In Reply I appreciate the comments of Mr Rothstein and Dr Siegal on my recent Viewpoint about the Declaration of Helsinki. We agree on many points, including that the duty owed by physicians to patients can be “inconsistent with clinical research whose purpose is to produce generalizable knowledge.” I certainly concur that “the important ends of medical research do not justify any and all means.” Indeed, appropriately protecting research participants has long been at the core of research ethics. And as Rothstein and Siegal also note, “balancing risks and possible benefits” is an important part of determining those protections.
