The Concept of Exploitation in Medical and Health Related Research Ethics: Literature Analysis

Increased International collaborative research activities in poor and low-income countries have several unique claims on our attention. First, the idea of involving human beings in research, putting forward participants openly to trials presents a novel experiment in which various academic disciplines can play in order to enhance fair studies. Second, apart from the need to conduct research in medical and health related areas, there have been many ethical challenges including the necessity to prevent harm among research participants and to ensure that they receive a fair share of benefits from research results. Despite existence of ethical guidelines and declarations, potential research participants from poor and low-income countries in particular, still risk exploitation due to limited health care access, and little awareness of research on human beings. It is, therefore, necessary for us to examine the main features of this system, which provides the framework within which research activities are done; in order to find out if and how research ethics can be used to enhance fair studies. This thesis has attempted to provide a careful assessment of current debates on exploitation in medical and health related research ethics, with special emphasis on the different revisions of the declaration of Helsinki - and other relevant international declarations and ethical guidelines through literature analysis; to investigate the concept of exploitation among vulnerable groups in poor and low income populations. Empirical case studies including informal discussions with existing research ethics committee members were sought from Tanzania. Analysed literature findings reveal that the concept of exploitation has been expressed in various ways. New forms of exploitation in medical and health related research ethics include the use of placebo and the modification of the concept of benefit to include forms of benefit not directly related to trials under consideration. There are strong urges to abandon the current revision of declaration of Helsinki and adopt the Universal Declaration on Bioethics and Human Rights (UDBHR), as the viable guideline in medical and health related research ethical requirements. The need to establish a coalition between member states regional wise is proposed as a desirable option in order to see to it that the UDBHR is implemented.