3. Justice
Justice in human subject research refers to questions of "fairness in distribution" or "what is deserved" to people. This implies that subjects ought to be treated equally and fairly with respect to one another and the experiment at hand. Generally speaking, it denotes that healthcare and (scarce) resources should be distributed evenly and fairly over populations. Within the context of research ethics, it demands that research subjects are to be selected fairly and without putting undue pressure on one particular social, racial or gender group.
An important safeguard for concerns of justice in experimental surgical protocols rests with the IRB (Institutional Review Board) system. IRBs have guidelines and formulas for even distribution over the various population denominators, to ensure a just selection system. This arrangement protects the validity of experimental results and the rights of subjects.
To illustrate the point, consider an experimental surgery that was not submitted to an IRB and performed without protocol or prior patient population assessments. It is doubtful that the patients chosen will be selected using a random, fair method that draws subjects evenly across the general population. Aside from potentially confounding the results of such an "informal study", it could also be an unfair method with respect to the patients selected. Certain patient groups will be more heavily burdened by the experiment, depending on the expected outcomes of the procedure. This underlines the ethical importance of selecting human subjects in a just and equitable manner.
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