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

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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…show more content…
in her article “The Ethics of Clinical Research in the Third World”, stating that it is only ethical to use placebo-controlled studies “when there is no known effective treatment” (Angell, 847). The current protocol consists of a lengthy treatment with costly drugs, but Angell argues that despite the logistics, beneficence still applies, and the available treatment should be the standard to which all others is measured against. There is also the guiding of issue of not only ensuring that subjects are not treated as just a minimal part of the ultimate goal, but ensuring that the subjects' well-beings be the primary concern for researchers as well. Yet, the available treatment is being withheld, leaving the placebo-controlled group without any treatment at all. The justification is weak at best, Angell says, with researchers claiming that the placebo-group would not be receiving the necessary treatment anyway, so they are simply observing the natural manifestation of the infection in the mother and infant that would occur regardless of the study. Yet, if there is a shift in ethical reasoning from what is “best” to what is “local”, vulnerable populations will be open to further exploitation by researchers and the practice is ultimately a direct violation of the guidelines set forth by the various public and global health organizations which all require equal protection to that received in the sponsoring nation (848). The context of the study,
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