David's doctoral thesis examined how harms and benefits should be evaluated and balanced within the framework of the harm–benefit analysis (HBA) used in the ethical review of animal experiments. The thesis also explored ways of strengthening the legitimacy of ethical oversight and the need to promote transparency through broader societal inclusivity.

From the findings, the thesis documented how harms and benefits can be defined, classified, assessed comprehensively, and balanced. Important decision criteria for the HBA highlighted in his thesis include focusing on the scientific rigour of the proposed experiment, the value of the knowledge it is expected to generate, the severity of the disease under study, and careful consideration and mitigation of the harm imposed on animals as part of a comprehensive assessment. The thesis also provided a comprehensive account of the different ways in which the HBA can be applied, including approaches that seek to assign numerical weights to harms and benefits as well as others that rely on structured deliberation among committee members. The thesis concluded that contextual, case-by-case ethical judgement by a diverse committee representing all stakeholder groups should be preferred to quantitative or scoring-based approaches.

To strengthen the legitimacy of ethical authorisations, the thesis recommended that the decision-making process should include people affected by health conditions among the participating stakeholder groups and that ethical verdicts should be grounded in consensus among all participating stakeholders. The thesis further recommended broadening the ethical framework of the HBA to include the psychological harm to research personnel in ethical evaluations. It also proposed that HBA procedures should be documented and made publicly available in order to encourage broader societal discussion of ethical evaluation and authorisation. A national citizens’ panel was in the end proposed to promote societal responsibility and participation in the conduct and oversight of animal research.