Therapeutic Research and Group Benefit
The dividing line between medical practice (diagnosis, therapy, prevention) and medical research has long proven a difficult issue. While medical practice is oriented towards the well-being of the individual patient, the goal of medical research is primarily to gain scientific insights. In many instances, however, both goals are pursued at the same time. Numerous labels are used to denote this special type of act, such as "therapeutic experiment" or experiments with a direct medical benefit for the test subjects (self-interested research). Purely scientific experiments are hence referred to as "for the benefit of others". In addition, a distinction is now made for so-called "experiments for group benefit", i.e. those that do not provide any medical benefit for the specific test subject but for the group to which the subject belongs. Membership of a group may be established in this context on the basis of a disease (e.g. Alzheimer's patients) or age (minors).
Critics assert that terms such as "therapeutic experiments" give rise to confusion between structurally different types of act - namely medical treatment, on the one hand, and scientific research, on the other. They therefore argue that all terms suggesting a third, independent type of act between medical practice and research should be done away with. What is more, the concept of "group benefit" is widely rejected. A key counter-argument here is that it is not understandable why a contingent relationship - such as the same age - between the test subjects, on the one hand, and the actual beneficiaries, on the other, should acquire an ethically legitimizing force. In particular, critics point out that one cannot automatically assume the existence of a strong group-based sense of solidarity between test subjects and research beneficiaries belonging to the same group. There is a critic concerning the 12th amendment of the German Drug Law in 2004, which legalized research that benefits a group of patients according to § 41 II Nr.2. Critics object, that the amendment contradicts the protection of the human dignity as it is determined in Art. 1 l of the German Constitution. The argument is that minors, who can’t consent to participate in an experiment and themselves do not benefit from their participation, are misused as a means to an end. Advocates of research which benefits a group of patients, like the lawyer Jochen Taupitz, emphasize that the constitutional right of human dignity is not to be understood individualistically and selfishly. According to the advocates of research that benefits groups, the Federal Constitutional Court stresses that the individual is part of a society. This could also be understood as the solidarity among a community of fate, like a group of children suffering from a rare disease. Research for the benefit of a group therefore does not necessarily contradict the constitutional right of human dignity as long as the degree of the individual’s protection is sufficiently high.
Taupitz, Jochen (2010): Ethische und rechtliche Aspekte der Durchführung von klinischen Studien an Kindern. In: Marckmann, Georg / Niethammer, Dietrich: Ethische Aspekte der pädiatrischen Forschung: Mit der Dokumentation der 26. Jahresversammlung des Arbeitskreises Medizinischer Ethik-Kommissionen in der Bundesrepublik Deutschland am 14. und 15. November 2008, 59-66.