British bioethicist John Harris has again plunged into controversy by arguing that medical research is so important that people should sometimes be forced to participate. In an article in the Journal of Medical Ethics, he balances the rights of the subject against the society’s need for medical advances, which he compares to taxation, jury duty or wearing seat belts. “There is a balance to be struck here,” he writes, “but is not a balance that must always and inevitably be loaded in favour of the protection of research subjects.”

Professor Harris acknowledges that his idea would shake long- established conventions, such as the World Medical Association’s Helsinki declaration. He suggests an addition to the declaration: “biomedical research involving human subjects cannot legitimately be neglected, and is therefore both permissible and mandatory, where the importance of the objective is great and the risks to and the possibility of exploitation of fully informed and consenting subjects is small.”

“The argument concerning the obligation to participate in research should be compelling for anyone who believes there is a moral obligation to help others, to be just and do one’s share. Little can be said to those whose morality is so impoverished that they do not accept these obligations”, Professor Harris says in a biting indictment of potential critics.

Children and incompetent people, such as patients who are demented or in a permanent vegetative state, should also be forced to participate, if necessary, says Professor Harris. “The presumption should surely be that [children] would have wished to behave decently and would not have wished to be free riders” who benefit from research but do not contribute, he contends. Normally, competent individuals should be preferred as research subjects, but in extreme cases, it might be necessary to enlist the incompetent.

In another article in the same journal, a leading Australian stem cell scientist uses Professor Harris’s libertarianism as a touchstone to gauge how much respect is due to a human embryo. Professor Bob Williamson, of the University of Melbourne, says that it is impossible to identify a single point at which an embryo deserves to be respected as a future person. Only at implantation does it begin to acquire a tenuous claim on respect. He relies heavily on Harris’s contention that only persons deserve respect and that a person is “any being capable of valuing its own existence” — a rather narrow gate which excludes many modes of human life.

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