A framework to link international clinical research to the promotion of justice in global health

Bioethics. 2014 Oct;28(8):387-96. doi: 10.1111/bioe.12009. Epub 2012 Dec 20.

Abstract

How international research might contribute to justice in global health has not been substantively addressed by bioethics. Theories of justice from political philosophy establish obligations for parties from high-income countries owed to parties from low and middle-income countries. We have developed a new framework that is based on Jennifer Ruger's health capability paradigm to strengthen the link between international clinical research and justice in global health. The 'research for health justice' framework provides direction on three aspects of international clinical research: the research target, research capacity strengthening, and post-trial benefits. It identifies the obligations of justice owed by national governments, research funders, research sponsors, and investigators to trial participants and host communities. These obligations vary from those currently articulated in international research ethics guidelines. Ethical requirements of a different kind are needed if international clinical research is to advance global health equity.

Keywords: global health; global justice; health capability paradigm; international clinical research; research ethics.

MeSH terms

  • Clinical Trials as Topic / economics
  • Clinical Trials as Topic / ethics*
  • Clinical Trials as Topic / standards
  • Clinical Trials as Topic / trends
  • Community-Based Participatory Research / economics
  • Community-Based Participatory Research / ethics*
  • Community-Based Participatory Research / standards
  • Developed Countries
  • Developing Countries
  • Ethics, Research
  • Global Health* / economics
  • Global Health* / ethics
  • Global Health* / standards
  • Global Health* / trends
  • Guidelines as Topic / standards
  • Health Services Accessibility / economics
  • Health Services Accessibility / ethics*
  • Humans
  • International Cooperation*
  • Moral Obligations*
  • Research Support as Topic / ethics
  • Social Justice* / ethics
  • Social Responsibility*