CYIL vol. 11 (2020)

MARTIN ŠOLC CYIL 11 (2020) smallpox acquired from vaccination. 100 We do not need to discuss here to what extent these views could have been considered rational at the end of the 18 th century. History has proven these concerns not true. We will never know for sure whether Kant would have agreed with vaccination, had he been given more accurate information about it. However, it can be taken for granted that voluntary taking of a very minimal risk cannot be judged as impermissible even under Kantianism. Otherwise, it would not be possible to lead a normal life. The same must apply to putting children at minimal risk if it should still be allowed to send them to school, let them play outside or help in the garden, since each of these activities is connected with non-zero risks. Furthermore, some authors argue that a person’s best interests need to be assessed in her or his relational context, taking into account the consequences of a decision on her or his relationships as well as her or his social and altruistic needs 101 . A more holistic approach to the person’s interests that does not exclude her or his psychosocial needs is sure to be welcomed. It could strongly support the participation of children in research that will not bring them a direct health benefit since they may still benefit from participating in emotional, psychological, and social ways. It might even be reasonable to speak about non-medically beneficial, rather than simply non-beneficial, research. This reasoning is, however, limited to children who already possess sufficient cognitive capacity to understand their contribution to others’ well-being, or at least to those who will develop this capacity in the future. 102 It can be concluded that under Kantianism, research on minors is justifiable with the possible exclusion of non-beneficial research (or at least the non-beneficial research on children who will never be able to understand its value). However, it needs to be noted that moral absolutism of Kantian theory sometimes leads to strongly counter-intuitive results: for example, Kant believed that people are never allowed to lie, even if it would prevent a murder 103 . It might be argued that given the pressing need for ethical decision-making in medical research, it is reasonable (and perhaps necessary) to combine elements of more normative approaches, even if it leads to rather “impure” outcomes from a theoretical perspective. This eclecticism is far from rare in contemporary applied ethics. For example, it is sometimes explicitly acknowledged that while utilitarianism is an important part of the modern ethicist’s armamentarium, it arguably should be combined with other ethical approaches 104 . In a similar way, we could understand Kantianism as a complement to other ethical theories, serving as the most sensitive indicator of possible violations of the child’s dignity in research. Of all normative theories, Kantianism is the least inclined to approve to research on minors. If it still justifies this research in almost all cases, it makes a strong case for the general ethical permissibility of such research. 100 See SHELL, Susan Meld. The Embodiment of Reason. Kant on Spirit, Generation, and Community. The University of Chicago Press, Chicago, London 1996, p. 408. 101 See GOOLD, Imogen, HERRING, Jonathan. Great Debates in Medical Law and Ethics. 2 nd ed. Palgrave, London 2018, pp. 74-75, or HERRING, Jonathan, FOSTER, Charles. Welfare means relationality, virtue and altruism. Legal Studies. (2012, Vol. 32, No. 3), pp. 480-498. doi: https://doi.org/10.1111/j.1748-121X.2012.00232.x. 102 For a brief discussion on whether children can benefit from participating in non-medically beneficial research by learning about the value of helping others, see RESNIK, David B. The Ethics of Research with Human Subjects. Protecting People, Advancing Science, Promoting Trust. Springer, 2018, pp. 222-223. 103 For a very brief discussion on Kant’s moral absolutism and its counterintuitive results, see ibid., pp. 76-77. 104 See GOOLD, Imogen, HERRING, Jonathan. Great Debates in Medical Law and Ethics. 2 nd ed. Palgrave, London 2018, p. 24.

424