Double standards in medical research in developing countries (Cambridge law, medicine and ethics)

When scientists from the developed world conduct clinical trials in the developing world, special ethical issues arise. What is owed to experimental and control groups? Should new drugs be tested against the best current treatment, or against what is locally available—even if that is nothing? What happens when local mores clash with international ethical guidelines? What role should local ethics review committees play? Should trials be conducted on a population whose poverty will prevent them from sharing fully in the fruits of the research? What can be done (and by whom?) to distribute these fruits more widely and fairly? These are just some of the questions Professor Ruth Macklin, a prominent bioethicist, addresses in this provocative book. It constitutes an articulate, policy level argument that research populations in the developing world must, whenever possible, receive treatment and benefits equal to those enjoyed by their counterparts in the developed world. Indeed, among the most interesting parts of this book is a discussion of several approaches for making medical drugs more affordable to developing countries. The book touches on the philosophical aspect, but focuses more on the practical application for the conduct of research, from the policy perspective of ethical guidelines. Non‐specialists might regard the descriptions of each version of several guidelines to be more detailed than they require. However, using these descriptions to frame the discussion allows Professor Macklin to highlight the range and evolution of thought on these topics. She capitalises here on her experience in helping to draft international research ethics guidelines. Professor Macklin is generally careful (save when criticising the US government) to present arguments of those with whom she disagrees, thus giving readers the opportunity to weigh matters for themselves. The book is clearly written and accessible, and will provide food for thought for researchers, ethicists, and others.