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Who is my brother's keeper?

M H Kottow1

  • 1Faculty of Medicine and Faculty of Philosophy and Humanities, University of Chile, Santiago, Chile. kottow@hotmail.com

Journal of Medical Ethics
|February 9, 2002
PubMed
Summary

Developed nations often use lower ethical standards in clinical research in poorer countries, despite prohibitions in their own nations. This paper critiques bioethical arguments justifying these double standards in medical and pharmaceutical practices and research.

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Area of Science:

  • Global Health Ethics
  • Bioethics
  • International Research Standards

Background:

  • Developed countries implement clinical and research practices in developing nations.
  • Justifications for these practices include placebo use, unapproved drug distribution, withholding therapy, and denying post-trial benefits.
  • These practices often contradict ethical standards in developed nations and the Declaration of Helsinki.

Purpose of the Study:

  • To critique bioethical arguments that support less stringent ethical standards in international clinical and research practices.
  • To challenge the justification of double ethical standards in medical and pharmaceutical practices, research strategies, and the application of research results.
  • To advocate for the universal application of ethical standards in global health research.

Main Methods:

  • Literature review and critical analysis of bioethical arguments.
  • Examination of justifications for differential ethical standards in clinical and research practices.
  • Analysis of arguments concerning placebo use, drug approval, and post-trial benefits.

Main Results:

  • The paper identifies and critiques arguments that defend lower ethical standards in research conducted in developing countries.
  • It highlights the inconsistency of these practices with ethical guidelines like the Declaration of Helsinki.
  • The analysis reveals a trend of bioethicists providing justifications for exceptions to universal ethical norms.

Conclusions:

  • There is a need to challenge and reject ad hoc arguments that permit lower ethical standards in research in developing nations.
  • Universal ethical standards must be upheld in all clinical and research practices, regardless of geographic location.
  • Scholars should promote the universalizability of ethics rather than defending ethically questionable exceptions.
Keywords:
Analytical ApproachBiomedical and Behavioral Research

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