ISSN Print: 2151-805X
ISSN Online: 2151-8068
Autonomy and Exploitation in Clinical Research: What the Proposed Surfaxin Trial Can Teach Us about Consent
ABSTRACT
It is well recognized that clinical research in resource-poor developing world environments presents ethical complications beyond those normally encountered in developed world clinical research. For example, the proposed Bolivian trial of the surfactant drug Surfaxin in 2001 intended to use a placebo control for a potentially fatal condition because the standard treatment was unaffordable there. This was thought to be exploitative and, as a result, the trial was redesigned and relocated. Closely examining the basis for these kinds of ethical objections reveals important truths about the foundational principles of clinical research ethics applicable to all contexts, whether the developing or developed world. Among these is a more complete understanding of the conditions for truly autonomous consent. Such consent is seen to require not only acquiescence, but for all ends to be mutually endorsed by all parties.
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