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Clinical Trials, Vol. 2, No. 3, 244-253 (2005)
DOI: 10.1191/1740774505cn084oa
© 2005 The Society for Clinical Trials

A critical history of individual and collective ethics in the lineage of Lellouch and Schwartz

Charles M Heilig

Mathematical Statistician, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE MS K21, Atlanta, GA 30341-3717, USA. E-mail: cheilig@cdc.gov

Charles Weijerb

Department of Bioethics, Dalhousie University, Halifax, Canada

The notions of individual and collective ethics were first explicitly defined in the biostatistical literature in 1971 to motivate a mathematical solution to a posed ethical dilemma. This paper reviews key antecedents to these concepts and traces explicit references to them over time, primarily in the biostatistical literature. Following a historical exposition of these texts, a critical thematic analysis shows the following: the normative force of these concepts has not been adequately argued. Individual and collective ethics do not solve the problem of how to use accumulating data to inform ethical action. The notions of the "individual" and the "collective" are too vague to prompt clear moral imperatives, especially in difficult cases. These concepts have not been successfully linked to a standard ethical framework. Finally, the paper concludes with the observation that a systematic, comprehensive ethical framework must be identified to fulfill the intuitions behind individual and collective ethics.


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