Medical breakthroughs owe their existence to the human subjects
who volunteer for studies. Federal and international regulations
aim to assure that research on human subjects is ethical—that
the potential benefits outweigh the risks, for example, and that
subjects give written informed consent. But recent trends may be
loosening the safety net. The number of trials has skyrocketed
in recent years, straining the oversight system and putting
pressure on researchers to recruit more subjects than ever
before. In addition, whereas trials used to be conducted mainly
at academic institutions, most are now run by for-profit
companies, which often pay doctors to sign up volunteers and pay
review boards to approve the trials. These arrangements raise
concerns about financial conflicts of interest.