Part 1: The Belmont Report
Justice
The principle of justice holds that the risks of participating in research and the beneficial results of research should be distributed fairly across both the group to which research subjects belong and the larger society.
One implication of the principle of justice is that medical research, as a whole, should ideally benefit all of society. For individual investigators, this raises questions about how scientifically rigorous information on population subgroups should be generated.
This principle also raises questions about whether the subjects of research, or those like them, must be potential beneficiaries of the results of research. History offers examples of practices that many now deem unjust. For example, in the 19th and early 20th centuries, physicians typically conducted research on poor patients in hospitals, but wealthy patients, whom physicians saw in private practice, had better access to beneficial treatments developed through research. The Belmont Report concludes that:
Whenever research supported by public funds leads to the development of therapeutic devices and procedures, justice demands both that these not provide advantages only to those who can afford them and that such research should not unduly involve persons from groups unlikely to be among the beneficiaries of subsequent applications of research.
U.S. Department of Health, Education and Welfare. The Belmont Report by The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. 18 April 1979. Accessed 14 August 2006. Available from http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm.