David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Developing World Bioethics 11 (2):63-74 (2011)
This article examines the relationship between bioethics and the therapeutic standards in HIV prevention research in the developing world, focusing on the closure of the pre-exposure prophylaxis (PrEP) trials in the early 2000s. I situate the PrEP trials in the historical context of the vertical transmission debates of the 1990s, where there was protracted debate over the use of placebos despite the existence of a proven intervention. I then discuss the dramatic improvement in the clinical management of HIV and the treatment access movement, and consider how these contexts have influenced research practice. I argue that as HIV prevention trials oblige researchers to observe the rate at which vulnerable people under their care acquire HIV, there is an obligation to provide antiretroviral treatment to seroconverters and other health care benefits that fall within the scope of researchers' entrustment, both to avoid exploitation and to enact reciprocal justice. I argue against propositions that the obligations to provide specific benefits are vague, fall only upon researchers and sponsors, and create injustices by privileging the few over the many. Finally, I contend that the realisation of a broader standard of care in HIV prevention research broadens the role of research from being a simple tool to produce knowledge to a complex intervention that can play a part in the reduction of health disparities
|Keywords||Pre‐exposure prophylaxis standard of care HIV prevention research developing world researcher obligation bioethics|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Charles Weijer & Guy LeBlanc, Revisiting the Ethics of HIV Prevention Research in Developing Countries.
Joseph Millum (2011). Post-Trial Access to Antiretrovirals: Who Owes What to Whom? Bioethics 25 (3):145-154.
Nicola Barsdorf, Suzanne Maman, Nancy Kass & Catherine Slack (2010). Access to Treatment in Hiv Prevention Trials: Perspectives From a South African Community. Developing World Bioethics 10 (2):78-87.
R. Macklin (2010). Intertwining Biomedical Research and Public Health in HIV Microbicide Research. Public Health Ethics 3 (3):199-209.
Bridget Haire, John Kaldor & Christopher Fc Jordens (2012). How Good Is “Good Enough”? The Case for Varying Standards of Evidence According to Need for New Interventions in HIV Prevention. American Journal of Bioethics 12 (6):21-30.
S. Philpott, K. West Slevin, K. Shapiro & L. Heise (2010). Impact of Donor-Imposed Requirements and Restrictions on Standards of Prevention and Access to Care and Treatment in HIV Prevention Trials. Public Health Ethics 3 (3):220-228.
Hans-Jörg Ehni (2006). The Definition of Adequate Care in Externally Sponsored Clinical Trials: The Terminological Controversy About the Concept “Standard of Care”. Science and Engineering Ethics 12 (1):123-130.
Charles Weijer & Guy J. Leblanc (2006). The Balm of Gilead: Is the Provision of Treatment to Those Who Seroconvert in HIV Prevention Trials a Matter of Moral Obligation or Moral Negotiation? Journal of Law, Medicine and Ethics 34 (4):793-808.
Paquita De Zulueta (2001). Randomised Placebo-Controlled Trials and HIV-Infected Pregnant Women in Developing Countries. Ethical Imperialism or Unethical Exploitation. Bioethics 15 (4):289–311.
Melissa Stobie & Catherine Slack (2010). Treatment Needs in Hiv Prevention Trials: Using Beneficence to Clarify Sponsor-Investigator Responsibilities. Developing World Bioethics 10 (3):150-157.
Jacquelyn Slomka (2009). Manufacturing Mistrust: Issues in the Controversy Regarding Foster Children in the Pediatric Hiv/Aids Clinical Trials. Science and Engineering Ethics 15 (4):503-516.
Franklin G. Miller & Howard Brody (2002). What Makes Placebo-Controlled Trials Unethical? American Journal of Bioethics 2 (2):3 – 9.
Douglas MacKay (2013). Standard of Care, Institutional Obligations, and Distributive Justice. Bioethics 28 (2).
Udo Schuklenk (2007). HIV Vaccine Trials: Reconsidering the Therapeutic Misconception and the Question of What Constitutes Trial Related Injuries. Developing World Bioethics 7 (3).
Angela Ballantyne (2008). Benefits to Research Subjects in International Trials: Do They Reduce Exploitation or Increase Undue Inducement? Developing World Bioethics 8 (3):178-191.
Added to index2010-12-27
Total downloads3 ( #267,324 of 1,096,251 )
Recent downloads (6 months)0
How can I increase my downloads?