a review and critique of international ethical principles

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1、Chapter2AReviewandCritiqueofInternationalEthicalPrinciplesNuriaHomedesandAntonioUgaldeHistoryshowsthathealthprofessionalswhoconductbiomedicalresearchcontinuallyconfrontthetensionbetweentheadvancementofscientificknowledgeandtheprotectionofhumansubjects.Therehavebeenspectacularadvancesinthescience

2、ofmedicineduringthepast150years,buttheassociateddisregardandactivemalfeasancetowardstheparticipantsinsomeexperimentalsituationshaveledtomanyattemptstoprotectstudyvolunteers.Unfortunately,ethicalviolationscontinueinclinicalresearch,possiblymoresoindevelopingcountrieswhereregulationstoprotecthuma

3、nsubjectsarenotfullyinplace.ThischapterreviewstheinternationallyacceptedCodesofEthics,theirrelevanceandpotentialforlow-andmiddle-incomecountries,andtheissuesthatcontinuetobediscussedbybioethicistswhentheytrytoagreeonstandardsforclinicalresearchinthedevelopingworld.2.1TheNu¨rembergCodeandItsPred

4、ecessorsTheNu¨rembergCode(1947)isfrequentlyidentifiedasthefirstdocumenttodiscussethicalrulesforhumanbeings.TheCodewaswritteninresponsetothebehaviorofsomeresearchersinthemidtwentiethcenturyandthelackofethicalguidelines.VollmannandWinau(1996)notethatthefirstattemptstoprotectstudyparticipantsdatetoth

5、eendofthenineteenthcentury.Atthattime,mostresearchwasdirectedtowardsunderstandingthepathophysiologyofdiseaseandtheresponseoftheindi-vidual,withresearchintodiseasepreventionandtreatmentfollowingatalaterdate.Mostofthesestudiestookplacewithhospitalizedpatients,frequentlywithouttheirN.Homedes(*)Sch

6、oolofPublicHealth,DivisionofManagementPolicyandCommunityHealth,UniversityofTexasHoustonHealthScienceCenter,ElPaso,TX,USAe-mail:nhomedes@utep.eduA.UgaldeDepartmentofSociology,UniversityofTexas,Austin,TX,USAN.HomedesandA.Ugalde(eds.),ClinicalTrialsinLatinAmerica:WhereEthics7andBusinessClash,Resea

7、rchEthicsForum2,DOI10.1007/978-3-319-01363-3_2,©SpringerInternationalPublishingSwitzerland20148N.HomedesandA.Ugaldeconsent.Researchwasalsosometimesconductedonprisoners.In1891,thePrussianMinisteroftheInteriorsentanofficiallettertoal