Bioethics 25 (3):145-154 (2011)

Joseph Millum
University of St. Andrews
ABSTRACTMany recent articles argue that participants who seroconvert during HIV prevention trials deserve treatment when they develop AIDS, and there is a general consensus that the participants in HIV/AIDS treatment trials should have continuing post‐trial access. As a result, the primary concern of many ethicists and activists has shifted from justifying an obligation to treat trial participants, to working out mechanisms through which treatment could be provided. In this paper I argue that this shift frequently conceals an important assumption: that if there is an obligation to supply treatment, then any party who could provide it may be prevailed upon to discharge the obligation. This assumption is false. The reasons why trial participants should get ART affect who has the duty to provide it. We should not burden governments with the obligations of sponsors, nor researchers with the obligations of the international community. And we should not deprive a group of treatment because their need is less salient than that of research participants. Insisting otherwise may lead to people being wrongfully deprived of access to antiretrovirals.
Keywords info:mesh/Anti-Retroviral Agents  info:mesh/Clinical Trials as Topic  info:mesh/Humans  info:mesh/Research Subjects  info:mesh/Health Services Accessibility  info:mesh/Bioethical Issues  info:mesh/HIV Infections  Humans   HIV Infections   Anti-Retroviral Agents   Bioethical Issues
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DOI 10.1111/bioe.2011.25.issue-3
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