STATE CAPACITY AND THE FATE OF JUSTICE

Contemporary bioethics often blurs the line between clinical care and medical research, urging us to see health care as a “learning system.” This article pushes back, defending the ethical importance of the research–practice distinction. It argues that pragmatic clinical research often requires more rigorous informed consent than its advocates suggest, and it reinterprets the principle of clinical equipoise—long dismissed in research ethics—as a tool for distinguishing which practices demand greater transparency and patient protection.