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May 2006, Vol 96, No. 5 | American Journal of Public Health 781-787
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.063719

HEALTH POLICY AND ETHICS

Justice and Fairness in the Kennedy Krieger Institute Lead Paint Study: the Ethics of Public Health Research on Less Expensive, Less Effective Interventions

David R. Buchanan, DrPH and Franklin G. Miller, PhD

David R. Buchanan is with the School of Public Health and Health Sciences, University of Massachusetts, Amherst. Franklin G. Miller is with the Division of Research Ethics, Center for Clinical Bioethics, National Institutes of Health, Bethesda, Md.

Correspondence: Requests for reprints should be sent to David Buchanan, DrPH, Professor of Community Health Education, 306 Arnold House, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003 (e-mail: Buchanan{at}schoolph.umass.edu.)

The Kennedy Krieger lead paint study stirred controversial questions about whether research designed to develop less expensive interventions that are not as effective as existing treatments can be ethically warranted. Critics questioned the social value of such research and alleged that it sanctions a double standard, exploits participants, and is complicit in perpetuating the social injustice.

In response, we demonstrate the propriety of conducting research on interventions that can be extended to the population in need by stipulating the limited conditions in which it is ethically warranted and providing fair terms of participation. We contend that the failure to conduct such research causes greater harm, because it deprives disadvantaged populations of the benefits of imminent incremental improvements in their health conditions.




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