While randomized controlled trials are essential to health research, many of these trials fail to recruit enough participants. Approaching recruitment through the lens of behavioral science can help trialists to understand influences on the decision to participate and use them to increase recruitment. Although this approach is promising, the use of behavioral influences during recruitment is in tension with the ethical principle of respect for persons, as at least some of these influences could be used to manipulate potential participants. In this paper, we examine this tension by discussing two types of behavioral influences: one example involves physician recommendations, and the other involves framing of information to exploit cognitive biases. We argue that despite the apparent tension with ethical principles, influencing trial participants through behavior change strategies can be ethically acceptable. However, we argue that trialists have a positive obligation to analyze their recruitment strategies for behavioral influences and disclose these upfront to the research ethics committee. But we also acknowledge that since neither trialists nor ethics committees are presently well equipped to perform these analyses, additional resources and guidance are needed. We close by outlining a path toward the development of such guidance.
With an increasing use of artificial intelligence (AI) systems, theorists have analyzed and argued for the promotion of trust in AI and trustworthy AI. Critics have objected that AI does not have the characteristics to be an appropriate subject for trust. However, this argumentation is open to counterarguments. Firstly, rejecting trust in AI denies the trust attitudes that some people experience. Secondly, we can trust other non-human entities, such as animals and institutions, so why can we not trust AI systems? Finally, human-AI trust is criticized based on a conception of human-human trust, which does not recognize the distinctiveness of the human-AI relationship. This article aims to refute these counterarguments based on the genealogical analyses of 'trust' and 'trustworthiness' of Karen Jones and Thomas Simpson, who show that trust and trustworthiness help to overcome vulnerabilities. This function of trust gives reason to use human-human trust as a standard. For this function, it is important that trustees are responsive to trust. While animals and institutions could be responsive, narrow AI systems are unable to be responsive to trust. Therefore, we should not apply trust to AI and instead direct our trust to those who can be responsive to and held responsible for our trust.
Community engagement is increasingly defended as an ethical requirement for biomedical research. Some forms of community engagement involve asking the consent of community leaders prior to seeking informed consent from community members. Although community consent does not replace individual consent, it could problematically restrict the autonomy of community members by precluding them from research when community leaders withhold their permission. Community consent is therefore at odds with one of the central principles of bioethics: respecting autonomy. This raises the question as to how community consent can be justified or even required. This paper aims to provide an answer to this question by arguing, based on the work of Taylor and Kymlicka, that community practices are important for the identity and autonomy of community members. When these practices are incompatible with a solitary focus on individual informed consent, they need to be protected by making these decision‐making practices (including asking permission to community authorities) part of the consent process. Since these decision‐making practices are important for the autonomy of community members, community consent with the goal of protecting these practices is not necessarily in conflict with autonomy.
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