Researching the vulnerables: issues of consent and ethical approval

Imagine you are a biomedical scientist attempting to cross a busy, beggar-crowded road in Lagos. You suddenly notice that the loud horns of the speeding cars, trucks and trailers draw no visible physiologic response from any of the beggars including their children and babies, unlike the rest of the crowd. Consequently, certain questions such as the following begin to engage your mind: Is this phenomenon a kind of habituation? If so, is its onset the same for the blind ones amongst them? Have these beggars acquired a neural system absent from "normal" people? If so, just how long does it take for such a system to be established? At the very height of this creative outburst, you however realize that the informed consent and ethical approval you would need for this particular research differs from the type you have previously encountered in your career.... Although the above scenario suggests that new and difficult ethical questions may confront scientists while pursuing their curiosity, our research ethics guidelines do not currently address this issue. This paper explores some of the ethical challenges involved in carrying out basic research on vulnerable subjects such as beggars. It highlights how the notions of autonomy and informed consent in this context become vague, thus, liable to exploitation. Ultimately, the paper offers a useful framework in relation to developing a research ethics committee charged with the moral mandate of overseeing the integrity of research involving this vulnerable population in particular and basic biomedical research in general.