censorship. The case of Taste, Ties, and Time also raises questions. In this case, one group of students bears the burdens of the research and society as a whole benefits. To be clear, however, this was not an especially vulnerable population. Finally, in Emotional Contagion the participants were a sample from the population most likely to benefit from the results of the research, a situation well aligned with the principle of Justice.