Professional responsibility and the protection of human subjects of research in Canada.

Fundamental principles that characterize medicine’s social contract are primacy of the patient’s welfare, patient autonomy and social justice. Professions become de facto trustees of the public interest if those principles are maintained in the face of pressures from the state or the marketplace. Professions must protect not only vulnerable persons but also vulnerable social values. If professions do not meet their responsibility, public criticism ensues and, in the case of medicine, characterizes physicians as servants of the state or tools of business.