According to Maggie’s writeup, “UC Davis officials say that approval was poorly done — that the patients had misunderstood the surgeons and vice versa — leading to a situation where the volunteers can’t really be said to be truly volunteering.”
or the surgeons promising it would work.
I didn’t say that any surgeon promised it would work, nor do I know the details of exactly how it was proposed, but the whole point is that when the balance of power is as I described it, and a doctor tells a terminally ill person that they have a strong hunch that something could just work, the consent can sometimes go from “informed consent” to “wishful thinking consent.” That’s why IRB boards exist, to provide an unbiased advocate for the patient.
A bureaucracy with a vested interest in avoiding risk should not have the ability to harshly sanction surgeons who took risks with the consent of terminal ill patients. It’s a straightforward moral hazard; the board will nearly always exhibit group behavior (which is distinct from individual behavior) that will retard the ability of dying humans to willingly make a gift of their final days or hours to the cause of human knowledge. That’s wrong, even if you accept that some patients will die without having fully understood their options.
If the patient’s not terminal, and suffers or dies as the result of the experimentation, the situation is obviously different, and the balance changes. Then it would be reasonable to err in the opposite direction, understanding that bureaucrats and elders usually act to retard progress in any field (other than weaponry and destruction) but that experimenters can’t be given incentive to misinform patients to gain consent - that’s yet another moral hazard.
The counter argument boils down to assuming that an abject fear of death is a highly desirable human characteristic, and that it’s better to force suffering humans to experience the maximum possible lifespan rather than risk allowing them to make their own decisions, which could possibly be ill-informed.
