COMPLEXITIES OF MEDICAL RESEARCH IN DEVELOPING COUNTRIES: STANDARD OF CARE: RESPONSIBILITIES OF ETHICS COMMITTEES

Abstract

Increased awareness of human rights particularly those of vulnerable and emphasis on protection of less strong from stronger groups, have extended the limits of biomedical ethics where human participants are involved in the research. Inequalities amongst various global groups and subgroups in respect to financial resources and healthcare with increased collaborative biomedical research, particularly for-profit institutions have raised ethical issues one being the standard of care in research in developing countries. Emergence of newer and complex infectious diseases and resurgence of older ones in recent past has prompted Western world to undertake research in the Eastern hemisphere of the globe. But it has generated complex and various ethical dilemmas. Ethics demands that enrollees of research in developing countries not only be judiciously remunerated but outcomes of the studies be directly beneficial and affordable to them along with provision of parallel benefits. The core point of discussion amongst various partners is the selection from possible choices of standard of care to human participants in less developed countries. While some authors have argued for alternate standards whereas others suggest to compromise on this demand in particular conditions with permission from Ethics Committees. These suggestions, besides empowering the ERCs have put more burden on them to prepare guidelines and resolve the encountered issues where presently available guidelines are inadequate or insufficient. This work provides in-depth discussion and analyses possible alternatives to this complex dilemma.