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Lots of interesting issues posed, both in class session and below.  Among the thoughts on my mind is that many of the problems being addressed are of our own making and reflect culturally idiosyncratic (perhaps not sustainable?) presumptions about biomedical research, human risk, and money.  Lots of very useful drugs have never been through the kind of clinical testing we demand today.  And it is not at all clear to me that one needs double-blind, control group testing  to evaluate either hazard or efficacy in most cases.   Such rigorous procedures are needed only when one is looking for very small effects.  Finally, I think it needs to be admitted that much clinical testing is driven not by a general concern for public health but rather by profit motives.  Under these circumstances, I might be inclined not only to pay test subjects but to insist that they be included among the authors on any resulting papers.