There has been more medical legal scholarship on the conduct of medical
research involving human subjects than almost any other consent topic—in
interesting contrast to the nearly complete lack of litigation alleging injuries
from improperly conducted research. Medical research is controversial because
of the abuses that occurred in the not-too-distant past, rather than a current
litigation threat. Ranging from the medical experiments conducted by the Nazis
to the Tuskegee syphilis experiment [Jones JH. Bad Blood: The Tuskegee
Syphilis Experiment. New York: Free Press; 1981.] conducted by the U.S. Public
Health Service, these abuses resulted in the promulgation of two major
international codes and extensive congressional regulation. [Katz J, Capron
AM, Glass ES. Experimentation with Human Beings: The Authority of the
Investigator, Subject, Professions, and State in the Human Experimentation
Process. New York: Russell Sage Foundation; 1972.] Any patient injured by an
experiment that violates these codes or regulations can sue the physician for
medical malpractice. More commonly, however, investigators or their
institutions are sanctioned by the Department of Health and Human Services
(HHS) or the U.S. Public Health Service for not complying with governmental
regulations.
In one area, litigation (and criminal investigation) is probable. The growth of
joint research agreements between universities and medical businesses,
combined with the involvement of medical scientists in for-profit ventures, has
put many scientists in violation of laws dealing with conflicts of interest and
stock fraud. The Public Health Service has also promulgated rules governing
misconduct in science, which could be the basis for fraud-related litigation.
Lawsuits asserting financial fraud are not covered by medical malpractice
insurance and are especially dangerous to physicians. The physician-scientist
must pay the defense costs for such actions and any fines or damages if the
defense is unsuccessful.