The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
The Ethics of Clinical Research in the Third World
Abstract
An essential ethical condition for a randomized clinical trial comparing two treatments for a disease is that there be no good reason for thinking one is better than the other.1,2 Usually, investigators hope and even expect that the new treatment will be better, but there should not be solid evidence one way or the other. If there is, not only would the trial be scientifically redundant, but the investigators would be guilty of knowingly giving inferior treatment to some participants in the trial. The necessity for investigators to be in this state of equipoise2 applies to placebo-controlled trials, as . . .
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Even within the paucity of literature on conducting clinical trials in low resource countries, the literature mostly relates to ethical issues [19, 26–28].”
From Barriers for conducting clinical trials in developing countries—A systematic review (2018) · cites this paper as [26]
Citations
Cites
Clozapine for the Treatment-Resistant Schizophrenic: A Double-blind Comparison With Chlorpromazine
Kane, J. (1988) · Archives of General Psychiatry · doi:10.1001/archpsyc.1988.01800330013001 · Cited by 4,156
Connor, E. M., SPERLING, R. S., Gelber, R. D., Kiselev, P., Scott, G. B., O’Sullivan, M. J., VanDyke, R., Bey, M., Shearer, W. T., Jacobson, R. L., et al. (1994) · New England Journal of Medicine · doi:10.1056/nejm199411033311801 · Cited by 3,685
Equipoise and the Ethics of Clinical Research
Freedman, B. (1987) · New England Journal of Medicine · doi:10.1056/nejm198707163170304 · Cited by 2,339
A history and theory of informed consent
Kapp, M. B. (1986) · Journal of Legal Medicine · doi:10.1080/01947648609513478 · Cited by 2,328
Carlsson, A., & Lindqvist, M. (1963) · Acta Pharmacologica et Toxicologica · doi:10.1111/j.1600-0773.1963.tb01730.x · Cited by 2,156
International Ethical Guidelines for Biomedical Research Involving Human Subjects
Cioms (1993) · Cited by 1,311
Bass, J. B., Farer, L. S., Hopewell, P. C., O'Brien, R., Jacobs, R. F., Ruben, F. L., Snider, D. E., & Thornton, G. F. (1994) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.149.5.8173779 · Cited by 1,190
Lurie, P. G., & Wolfe, S. M. (1997) · New England Journal of Medicine · doi:10.1056/nejm199709183371212 · Cited by 884
SPERLING, R. S., Shapiro, D. E., Coombs, R. W., Todd, J. A., Herman, S. A., McSherry, G., O’Sullivan, M. J., Dyke, R. B. V., Jiménez, E., Rouzioux, C., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199611283352201 · Cited by 800
Olanzapine versus Placebo and Haloperidol
Beasley, C. M., Tollefson, G. D., Tran, P., SATTERLEE, W. G., Sanger, T. M., & Hamilton, S. H. (1996) · Neuropsychopharmacology · doi:10.1016/0893-133x(95)00069-p · Cited by 777
Research works printed but not linked: 2
- 10.2307/3562946 · DOI
- 1990, MMWR Morb Mortal Wkly Rep, 39, 9
Cited by
Sorted by citations
Items 601–700 of 862
Big Pharma and Big Medicine in the Global Environment
Figert, A. E., & Bell, S. E. (2014) · Routledge eBooks · doi:10.4324/9780203101827.ch26 · Cited by 1
Extending the Progressive Tradition to Poor Countries: The Role of Universities and Colleges
Gathuo, S. (2016) · Higher Learning Research Communications · doi:10.18870/hlrc.v6i2.296 · Cited by 1
Ethics Committees: Procedures and Duties
Koepsell, D. (2016) · SpringerBriefs in ethics · doi:10.1007/978-3-319-51277-8_7 · Cited by 1
Knowledge, Framing, and Ethics in Programme Design and Evaluation
Jacob, S. (2018) · Springer eBooks · doi:10.1007/978-981-13-2450-5_3 · Cited by 1
The Dilemma of Outsourcing Drug Trials
Barat, S. (2020) · ATHENS JOURNAL OF HEALTH & MEDICAL SCIENCES · doi:10.30958/ajhms.7-2-2 · Cited by 1
It’s ethical to test promising coronavirus vaccines against less-promising ones
Eyal, N., & Lipsitch, M. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2014154117 · Cited by 1
Mental Health of East and West Area People in Ahmedabad
Rathod, J., & Kaji, D. S. M. (2015) · International Journal of Indian Psychology · doi:10.25215/0203.021 · Cited by 1
International Human Rights Law and the Social Determinants of Health
Forman, L. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.009 · Cited by 1
Evaluating Global Health Impact and Increasing Access to Essential Medicines
Hassoun, N. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.034 · Cited by 1
Mass Migration and Health in the Anthropocene Epoch
Straehle, C. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.024 · Cited by 1
Health Systems and Health and Healthcare Reform
McKee, M. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.006 · Cited by 1
Global Health Governance for Developing Sustainability
Ruggiero, E. D. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.037 · Cited by 1
Haire, B. G. (2021) · Indian Journal of Medical Ethics · doi:10.20529/ijme.2021.020 · Cited by 1
Debt, Structural Adjustment, and Health
Rudin, J., & Sanders, D. M. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.013 · Cited by 1
Pogge, T. W. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.033 · Cited by 1
Dwyer, J. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.038 · Cited by 1
Responsibility for Global Health
Buchanan, A. E., & DeCamp, M. W. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.010 · Cited by 1
State of Global Health in a Radically Unequal World
Schrecker, T., & Labonté, R. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.002 · Cited by 1
Ethical Dilemmas in Psychological Research with Vulnerable Groups in Africa
Salaam, A. O., & Brown, J. M. (2013) · Ethics & Behavior · doi:10.1080/10508422.2013.774861 · Cited by 1
Yang, K., Kurian, A., & Barankin, B. (2014) · Springer eBooks · doi:10.1007/978-3-319-09027-6_8 · Cited by 1
Collaboration within Academia and with Industry
Shamoo, A. E., & Resnik, D. B. (2022) · Oxford University Press eBooks · doi:10.1093/oso/9780197547090.003.0004 · Cited by 3
Vulnerability in a Positional Sense: The Case of Clinical Trials
Macioce, F. (2022) · Critical political theory and radical practice · doi:10.1007/978-3-031-07547-6_7 · Cited by 1
Ethical Issues and Challenges Facing the Pharmaceutical Industry
Eaton, M. L. (2007) · Elsevier eBooks · doi:10.1016/b0-08-045044-x/00026-2 · Cited by 1
Bomoyi, Z. A. (2011) · ResearchSpace (University of KwaZulu-Natal) · Cited by 1
Placebos in klinischen Versuchsreihen
Ehni, H., & Wiesing, U. (2006) · Ethik in der Medizin · doi:10.1007/s00481-006-0439-5 · Cited by 1
O sistema CEP/CONEP no Brasil: discurso e realidade dez anos depois
Werner, J. D. A., & Velho, M. T. D. C. (2008) · Revista do Direito · doi:10.17058/rdunisc.v0i29.565 · Cited by 1
Justice in International Research
London, A. J. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-373932-2.00058-2 · Cited by 1
de Freitas, C. B. D., & Novaes, H. M. D. (2009) · Revista Bioética · Cited by 1
I Thought We Were in This Together?
Trachtman, H. (2002) · The American Journal of Bioethics · doi:10.1162/152651602317533640 · Cited by 1
Microbicides in HIV infection prophylaxis – not only ethical challenges
Rogowska-Szadkowska, D., & Chlabicz, S. (2008) · HIV & AIDS Review · doi:10.1016/s1730-1270(10)60009-4 · Cited by 1
Williams, J. N. (2000) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.v29n5p557 · Cited by 1
Research as a visiting doctor in Afghanistan and Cambodia
Pilsczek, F. H. (2001) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.628 · Cited by 1
Desafíos éticos en la investigación y aplicación clínica de la genética
Fernando Novoa, S. (2007) · Revista chilena de neuro-psiquiatría · doi:10.4067/s0717-92272007000400006 · Cited by 1
Govender, S. (2012) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg) · Cited by 1
Perceptions of participants and community members about research on gender-based violence
Sikweyiya, Y. M. (2014) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg) · Cited by 1
The Multiple Perspectives of thePatient as Victim and VectorView
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0007 · Cited by 1
Vertical Transmission of Infectious Diseases and Genetic Disorders
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0011 · Cited by 1
(1999) · Duke University Press eBooks · doi:10.1215/9780822396963-002 · Cited by 1
The ethics of pharmaceutical medicine
Bragman, K. (2000) · International Journal of Pharmaceutical Medicine · doi:10.1097/00124363-200008000-00012 · Cited by 1
(1998) · Death Studies · doi:10.1080/074811898201425 · Cited by 1
Nicholson, R. (2006) · Encyclopedia of Life Sciences · doi:10.1038/npg.els.0005178 · Cited by 1
Mayes, C. R., & Kerridge, I. (2012) · Oxford University Press eBooks · doi:10.1093/obo/9780199756797-0029 · Cited by 1
Comment on the Ethics of Placebo-Controlled Trials in Patients with Type 2 Diabetes Mellitus
Misbin, R. I. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.84.2.823 · Cited by 1
Ungrin, M., Oliver, M., Wright, J. M., Mesiano‐Crookston, J., Gasperowicz, M., Fisman, D. N., & Nielson, C. (2023) · MetArXiv (OSF Preprints) · doi:10.31222/osf.io/ey7bj · Cited by 1
Ethics and international research
Edi-Osagie, E. C. O., Edi-Osagie, N. E., Lurie, P. G., Wolfe, S. M., Burdon, J., Baraza, R., Landray, M., Halsey, N. A., Sommer, A. H., Black, R. E., et al. (1998) · BMJ · doi:10.1136/bmj.316.7131.625a · Cited by 1
Communication with Patients in Clinical Research
Zwitter, M. (2012) · Springer eBooks · doi:10.1007/978-1-4614-3369-9_42
Researcher-Participant Relations
Loue, S., & Pike, E. C. (2007) · Springer eBooks · doi:10.1007/978-0-387-71362-5_5
Research in International Settings
Loue, S., & Pike, E. C. (2007) · Springer eBooks · doi:10.1007/978-0-387-71362-5_15
Ethics and Clinical Trials: Are they Compatible?
Jadad, A. R., & Enkin, M. W. (2007) · doi:10.1002/9780470691922.ch8
La investigación y los conflictos de interés: Una mirada a vuelo de pájaro
Manrique, J. L., Torres, S. N., Andrijic, M., & Combi, A. (2015) · Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón
Ibarreta, D., Lheureux, K., & Rodríguez‐Cerezo, E. (2016)
Vidal, S. (2015) · Revista Colombiana de Bioética · doi:10.18270/rcb.v5i2.848 · Cited by 1
Alvarez, A. A. A. (2010) · Project Muse (Johns Hopkins University)
Bioética: una disciplina necesaria en la formación científica
Cañedo, Á. L. (2011) · Revista de Bioética y Derecho · doi:10.1344/rbd2011.22.7666
Sequential stages of clinical trials and overview of issues to be considered
Clemens, J. D., & Ochiai, R. L. (2005) · Birkhäuser Basel eBooks · doi:10.1007/3-7643-7381-4_11
Comment on the Ethics of Placebo-Controlled Trials in Patients with Type 2 Diabetes Mellitus
Misbin, R. I. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.2.5472-8
A Matter of Obligation: Physicians Versus Clinical Investigators
Morreim, E. H. (2007) · Springer eBooks · doi:10.1007/978-1-4020-6260-5_10
Abratt, R. P. (2000) · Evidence-based Oncology · doi:10.1054/ebon.2000.0066
Dutch experience of euthanasia
Bonicalzi, V., & Canavero, S. (2001) · The Lancet · doi:10.1016/s0140-6736(01)05800-7
Perinatal HIV transmission—A global problem: Controversy and protection of the next generation
Wilfert, C. M. (1998) · Seminars in Pediatric Infectious Diseases · doi:10.1016/s1045-1870(98)80024-1
Testing Drugs Together With Those Who Need Them
Ehni, H., & Wiesing, U. (2012) · World Medical & Health Policy · doi:10.1515/1948-4682.1216
Vaccine research, adolescents and Africa
Abrams, A., & Kredo, T. (2013) · Human Vaccines & Immunotherapeutics · doi:10.4161/hv.22143
Thompson, J. R. (2003) · British Journal of Ophthalmology · doi:10.1136/bjo.87.4.380
Hastening slowly: Mr Dobson plays a waiting game
Klein, R. (1997) · BMJ · doi:10.1136/bmj.315.7114.966
Human Rights and the Regulation of Transnational Clinical Trials
Pierik, R. (2014) · Political Studies · doi:10.1111/1467-9248.12134
Moodley, K. (2004) · SUNScholar (Stellenbosch University)
Guidance for trials in Helicobacter pylori infection
GOMOLLON, F. (1998) · Gut · doi:10.1136/gut.43.5.728d
La responsabilidad ética en la fase III de los ensayos clínicos
Rodríguez, J. (1999) · Biomédica · doi:10.7705/biomedica.v19i3.1020
EDITORIAL ESPECIAL SPECIAL EDITORIAL
Greco, D. B. (2003)
CHAPTER 22 THE "VULNERABILITY" QUAGMIRE IN INTERNATIONAL RESEARCH
Kissell, J. L. (2008)
A Critical Assessment of the Work of Research Ethics Committees.
Moodley, K. (2004)
Cross-Cultural Considerations in Medical Ethics
Angell, M. E. (2005) · Springer eBooks · doi:10.1007/1-4020-3062-2_5
Self-citationCRITICAL VALUES: FEMINIST PHILOSOPHY OF SCIENCE AND THE COMPUTING SCIENCES
Sherron, C. (2003) · OhioLink ETD Center (Ohio Library and Information Network)
Exploitation in Clinical Drug Trials
Fundora, D. F. (2013)
Kauffman, Y. S., Jonkman, L. J., & Connor, S. E. (2016) · Pharmacy Education
El uso del placebo en investigación
Busso, C. (2011)
Eiceldonatie voor stamcelonderzoek: schuilt er kwaad in de vergoeding
Mertes, H., & Pennings, G. (2008) · Ethiek en Maatschappij · doi:10.21825/em.94478
San José State University Philosophy 133 "Ethics in Science" Spring 2014
Stemwedel, J. D. (2014)
Women's Health LiteratureWatch & Commentary
Peters, G. N. (1998) · Journal of Women s Health · doi:10.1089/jwh.1998.7.265
Lum, L. C. S., & Tang, S. F. (2016) · Journal of Pediatric Intensive Care · doi:10.1055/s-0036-1584672
Compensation and the Victims of Constraint
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0018
Should Rapid Tests for Hiv Infection Now Be Mandatory During Pregnancy or In Labor?
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0012
From the Magic Mountain to a Dying Homeless Man and His Dog:
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0009
The Biological Basics of Infectious Disease
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0002
How Infectious Disease Got Left Out of Bioethics
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0004
ThePatient as Victim and VectorView as Critical and Diagnostic Tool
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0021
Closing The Book on Infectious Disease
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0005
Tausig, M., Subedi, J., & Subedi, S. (2007) · Advances in medical sociology · doi:10.1016/s1057-6290(07)09012-2
Immunization and the Hpv Vaccine
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0014
Informed Consent and Clinical Trial Participation
Akrong, L., Horstman, K., & Arhinful, D. K. (2014) · Palgrave Macmillan US eBooks · doi:10.1057/9781137456038_2
Pandemic Planning and the Justice of Health-Care Distribution
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0019
Embedded Autonomy and the “Way-Station Self”
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0006
Lazzarini, Z., & Kohorn, J. E. V. (2005) · Elsevier eBooks · doi:10.1016/b978-012465271-2/50022-4
Seeing Infectious Disease as Central
Battin, M. P., Francis, L. P., Jacobson, J. A., & Smith, C. B. (2009) · doi:10.1093/acprof:oso/9780195335842.003.0001
Ethical considerations in multiple sclerosis clinical trials
Miller, A., Gligorov, N., & Krieger, S. C. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9781139023986.025
Metadata
- Authors
- Angell, M.
- Corresponding author
- Angell, Marcia
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1997-09-18
- Volume
- 337
- Issue
- 12
- Pages
- 847-849
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2062146075
- Cited by
- 863
- References
- 31
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 28 · 2023: 18 · 2022: 32 · 2021: 63 · 2020: 19 · 2019: 13 · 2018: 12 · 2017: 20 · 2016: 25 · 2015: 26 · 2014: 45 · 2013: 32 · 2012: 27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Nursing › Issues, ethics and legal aspects › Biomedical Ethics and Regulation
- Keywords
- clinical research ethics, randomized controlled trials, equipoise, developing countries, research participant protection
- MeSH terms
- Clinical Trials as Topic, Developing Countries, Ethics, Medical, Humans, Informed Consent, Placebos, Tuberculosis, Pulmonary, United States, United States Public Health Service, HIV Infections, AIDS-Related Opportunistic Infections, Ethical Review, Moral Obligations, Withholding Treatment, Ethical Relativism, Codes of Ethics, Control Groups, Editorial Policies, Research Subjects, Therapeutic Human Experimentation, Pregnant Women, Pregnant People, Internationality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review