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Ethical Issues in the Design and Conduct of Clinical Trials in Developing Countries
Abstract
There has been considerable controversy about the ethics of clinical trials that are sponsored or conducted by groups in industrialized countries but carried out in developing countries.18 The National Bioethics Advisory Commission, of which we serve as chairman and executive director, respectively, has recently addressed these and related issues.9 International collaborative research covers a broad spectrum of methods, topics, and research strategies. In this essay, we discuss ethical issues in the design and conduct of clinical trials in developing countries. In particular, we focus on phase 3 and other drug trials that, if successful, can lead to the use . . .
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“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 [27]
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Cites
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
Lurie, P. G., & Wolfe, S. M. (1997) · New England Journal of Medicine · doi:10.1056/nejm199709183371212 · Cited by 884
The Ethics of Clinical Research in the Third World
Angell, M. (1997) · New England Journal of Medicine · doi:10.1056/nejm199709183371209 · Cited by 863
Ethical Complexities of Conducting Research in Developing Countries
VARMUS, H. E., & Satcher, D. S. (1997) · New England Journal of Medicine · doi:10.1056/nejm199710023371411 · Cited by 424
A new look at international research ethics
Benatar, S. R. (2000) · BMJ · doi:10.1136/bmj.321.7264.824 · Cited by 326
Investigators' Responsibilities for Human Subjects in Developing Countries
Angell, M. E. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003303421309 · Cited by 175
Research in Developing Countries: Taking "Benefit" Seriously
Glantz, L. H., Annas, G. J., Grodin, M. A., & Mariner, W. K. (1998) · The Hastings Center Report · doi:10.2307/3528268 · Cited by 165
Operational guidelines for ethics committees that review biomedical research
Eckstein, S. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511550089.069 · Cited by 149
Research and Informed Consent in Africa — Another Look
IJsselmuiden, C., & Faden, R. (1992) · New England Journal of Medicine · doi:10.1056/nejm199203193261212 · Cited by 141
Guenter, D., Esparza, J., & Macklin, R. (2000) · Journal of Medical Ethics · doi:10.1136/jme.26.1.37 · Cited by 107
Research works printed but not linked: 1
- Office of the Inspector General. Institutional review boards: a time for reform. Washington, D.C.: Department of Health and Human Services, 1998.
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Items 101–200 of 203
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Kavanaugh, A. (2005) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2004.030817 · Cited by 10
International Collaboration for Global Public Health
Meslin, E. M., & Garba, I. (2016) · Public health ethics analysis · doi:10.1007/978-3-319-23847-0_8 · Cited by 10
Self-citationReporting of informed consent and ethics committee approval in genetics studies of stroke
Meschia, J. F., & Merino, J. G. (2003) · Journal of Medical Ethics · doi:10.1136/jme.29.6.371-a · Cited by 10
The Challenges In Conducting Research Studies In Arabic Countries
Sheblaq, N. R., & Najjar, A. A. (2019) · Open Access Journal of Clinical Trials · doi:10.2147/oajct.s215738 · Cited by 9
Perinatal research in developing countries – Is it possible?
Duley, L., Hofmeyr, G. J., Carroli, G., Lumbiganon, P., & Abalos, E. J. (2006) · Seminars in Fetal and Neonatal Medicine · doi:10.1016/j.siny.2005.11.006 · Cited by 9
The role of research for sustainable paediatric cardiac programmes in developing countries
Mavroudis, C. D., Mavroudis, C. D., Jacobs, J. P., & Siegel, A. (2012) · Cardiology in the Young · doi:10.1017/s1047951112001989 · Cited by 9
Motivation and frustration in cardiology trial participation: The patient perspective
Meneguin, S., & César, L. A. M. (2012) · Clinics · doi:10.6061/clinics/2012(06)10 · Cited by 9
Meslin, E. M., Were, E. O., & Ayuku, D. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-013-2456-7 · Cited by 8
Self-citationStrusberg, I., Bertoli, A. M., Ramos, M., Fierro, G., Pizzolato, R., Exeni, I. E., & Strusberg, A. M. (2005) · Contemporary Clinical Trials · doi:10.1016/j.cct.2004.11.016 · Cited by 8
Research ethics in the modern era
Thakur, S., & Lahiry, S. (2019) · Indian Journal of Dermatology Venereology and Leprology · doi:10.4103/ijdvl.ijdvl_499_18 · Cited by 8
La gouvernance des innovations médicales
Novaes, S. (2007) · Presses Universitaires de France eBooks · doi:10.3917/puf.tourn.2007.01.0097 · Cited by 8
Substantial evidence of effect
Gould, A. L. (2002) · Journal of Biopharmaceutical Statistics · doi:10.1081/bip-120005740 · Cited by 8
Informed consent: time for more transparency
Yazıcı, Y., & Yazıcı, H. (2010) · Arthritis Research & Therapy · doi:10.1186/ar3004 · Cited by 8
Ethical issues related to the use of placebo in clinical trials.
Lau, J. T. F., Mao, J., & Jh, W. (2003) · PubMed · Cited by 8
Valji, K. (2002) · Journal of Vascular and Interventional Radiology · doi:10.1016/s1051-0443(07)61714-x · Cited by 8
How to make consent informed: possible lessons from Tibet.
Miller, S., Le, P. V., Craig, S. R., Adams, V., Tudor, C., Sonam, N. V., Nyima, N. V., Droyoung, N. V., Tshomo, M., Lhakpen, N. V., et al. (2007) · PubMed · Cited by 7
Informed consent in Sri Lanka: A survey among ethics committee members
Sumathipala, A., Siribaddana, S., Hewage, S. N., Lekamwattage, M., Athukorale, M., Siriwardhana, C., Murray, J., & Prince, M. J. (2008) · BMC Medical Ethics · doi:10.1186/1472-6939-9-10 · Cited by 7
Keinonen, T., Miettinen, P., Saano, V., & Ylitalo, P. (2003) · Paediatric and Perinatal Drug Therapy · doi:10.1185/146300903774115766 · Cited by 7
The Costs of Institutional Review Boards
Dickler, H. B., & Korn, D. (2005) · New England Journal of Medicine · doi:10.1056/nejm200507213530320 · Cited by 7
The Principle of Equipoise in Pediatric Drug Trials
Chau, K., & Koren, G. (2014) · Pediatric Drugs · doi:10.1007/s40272-014-0105-1 · Cited by 6
Clinical trials in advanced stage lung cancer: a survey of patients' opinion about their treatment
Zarić, B., Perin, B., Ilić, A., Kopitović, I., Matijašević, J., Andrijević, L., Sečen, N., Stanić, J., Bijelović, M., Kosjerina, Z., et al. (2011) · Multidisciplinary Respiratory Medicine · doi:10.1186/2049-6958-6-1-20 · Cited by 5
Challenges and opportunities: what we are learning from the clinical natalizumab experience
Kachuck, N. J. (2005) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.5.5.605 · Cited by 6
Brunet‐Jailly, J. (2003) · Autrepart · doi:10.3917/autr.028.0037 · Cited by 6
Ethics in Acute Care Research: A Global Perspective and Research Agenda
Hirshon, J. M., Hansoti, B., Hauswald, M., Sethuraman, K. N., Kerr, N. L., Scordino, D., & Biros, M. H. (2013) · Academic Emergency Medicine · doi:10.1111/acem.12271 · Cited by 6
Strengthening clinical and research ethics in Nigeria—an agenda for change
Anya, I., & Raine, R. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61661-x · Cited by 6
Ethical dilemmas encountered during clinical drug trials
Daikos, G. K. (2004) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2004.03.004 · Cited by 5
[Declaration of Helsinki: its vicissitudes during the last five years].
Klimovsky, E., Saidon, P., Nudelman, L., & Bignone, I. (2002) · PubMed · Cited by 5
Caplan, A. L., & Schwartz, J. L. (2008) · Elsevier eBooks · doi:10.1016/b978-1-4160-3611-1.50080-5 · Cited by 4
Choudhury, S. R., & Knapp, L. A. (2005) · European Journal of Human Genetics · doi:10.1038/sj.ejhg.5201497 · Cited by 4
Vulnerability from a Global Medicine Perspective
Jotkowitz, A. (2004) · The American Journal of Bioethics · doi:10.1080/15265160490497146 · Cited by 4
Lü, F., Suda, K. J., & Marks, K. E. (2012) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-012-9711-6 · Cited by 4
Oduwo, E., & Edwards, S. (2014) · Trials · doi:10.1186/1745-6215-15-287 · Cited by 4
Cohen, J. A., & Rudick, R. A. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9781139023986.009 · Cited by 4
The Ethics of Research in Lower Income Countries: Double Standards Are Not the Problem
Wendler, D. S. (2017) · The Journal of Clinical Ethics · doi:10.1086/jce2017283239 · Cited by 3
Designing a clinical research study
DeRenzo, E. G., Singer, E. A., & Moss, J. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-386935-7.00004-9 · Cited by 3
FAIR BENEFITS AND ITS CRITICS: WHO IS RIGHT?
Wendler, D. S., & Shah, S. K. (2017) · PubMed · Cited by 3
Corvin, W., & Antoinette, J. (2006) · Cited by 3
Revised CIOMS International Ethical Guidelines for Biomedical Research
Idänpään-Heikkilä, J. E., & Fluss, S. S. (2003) · Journal of Commercial Biotechnology · doi:10.1057/palgrave.jcb.3040067 · Cited by 3
Lurie, P. G. (2021) · Indian Journal of Medical Ethics · doi:10.20529/ijme.2021.023 · Cited by 3
The globalization of clinical drug development
Thiers, F. A. (2006) · DSpace@MIT (Massachusetts Institute of Technology) · Cited by 3
El-Shabrawy, E. M. (2014) · Journal of Advances in Medicine and Medical Research · doi:10.9734/bjmmr/2014/7071 · Cited by 2
Jafarey, A. M. (2002) · Science and Engineering Ethics · doi:10.1007/s11948-002-0055-9 · Cited by 2
Informed consent and the use of placebo in poland: Ethical and legal aspects
Zaborowski, P., & Górski, A. (2004) · Science and Engineering Ethics · doi:10.1007/s11948-004-0074-9 · Cited by 2
Experimentación biomédica en seres humanos en países menos desarrollados
Tobler, C. A. (2006) · Revista Colombiana de Bioética · Cited by 2
Barbeito, M. I. (2011) · Cited by 2
Establishing Training Programs for Research Ethics Committees
Abass, S. K. (2017) · Research ethics forum · doi:10.1007/978-3-319-65266-5_34 · Cited by 2
Ética de la salud pública: Casos de todo el mundo
de la Salud, O. P. (2022) · Pan American Health Organization eBooks · doi:10.37774/9789275325629 · Cited by 2
Assessment of the knowledge of asthma amongst adult asthmatics and their quality of life
Williams, Z. (2009) · Unisa Institutional Repository (University of South Africa) · Cited by 2
Silaigwana, B. (2017) · ResearchSpace (University of KwaZulu-Natal) · Cited by 2
Community Consent for Research on the Impaired Elderly
Thomasma, D. C. (2001) · International library of ethics, law, and the new medicine/The international library of ethics, law, and the new medicine · doi:10.1007/978-94-015-9682-4_11 · Cited by 2
Paredes, R., Karol, A. B., Markus, A., Argulian, A., Omori, R., Fujiwara, Y., Joshi, H. N., Doroshow, D. B., & Galsky, M. D. (2026) · JCO Global Oncology · doi:10.1200/go-25-00411 · Cited by 1
Rui, V. (2003) · Análise Social · Cited by 1
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Homedes, N., & Ugalde, A. (2013) · Research ethics forum · doi:10.1007/978-3-319-01363-3_2 · Cited by 1
Progress in the Development and Testing of HIV Vaccines
Ackers, M., Bartholow, B. N., & Mastro, T. D. (2004) · Elsevier eBooks · doi:10.1016/b978-012764051-8/50041-x · Cited by 1
MacKenzie, C. R., & Paget, S. A. (2009) · Elsevier eBooks · doi:10.1016/b978-032305475-1.50056-2 · Cited by 1
McGowan, I. (2009) · Elsevier eBooks · doi:10.1016/b978-0-12-374235-3.00004-2 · Cited by 1
Caplan, A. L., & Schwartz, J. L. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-35761-6.00084-5 · Cited by 1
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Mastroleo, I. (2015) · Journal of Science Humanities and Arts - JOSHA · doi:10.17160/josha.2.5.57 · Cited by 1
Clinical Research in International Settings
Olopade, C. O., Tagle, M., & Olopade, O. I. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-849905-4.00008-3 · Cited by 1
Ethics in Cross‐Cultural Psychology
Beck, S., & de Merode, J. (2013) · The Encyclopedia of Cross‐Cultural Psychology · doi:10.1002/9781118339893.wbeccp203 · Cited by 1
Study designs, duration, and choice of comparators including the use of placebo
Lewis, J. A. (2002) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2002.4.4/jlewis · Cited by 1
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Brown, S. M., Sikora, K., & Levin, A. (2003) · Journal of Medical Ethics · doi:10.1136/jme.29.6.371 · Cited by 1
Ethical dilemmas encountered during clinical drug trials.
Daicos, G. (2001) · PubMed · Cited by 1
When Policy Analysis Is Carried Out in Public
Meslin, E. M. (2003) · Humana Press eBooks · doi:10.1007/978-1-59259-370-5_4 · Cited by 1
Self-citationResearch in International Settings
Loue, S., & Pike, E. C. (2007) · Springer eBooks · doi:10.1007/978-0-387-71362-5_15
Dengue Vaccine: A Double-Edged Sword
Tan, L. C. M. (2011) · Project Muse (Johns Hopkins University)
The informed consent in digestive endoscopy: utility and patients perceptions
Arango, L. A. Á., & Villamil, E. R. (2007) · Revista Colombiana de Gastroenterología
Alvarez, A. A. A. (2010) · Project Muse (Johns Hopkins University)
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Clemens, J. D., & Ochiai, R. L. (2005) · Birkhäuser Basel eBooks · doi:10.1007/3-7643-7381-4_11
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Jain, H. (2016) · Zenodo (CERN European Organization for Nuclear Research) · doi:10.5281/zenodo.3972243
Tausig, M., Subedi, J., & Subedi, S. (2007) · Advances in medical sociology · doi:10.1016/s1057-6290(07)09012-2
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Nelson, K., & Classic, K. L. (2015) · Series in medical physics and biomedical engineering · doi:10.1201/b19063-30
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Akrong, L., Horstman, K., & Arhinful, D. K. (2014) · Palgrave Macmillan US eBooks · doi:10.1057/9781137456038_2
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Barfield, R. C., & Kodish, E. D. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-3431-5.00034-0
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Miller, A., Gligorov, N., & Krieger, S. C. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9781139023986.025
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Manterola, C., & Otzen, T. (2015)
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Johnson, S. A. (2017) · Springer eBooks · doi:10.1007/978-3-319-53204-2_6
Karakurt, S., Bostancı, K. K. M. E., Eryüksel, E., Maesano, I. A., Zarić, B., Perin, B., Ilić, A., Kopitović, I., Matijašević, J., Andrijević, L., et al. (2011)
BMC Medical Ethics BioMed Central
Akabayashi, A., Slingsby, B. T., Nagao, N., & Kai, I. (2013)
(2006) · Elsevier eBooks · doi:10.1016/b978-012210751-1/50017-1
(2020) · Elsevier eBooks · doi:10.1016/b978-0-12-386935-7.09998-9
MacKenzie, C. R., & Paget, S. A. (2011) · Elsevier eBooks · doi:10.1016/b978-0-323-06551-1.00026-9
Piantadosi, S. (2005) · Wiley series in probability and statistics · doi:10.1002/0471740136.biblio
Caplan, A. L., & Schwartz, J. L. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-0090-5.00078-1
Johnson, S. A. (2010) · Springer eBooks · doi:10.1007/978-90-481-9953-2_6
Bortner, A. C., & Ramers, C. B. (2021) · doi:10.1093/med/9780197576595.003.0053
Caplan, A. L., & Schwartz, J. L. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-79058-1.00086-4
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Metadata
- Authors
- Shapiro, H. T., & Meslin, E. M.
- Affiliations
- National Institutes of Health (US)
- ORCID
- Meslin, Eric M.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2001-07-12
- Volume
- 345
- Issue
- 2
- Pages
- 139-142
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2065625460
- Cited by
- 204
- References
- 13
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 8 · 2019: 4 · 2018: 5 · 2017: 9 · 2016: 7 · 2015: 6 · 2014: 6 · 2013: 13 · 2012: 8
- FWCI
- 15.50
- 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 trial ethics, developing countries, international collaborative research, research ethics oversight, National Bioethics Advisory Commission
- MeSH terms
- Clinical Trials as Topic, Developing Countries, Ethics, Medical, Helsinki Declaration, Humans, Research Design, United States, Ethical Review, Vulnerable Populations, Internationality
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