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J Med Ethics 36:500-504 doi:10.1136/jme.2009.032656
  • Research ethics

Between the needy and the greedy: the quest for a just and fair ethics of clinical research

  1. Claudio Lorenzo1
  1. 1UNESCO Chair of Bioethics – Post-Graduation Program of Bioethics, Public Health Department, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
  2. 2Section for Medical Ethics, Department of General Practice and Community Medicine, University of Oslo, Oslo, Norway
  3. 3Centre for International Health, University of Bergen, Bergen, Norway
  4. 4Unesco Regional Consultant for Bioethics, SHS Sector, Regional Office for Science of UNESCO- Montevideo, Montevideo, Uruguay
  5. 5Education Programme of Bioethics – Redbioética Unesco, Córdoba, Argentina
  1. Correspondence to Dr Volnei Garrafa, UNESCO Chair of Bioethics – Post-Graduation Program of Bioethics, Faculty of Health Sciences, University of Brasília, PO Box 04451, CEP 70904-970, Brasília, Federal District, Brazil; volnei{at}unb.br
  • Received 14 August 2009
  • Revised 24 March 2010
  • Accepted 31 March 2010

Abstract

The acceleration of the market globalisation process over the last three decades has internationalised clinical research and influenced both the way in which it is funded and the development and application of research practices. In addition, in recent years international multicentre randomised clinical trials have become the model par excellence for research on new medicines. The neoliberal model of globalisation has induced a decline in state power, both with regard to establishing national research for health priorities and to influencing the development of adequate ethical guidelines to protect human beings that participate in multinational research. In this respect, poor and low-income countries, which lack sustainable control and review systems to deal with the ethical and methodological challenges of complex studies conducted by researchers from affluent countries and funded by large multinational pharmaceutical companies, are particularly vulnerable. The aim of the present paper is to explore critically some of the actual and possible ethical pitfalls of globalisation of clinical research and propose mechanisms for turning transnational clinical research into a more cooperative and fairer enterprise.

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.