By M. Taylor
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Nor. of course. can requiring consent be any corrective to overestimating the benefits. The simple point is that. in cases like these. and there need only be a few real oneSt requiring informed consent gives no help in achieving maximum welfare. In such cases. one can only insist on informed consent if one holds the Kantian (or Kantian-like) view that there is something gravely wrong with imposing costs on people against their wills no matter how great the benefit. And no self-respecting utilitarian can accept that.
If this judgment is correct, then I will produce better results on the whole if I treat informed consent as an independent constraint; thus I do not assess protocols exclusively on the basis of their expected cost/benefit ratios. It is, therefore, my recognition both of my own limitations and of the imperfections inherent in the review process which lead me to prefer an indirect to a direct strategy. Since the two strategies will often appear indistinguishable, it is important to appreciate the crucial difference between them.
Informed consent may, as Wayne Sumner suggests, reduce the number of mistaken risk/benefit judgements. But how would we know, if there are not attempts or ways of assessing benefits? If an archer's target is never closely inspected, we have no way of telling whether the 'indirect strategy' of aiming slightly above the bull's eye is better than aiming at it. Clearly, IRBs are not staffed by Utilitarians: their range of harms and benefits is too narrow, and their attitude to probabilities and evidence too cavalier.