CHAPTER 5

Choose Action

Systematic Ethical Decision Making

I cannot for want of sufficient premises, advise you what to determine, but if you please I will tell you how.

—Benjamin Franklin1

ON MARCH 13 , 2006, six men were infused with a brandnew drug, TGN1412, in a research facility outside London, England. Within minutes, one of the men complained of a headache. Within hours, all six were rushed to Northwick Park Hospital with multipleorgan shutdown. Only massive doses of steroids, administered intravenously, along with mechanical ventilation and other high-tech support, brought the men back from the brink of death.2

The episode marked one of the most disastrous clinical drug trials—and triggered a storm of criticism. Why, observers asked, ...

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