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ETHICAL PROBLEMS AND SOLUTIONS FOR CLINICAL RESEARCH IN HUMAN NUTRITION

The clinical nutritionist shares the usual ethical problems of other medical scientists, but he also confronts some unusual ones that are unique to his questions and his methods. Such particular problems can be usefully emphasized by reference to illustrative examples in the scientific literature. Nutritionists have a proud tradition of accomplishment with the experimental method. Few other scientific disciplines have so productively proceeded from hypothesis to animal trial to human confirmation. The early trials of Lind were a model of clinical experimentation. The astute observations by Eijkman of animal disease, the extension to feeding trials, and the application to human beri-beri form a model of propriety. The development of the control of pellagra by Goldberger and Wheeler is a fine demonstration of propriety in human research by responsible investigators. It seems appropriate for a nutritionist to reexamine the options for experimental subjects and the myth of “informed consent.” From this I will propose an extension of our professional mechanisms for maintaining a surveillance over clinical research through the development of an institutional “propriety committee” composed of the investigator’s peers.