 It is often said that those working in bioethics are obsessed with the principle of respect for individual autonomy. Advocates of this view of bioethicists cite the high esteem accorded in the field to the requirement of obtaining individual informed consent and the frequent attempts to resolve bioethical challenges by citing its satisfaction. One might assume that this view within bioethics traces to implicit endorsement of a libertarian analysis according to which it is permissible for competent and informed individuals to do whatever they prefer, provided those with whom they interact are competent, informed and in agreement. In the words of Mill, investigators should be permitted to conduct research and expose participants to risks provided they obtain their “free, voluntary, and undeceived consent and participation” (On Liberty, page 11). Setting aside the question of whether this view accurately characterizes bioethics and bioethicists generally, it does not apply to the vast majority of work done on the ethics of clinical research. Almost no one in the field argues that it is permissible for investigators to conduct any research they want provided they obtain the free and informed consent of those they enroll.