Chapter  7: Human Experimentation

Section 5. Case Study

Prepared by  Douglas Graudons (2002)

HIV Experiments in Third World Countries

Over 1000 babies are born each day in developing countries that are HIV positive. The majority of these babies are born in Africa. In 1995 the National Institutes of Health and the Centers for Disease Control and Prevention initiated clinical trials in developing countries with the goal being to find a cheaper way, compared to conventional AZT regiments, to prevent the spread of HIV from mother to fetus/child. The main ethical problem with these experiments was that the control groups received placebo, instead of the standard AZT therapy that is given in the US. These experiments could not be carried out in the US because AZT is a known treatment in stopping HIV transmission, and when there is a known treatment it must be given instead of a placebo. Also in 1993 the World Health Organization set standards stating human subjects in third world countries are to receive treatment equivalent to that in the country conducting the research. Ethicists throughout the world were enraged when they found out what was going on in Africa.

Articles/sites describing the case:

READ:  1) http://www.aegis.com/news/ap/1997/AP970907.html

This article talks about AZT studies in Africa and the ethical problems associated with the studies.

READ: 2) http://www.uky.edu/studentOrgs/AWARE/archives/wpaids.html

This article talks about AZT studies in Africa, with attention to informed consent, vulnerable populations, and economic concerns.

READ 3) http://www.rwor.org/a/v19/920-29/926/aids.htm

This article talks about how US funded experiments are offering placebos instead of known proven treatment to HIV positive women in Africa and the Dominican Republic.

This article talks about the ethics and economics of human experiments in third world countries.

Ethical positions:

READ: http://journalofscience.wlu.edu/archive/Spring2000/EthicsofHIVDrug.html

An essay illustrating how US funded maternal-fetal HIV transmission studies are not designed following ethical principles.

International Ethical Guidelines for Biomedical Research Involving Human Subjects

THE NUREMBERG CODE

READ:  http://www.healthlibrary.com/reading/ethics/july-sept99/threat.htm

An essay talking about how researchers and pharmaceutical companies are attempting to "water down" ethical guidelines established by the Council of International Organizations of Medical Services and the Declaration of Helsinki.

 http://old.citizen.org/hrg/PUBLICATIONS/1415.htm

In a letter to Department of Health and Human services Secretary Dr's Laurie, Wolf, et al, describes ethical problems related to AZT mother-fetus studies in Africa.

Proceed to the DECISION SCENARIO section of the chapter by clicking here> section.

Copyright Philip A. Pecorino 2002. All Rights reserved.

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