The Ethics of Clinical Research in the Third World by Marcia Angell

954 Words2 Pages

Third world countries and underdeveloped nations have become the new proverbial Petri dish of experimentation and offer particular conditions which researchers would never be able to find in their home countries. This only serves to highlight the problem that inherently faces all research studies, the ethical debate in regards to the protection and rights of their subjects. Is it feasible to expect the same standards to apply in certain countries where an economical imbalance between what is possible and what is not can be the largest hurdle to overcome? These are key issues examined in the New England Journal of Medicine by author Marcia Angell, M.D., and co-authors Harold Varmus, M.D. and David Satcher, M.D. in their respective articles that consider the ethical standards that should prevail in such circumstances. Should researchers be upheld to universal standards, or are the standards more applicable in a “local” sense, where the conditions and the constraints of the location provide the context for how the principles should be applied? Ethical violations committed on underprivileged populations first surfaced close to 50 years ago with the discovery of the Tuskegee project. The location, a small rural town in Arkansas, and the population, consisting of black males with syphilis, would become a startling example of research gone wrong. The participants of the study were denied the available treatment in order further the goal of the research, a clear violation of the Belmont Report principle of beneficence. This same problem faces researchers today who looking for an intervention in the vertical transmission of HIV in Africa, as there is an effective protocol in industrialized nations, yet they chose to use a placebo-contro... ... middle of paper ... ...ide grounds for a debate. There is no true “what is good for the goose” or cover all principle when dealing with such diverse conditions as those found in our world. While the Belmont Principles should be at the core of all research studies, the context chosen may be able to provide some guidance into their applications. Either end of the scope offers its drawbacks, the median ground may be hard to achieve, but as long as the debate continues, studies on vulnerable populations will remain in focus and hopefully help to find the median ground. Works Cited Angell, Marcia. "The Ethics of Clinical Research in the Third World." New England Journal of Medicine. 337.12 847-849. Web. 9 Feb. 2014. Varmus , Harold, and David Satcher. "Ethical Complexities of Conducting Research in Developing Countries." New England Journal of Medicine. 337.14 1003-1005. Web. 9 Feb. 2014.

Show More
Related

  • Henrietta Lacks Ethics

    2327 Words  | 5 Pages

    Johns Hopkins Hospital would use people in their “public wards”, who were predominately of low socioeconomic status, as research material without any permission or knowledge of their participation (Skloot, 2010, p. 30). The main ethical principles that apply in the this scenario of not receiving consent to have personal information and even bodily material used for research are: Integrity (1.04), Rights and Prerogatives of Clients (2.05), Characteristics of Responsible Research (9.02), and Informed Consent (9.03). This dilemma was not handled correctly because doctors during that time were interested in studying cancer cells and believed that it was acceptable to take people’s cells as a form of payment because they were receiving free medical treatment. Henrietta, in particular, was never asked or even told that her healthy and tumorous cells were being extracted during the day of her first cancer treatment (p. 33). Those at stake during this particular issue are the patients in the public wards, including Henrietta, the doctors Richard TeLinde, George Gey, and Howard Jones, the Lacks family, and many other families who do not know their loved ones are being used for science. Although laws were not set in place at the time, the doctors should have been presenting patients with consent forms and fully disclosing all the information pertaining to how they

    Read More

  • The Belmont Report: The Henrietta Lacks Case

    1392 Words  | 3 Pages

    According to the Belmont Report (1979), justice is relevant to the selection of subjects of research at two levels: the social and the individual. Skloot (2010) describes how “Gey took any cells he could get his hands on” and how “TeLinde began collecting samples from any woman who walked into Hopkins with cervical cancer” (p. 30). These two doctors did not exhibit fairness in their selection of subjects. Dr. TeLinde was collecting samples from women on the color ward and did not consider the appropriateness of placing further burdens on already burdened persons. The women whose tissue samples are being gathered for research are the women who will most likely be the last to benefit; because more advantaged populations (wealthy and white) will initially be the primary

    Read More

  • case study 4

    583 Words  | 2 Pages

    Slosar, J. P. (2004). Ethical decisions in health care. Health Progress. pp. 38-43. Retrieved from http://www.chausa.org/publications/health-progress/article/january-february-2004/ethical-decisions-in-health-care

    Read More

  • African American Nursing Case Study

    1069 Words  | 3 Pages

    There are a number of ethical issues in this case. A major ethical issue surrounding this study pertains to the subjects being enrolled without their informed consent. The test subjects were also promised free “bad blood” treatments, which is not what they were receiving at all. Members were misinformed of the purpose of the study and the details regarding their involvement. In addition they were not informed of the disease they had (syphilis) or how serious the disease processes were. An agreed autopsy after death had to be made in order to have their funeral costs paid for. None of the subjects were given proper treatment for their disease, and when penicillin became available as an effective treatment for syphilis, they were not allowed to

    Read More

  • Film Analysis based on Miss. Evers Boys

    1011 Words  | 3 Pages

    When penicillin was discovered in 1940 and was the only cure for syphilis at that time. The participants form Tuskegee Syphilis Experiment were excluded from many campaigns that were taking place in Macon County, Alabama to eliminate venereal diseases (Person Education, 2007). This experiment lasted forty years and by the end 28 of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with congenital syphilis (info please, 2007). The directors of this experiment used ethical, interpersona... ... middle of paper ... ...

    Read More

  • Marcia Angell Research Ethics

    1683 Words  | 4 Pages

    When doing any studies with human subjects, “the safest and most reasonable position is that people everywhere are likely to respond similarly to the same treatment” (300). With third world countries, Angell states there are dissimilarities between population, but that cannot be anticipated. The local of standard care should not be different, the best treatment and care should always be given regardless of where the study takes place and who the subjects are. As clinical trial studies are becoming more popular, researchers need to understand the same protection goes to the people rather they are aboard or at home. Studies done in third world countries are unethical because they cannot afford the same effective treatment.

    Read More

  • Control in a Clinical Trial

    1532 Words  | 4 Pages

    As Epstein (2007) alluded that pharmaceutical companies could be exploiting the poor infrastructure, deferential patient population and the lack of regulatory body in developing countries to conduct clinical trials that are ethically unacceptable [‎12].

    Read More

  • Deadly Deception Summary

    414 Words  | 1 Pages

    The study took advantage of an oppressed and vulnerable population that was in need of medical care. Some of the many ethical concerns of this experiment were the lack of informed consent, invasion of privacy, deception of participants, physical harm, mental harm, and a lack of gain versus harm. One ethical problem in this experiment was that the benefits did not outweigh the harm to participants. At the conclusion of the study there were virtually no benefits for the participants or to the treatment of syphilis. We now have

    Read More

  • Negotiating a Budget

    915 Words  | 2 Pages

    1. Capp, Marshall B. "Ethical and Legal Issues in Research Involving Human Subjects: Do You Want a Piece of Me? -- Kapp 59 (4): 335 -- Journal of Clinical Pathology." BMJ Journals. J Clin Pathol, 18 Jan. 2006. Web. 11 Feb. 2012.

    Read More

  • Racial Discrimination and Health Care

    1821 Words  | 4 Pages

    Steinbock, Bonnie, Alex J. London, and John D. Arras. "’Rights- Based’ Approaches." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 23. Print.

    Read More

  • Government Testing on Human Subjects and the Intricacies of Informed Consent

    2010 Words  | 5 Pages

    Freedman, B. (1987). Equipoise and the Ethics of Clinical Research. New England Journal of Medicine, 48, 44-48.

    Read More

  • Outsourcing Clincal Trials

    1885 Words  | 4 Pages

    The globalization of clinical trials is a fairly new phenomenon and the price of developing new drugs on average costs $1 billion and most of that cost stems from human clinical trials. In the “Ethical and Scientific Implications of the Globalization of Clinical Research” essay, the reason for outsourcing clinical trials to developing countries is the increasingly bureaucratic and expensive regulatory environment in many wealthy countries. Regulating clinical research have become very complex, placing a...

    Read More

  • Clinical trials

    652 Words  | 2 Pages

    Freedman B. Equipoise and the ethics of clinical research. N Engl J Med. 1987; 317(3): 141-145

    Read More

  • The Ethical Structure Behind Human Experimentation

    3400 Words  | 7 Pages

    The history of medical research in the twentieth century provides abundant evidence which shows how easy it is to exploit individuals, especially the sick, the weak, and the vulnerable, when the only moral guide for science is a naive utilitarian dedication to the greatest good for the greatest number. Locally administered internal review boards were thought to be a solution to the need for ethical safeguards to protect the human guinea pig. However, with problems surrounding informed consent, the differentiation between experimentation and treatment, and the new advances within medicine, internal review boards were found to be inadequate for the job. This led to the establishment of the National Bioethics Advisory Commission by President Bill Clinton in the hopes of setting clear ethical standards for human research.

    Read More

  • Self And Social Psychology

    2999 Words  | 6 Pages

    ... common among social psychologist like what happened when someone conducted a research called The Tuskegee Study of Untreated Syphilis in the Negro Male. The patients in this study were not treated with the disease. The reason why they were selected for the study is to find out the outcome of having Syphilis and not find a cure for it. The research was deemed unethical because the patients were at risk not knowing that they are indeed suffering from Syphilis. They don’t know the symptoms, the cure or the medicine that they should take and it shows that they were rob of the opportunity to get well because the said fact was hidden from them. If there would be another research to be done regardless of the topic, it might be impossible to get participants because of fear that such unethical behavior from researchers might happen again putting everyone’s lives at risk.

    Read More

More about The Ethics of Clinical Research in the Third World by Marcia Angell

Open Document