Exploitation and the Ethics of Clinical Research Participation in Nigeria: A Kantian Perspective

Involving human subjects in clinical research exposes them to exploitation. Some philosophers see exposure to excessive risk, lack of informed consent and unfair distribution of benefits relative to harm as the essential features of exploitation. To examine the plausibility of this claim, I explore three transactional accounts of exploitation espoused by Matt Zwolinski, Jeremy Snyder, and Alan Wertheimer. For Zwolinski, exploitation occurs in nonconsensual interaction that leaves one of the interacting parties worse off, violates their rights, or both. Snyder's account is on the duty of beneficence, while Wertheimer's account is on the nature of the fairness of distribution of benefits of transactions. I contend that the accounts of exploitation offered by Zwolinski, Snyder and Wertheimer are inadequate to sufficiently explain the moral wrongness in clinical research like the Lilly and AstraZeneca clinical trials. Interactions can be exploitative even when consensual, beneficial, not excessively risky, and does not worsen the interacting parties. More importantly, exploitation also occurs in relationships that are not transactional, like in clinical research cases. I argue that key to an adequate notion of exploitation, thus, is the Kantian idea of treating someone as a mere means. I argue that an adequate view would be based on the principle that exploitation involves an objectionable relationship of servility between exploiter and exploited.