Rose - terrific brain teaser - here's my immediate reaction to one of the quotes from the article; hope this turns into a great discussion!

JAMA says: "The current prevailing view is that participation in biomedical research is above and beyond the call of duty....we propose a novel public goods argument for an obligation to participate....biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it...Participation in research is a critical way to support an important public good....Consequently, all have a duty to participate...."

If this is true, then isn't good health a public good? If we have a duty or responsibility to participate, then don't the medical advances that result belong to everyone and not just to those with good insurance or more money?

In other words, it can be argued that the logical extension of JAMA's provocative idea would have major implications for the health care delivery system as well. The case for universal care would be strengthened. It would be difficult to argue that health care be denied for any reason if everyone were responsible to participate in trials. I kind of like it!