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Clinical research which poses net risks raises important ethical concern. Net-risk studies raise concern that subjects are being used as mere means to collect information to benefit future patients. Research procedures that pose net risks may seem to raise more concern when they are embedded within a study which offers a favorable risk-benefit profile overall.
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James Lind's (1716-1794) experiments on the treatment of scurvy inBritish sailors represent perhaps the first modern clinical trial because he attempted to address one of the primary challenges facing those who set out to evaluate medical treatments.
Hippocratic medicine tended to be very aggressive and observational rather than experimental. Common remedies prescribed by Hippocratic physicians included special diets, herbal medicines, exercise, baths, and massage.
German-Swiss physician and alchemist Paracelsus (1493–1542), Renaissance physician Andreas Vesalius (1514–1564), and English physician William Harvey (1578–1657) sought to apply the experimental method to medicine. They dissected animal and human bodies, which allowed them to develop a better understanding of human anatomy and physiology.
By the early twentieth century, physicians had mixed views about medical research. Physicians still accepted the Hippocratic ethos, but they were also interested in advancing medical science and testing new therapies. Although some physicians, such as Walter Reed, sought consent from their patients, medical practice was highly paternalistic. Physicians often treated their patients without explaining what they were doing or why. They were more concerned with helping their patients than obtaining consent and they often viewed medical experimentation as a necessary part of treatment. Indeed, physicians practicing medicine during this era did not have a clear sense of the difference between research and treatment and many mixed the two together.
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