Global Health and Global Health Ethics: Justice and research in developing countries

摘要: Clinical research is a morally complex activity. When properly conducted, it represents powerful tool for generating information and knowledge that often cannot be obtained by other means. oriented, this the key to advancing standard of care creating policies, practices interventions can used improve health large populations people. For almost two decades now, clinical has become an increasingly global enterprise. With “outsourcing” or “off-shoring” research, new ethical complexities have arisen are not easily accommodated within frameworks primarily oriented protecting participants in domestic context. In part because profound conditions social, economic political deprivation inequality play fundamental, sometimes unique, role cross-national research. Because such inequality, instance, what unreasonable risk someone high-income country (HIC) may represent valuable opportunity low- middle-income (LMIC). Similarly, potential generate significant social benefits HICs little relevance host communities struggle with poverty underdeveloped medical, public scientific infrastructures. Although there widespread agreement international should take unfair advantage disease LMICs, disagreement about need met order ensure fair consistent fundamental principles justice (Angell, 1997; Lurie & Wolfe, Crouch Arras, 1998; Glantz et al ., 1998).