A new look at international research ethics
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International research is often unethical and irrelevant to the needs of developing countries, argues Professor Solomon Benatar of the University of Cape Town's Bioethics Centre, in this week's BMJ. And it fails to address the huge inequities in global health.
Too much reliance is placed on international declarations to define what is ethical, all of which are open to interpretation contends professor Benatar. For example, it may not be right to use placebos in trials. The "standard of care" for international research has not been adequately defined and no description is offered that goes beyond mere drug therapy. The standard of medical practice and research in the United States, where half of all global health expenditure is spent on just 5 per cent of the world's population every year, cannot be the standard for most other countries.
And concerns about abuses of research ethics have failed to be extended to deprivation as a result of poverty and other threats to freedom, he writes. And the fact remains that 90 per cent of all medical research is undertaken on diseases that account for just 10 per cent of global illhealth.
"Research ethics must be more deeply rooted in the context of global health," writes professor Benatar. "It must forthrightly address the social, political, and economic forces that widen global inequities in health, and it must ultimately be concerned with reducing [these]."
Contact:
Professor Solomon Benatar, Department of Medicine and Bioethics Centre, University of Cape Town, South Africa
Tel (via University of Toronto): +1 416 978 7742
Fax: +1 416 978 1911Email: solly.benatar@utoronto.ca