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Landes M. Can context justify an ethical double standard for clinical research in developing countries?. Global Health. 2005;1(1):11doi: 10.1186/1744-8603-1-11.
Landes, M. (2005). Can context justify an ethical double standard for clinical research in developing countries?. Globalization and health, 1(1), 11. https://doi.org/10.1186/1744-8603-1-11
Landes, Megan. "Can context justify an ethical double standard for clinical research in developing countries?." Globalization and health vol. 1,1 (2005): 11. doi: https://doi.org/10.1186/1744-8603-1-11
Landes M. Can context justify an ethical double standard for clinical research in developing countries?. Global Health. 2005 Jul 26;1(1):11. doi: 10.1186/1744-8603-1-11. PMID: 16045801; PMCID: PMC1183235.
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Global Health. 2005 Jul 26;1(1):11. doi: 10.1186/1744-8603-1-11.

Can context justify an ethical double standard for clinical research in developing countries?.

Globalization and health

Megan Landes

Affiliations

  1. London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK. [email protected]

PMID: 16045801 PMCID: PMC1183235 DOI: 10.1186/1744-8603-1-11

Abstract

BACKGROUND: The design of clinical research deserves special caution so as to safeguard the rights of participating individuals. While the international community has agreed on ethical standards for the design of research, these frameworks still remain open to interpretation, revision and debate. Recently a breach in the consensus of how to apply these ethical standards to research in developing countries has occurred, notably beginning with the 1994 placebo-controlled trials to reduce maternal to child transmission of HIV-1 in Africa, Asia and the Caribbean. The design of these trials sparked intense debate with the inclusion of a placebo-control group despite the existence of a 'gold standard' and trial supporters grounded their justifications of the trial design on the context of scarcity in resource-poor settings.

DISCUSSION: These 'contextual' apologetics are arguably an ethical loophole inherent in current bioethical methodology. However, this convenient appropriation of 'contextual' analysis simply fails to acknowledge the underpinnings of feminist ethical analysis upon which it must stand. A more rigorous analysis of the political, social, and economic structures pertaining to the global context of developing countries reveals that the bioethical principles of beneficence and justice fail to be met in this trial design.

CONCLUSION: Within this broader, and theoretically necessary, understanding of context, it becomes impossible to justify an ethical double standard for research in developing countries.

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