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Research ethics

What makes risky early clinical trials worth doing?

Habets MG, van Delden JJ, Bredenoord AL · BMC medical ethics · 2014

Open access · cc by · source: Europe PMC

The authors argue that 'social value' should refer only to the improvement a tested intervention is expected to bring to patients, and that trials of interventions lacking such value should not expose people to risk at all.

Study at a glance

Design
Qualitative / archival — Philosophical conceptual analysis of how 'social value' is used in research-ethics literature and guidelines, followed by a normative proposal.
N
No participants or data; an argument paper.
Population
Clinical research involving human participants, especially first-in-human (phase I) trials
Outcome
Thesis that social value should mean the anticipated improvement an intervention brings to patients' wellbeing and should be a prerequisite for involving humans in research

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

They argue that existing taxonomies create an inconsistency: if phase I trials have less value than phase III trials, it is hard to explain why we accept higher risks in phase I. Placing value on the intervention, not the trial, removes that inconsistency. They propose a 'risk-value' rather than 'risk-benefit' assessment for first-in-human trials, and a two-step ethics review: first reject proposals whose intervention has no anticipated social value, then weigh value, translational prospect and validity against risks. They add that the public and patients, not only scientists, should help judge what counts as enough value.

Methodology

The authors survey how research-ethics writers and guidelines use 'social value', 'clinical value', 'progressive value' and similar terms, and show that these attach value to different things (knowledge, trials, information). They distinguish values of society from value for society, then propose a narrower concept of anticipated social value and separate it from a trial's translational prospect and its scientific validity. They illustrate with examples such as an antimicrobial peptide trial with a poorly chosen comparator.

Limitations

The authors admit that 'value' remains ambiguous and they do not solve the underlying philosophical question of what makes something valuable. They offer no standard for how much anticipated value is enough, leaving that to public deliberation, and they concede their proposal does not remove the problem of justifying high risks in phase I when participants gain no direct benefit. The practicality of extra review steps such as researcher-patient meetings is argued for but not tested.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsResearch ethicsconcept

    Ask what the tested intervention could be worth, not just whether the trial is well run.

    Social value should be attached to the intervention being tested rather than to the trial, which removes an inconsistency (accepting higher risk in phase I trials said to have lower value); the authors propose a risk-value rather than risk-benefit assessment for first-in-human trials and a two-step review that first rejects interventions with no anticipated social value.

    Evidence for the claim as stated.

  • SupportsResearch ethicsconcept

    The social-value paper wants tighter formal review (a two-step committee test plus public input on value), while the virtue-ethics paper argues that the conflicts investigators actually face cannot be settled by general guidelines and need cultivated judgment. Both accept review; they differ on where the main ethical work should happen.

    Evidence for the claim as stated.

  • SupportsResearch ethicsconcept

    The REC-outcomes paper doubts that committees are shown to protect anyone, while the social-value proposal adds new committee duties. These are compatible but in tension: adding tasks to a system whose outcomes are unmeasured.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Disagreement on the same question

    The social-value paper wants tighter formal review (a two-step committee test plus public input on value), while the virtue-ethics paper argues that the conflicts investigators actually face cannot be settled by general guidelines and need cultivated judgment. Both accept review; they differ on where the main ethical work should happen.

  • Scope difference — different assays, populations, or outcomes

    The REC-outcomes paper doubts that committees are shown to protect anyone, while the social-value proposal adds new committee duties. These are compatible but in tension: adding tasks to a system whose outcomes are unmeasured.

    Also on this tension

History

When this study was placed

Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.

  1. 2026-09-27

    Placed as supporting evidence on Research ethics

    Social value should be attached to the intervention being tested rather than to the trial, which removes an inconsistency (accepting higher risk in phase I trials said to have lower value); the authors propose a risk-value rather than risk-benefit assessment for first-in-human trials and a two-step review that first rejects interventions with no anticipated social value.

  2. 2026-09-27

    Placed as supporting evidence on Research ethics

    The social-value paper wants tighter formal review (a two-step committee test plus public input on value), while the virtue-ethics paper argues that the conflicts investigators actually face cannot be settled by general guidelines and need cultivated judgment. Both accept review; they differ on where the main ethical work should happen.

  3. 2026-09-27

    Placed as supporting evidence on Research ethics

    The REC-outcomes paper doubts that committees are shown to protect anyone, while the social-value proposal adds new committee duties. These are compatible but in tension: adding tasks to a system whose outcomes are unmeasured.

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