This first study considers patients' frequent complaints about anxiety, frustration, loneliness, boredom, and uselessness. It suggests changes, some of an almost obvious nature, which might be made in the physical and social environment of the wards to reduce the sense of strangeness and the cold, impersonal atmosphere that aggravate these discomforts.

ESTHER L. BROWN joined the Russell Sage Foundation in Manhattan in 1930 as a research associate and at her retirement in 1963 was its director of executive program planning.

There has hitherto been limited systematic social research on the prolongation and termination of life, and minimal agreement of the resolution of the moral and social dilemmas that dying provokes. Among the topics discussed by the contributors are: the social context of dying—when, where, and why people die; what they think about death; the cultural background of the patients' attitudes; and how medical practitioners cope with terminal illness. The social, ethical, legal, and economic problems arising from the prolongation and termination of life are also set forth.

ORVILLE G. BRIM, JR. is president of the Foundation for Child Development and former president of the Russell Sage Foundation.

HOWARD E. FREEMAN is director of the Institute for Social Science Research and professor of sociology at University of California, Los Angeles.

SOL LEVINE is university professor of sociology and community medicine at Boston University.

NORMAN SCOTCH is professor and chairman of the Department of Socio-Medical Services and Community Medicine at Boston University School of Medicine.

CONTRIBUTORS: Richard M. Bailey, Orville G. Brim, Jr., Diana Crane, Howard E. Freeman, Barney G. Glaser, Robert J. Glaser, Richard A. Kalish, Andie L. Knutson, Louis Lasagna, Monroe Lerner, Sol Levine, Bayless Manning, Robert S. Morison, Osler L. Peterson, David L. Rabin, Laurel H. Rabin, John W. Riley, Jr., Elisabeth K. Ross, Norman A. Scotch, Anselm L. Strauss, David Sudnow, Greer Williams
 

How are human subjects treated in biomedical research? What are the expressed standards and self-reported behavior of biomedical researchers in regard to what has sometimes been called their “animal of necessity”? What are some of the determinants of the “strict” and “permissive” patterns which describe the standards and behavior of biomedical researchers? These are the important questions asked and answered in Research on Human Subjects. It is a book based on four years of intensive research. Two studies were completed, one on a nationally representative sample of biomedical research institutions, a second on a sample of 350 researchers who actually use human subjects.

In their chapters on “the dilemma of science and therapy,” the authors look at the tension between the values of humane therapy and discovery in science. They show that the significant minority of researchers who are “permissive” on the issues of informed consent and a favorable risk-benefit ratio are more likely to be those who are “relative failures” in pursuing the science value.

Research on Human Subjects also documents the inadequate training that biomedical researchers get in the ethics of research on human subjects not only in medical schools but in their postgraduate training as well. The medical schools pay relatively more attention to the scientific training of their students than they do to the ethical training that should be its essential complement.

The local peer review groups that screen research on human subjects in the institutions where it is carried on are another central focus of attention of the research and analysis reported in this book. The peer review groups do a fairly good job but, the authors show, there are various conditions of their relative efficacy which are not met by review groups in many important research institutions. The medical school review groups, for example, have not been outstanding performers with respect to the several conditions of relative efficacy.

In the concluding chapter, the authors discuss the general problem of the social responsibilities of powerful professions and make very specific suggestions for policy change and reform for the biomedical research profession and its use of human subjects.

BERNARD BARBER is on the Barnard College and Graduate Faculties of Columbia University.

JOHN J. LALLY is at Lehman College, CUNY.

JULIA LOUGHLIN MAKARUSHKA is at Barnard College, Columbia University.

DANIEL SULLIVAN, formerly of Barnard College, now teaches at Carleton College.