Ethical Concerns of Placebo Use in Clinical Trials in Developing Countries

Ethical Concerns Surrounding Placebo Use in Clinical Trials

The use of placebos in clinical trials is a problem since, thereby, patients are deprived of treatment, which contradicts the principle of good. This issue is particularly acute in developing countries since they already cannot boast of a high level of medicine and its accessibility. Citizens agree to any treatment, as they are not sufficiently aware of the problem and understand that they do not have the funds for other treatment (Ndebele, 2017).

Pharmaceutical Industry Practices and Ethical Violations

The author of the article “The Ethics of Clinical Research in the World,” M. Angell (2010), claims that pharmaceutical companies use various methods to convince doctors to prescribe more drugs. Consequently, pharmaceutical companies ruin a person by creating false standards of treatment. The author notes that companies often buy doctors by funding their research.

Moreover, according to Angell (2010), companies often hide negative research results about their products, leading to dangerous health consequences for patients. The author tells about the treatment against syphilis in 1932 in one of the African countries (Angell, 2010). Treatments continued even after penicillin, a cure for syphilis, became known. Thus, according to Angell, the treatment continued until reporters found out about it.

Conditional Acceptance of Placebo Use

Specialists of the Scientific Council of the Federal Association of Physicians consider the use of such “drugs” ethical under certain conditions. If there is no proven drug therapy for this patient yet, the patient has only minor complaints, and such therapy has every chance of success (Marlink, 2017). Brody (2010) notes that using a placebo in third-world countries is unfair. Moreover, the author notes that using a placebo is often forced. A clear violation of medical ethics is the recommendation of homeopathic medicines, then there are effective conventional medicines. Thus, the study examines the ethical issues of using a placebo in third-world countries.

Research on the Placebo Effect and Its Practical Challenges

Angell expresses an opinion about the inadmissibility of using a placebo in third-world countries. According to Angell (2010), at the beginning of 2010, Dr. Karin Meissner interviewed about 400 doctors while studying the placebo effect at the Institute of Psychology at the Ludwig-Maximilian University of Munich. As a result, it turned out that doctors often face problems when using “alternative medicines” in their work since, in such cases, there is often no precise algorithm for prescribing treatment.

Human Rights and Public Health Risks in Clinical Trials

Angell makes convincing arguments that it is unethical to prescribe placebos in developing countries since people do not have the means and awareness of medicine. Brody (2010) notes that the expanding practice of developing drugs for the wealthy inhabitants of the planet through clinical trials on the disadvantaged population of the “third world” countries means something more than a simple redistribution of scientific resources. It threatens human rights, as well as public health, around the world. Brody (2010) also makes strong arguments in favor of abandoning the use of placebo in third-world countries.

Informed Consent and Exploitation of Vulnerable Populations

Sometimes, up to 80 percent of people do not know they can refuse to participate (Brody, 2010). These proofs of servitude are used as an argument to increase the number of studies. Only those with no choice are ready, without consulting a doctor, to undergo a testing program arbitrarily selected by a computer, without even knowing to which “section” of the tests they will be assigned. In other words, the poorest part of the population, the farthest from the medical benefits of civilization, takes part in clinical trials. Thus, Angell argues her point of view better since the article presents a large amount of statistical data and talks about researching this topic.

References

Angell, M. (2010). The ethics of clinical research in the third world. In Bioethics: Principles, issues, and cases. Oxford University Press.

Brody, B. (2010). Ethical issues in clinical trials in developing countries. In Bioethics: Principles, issues, and cases. Oxford University Press.

Marlink, R. (2017). Urgently creating the better in global health. Hastings Center Report, 47(5), 25-26. Web.

Ndebele, P. (2017). Standards of care in global health: Identifying the Right Question. Hastings Center Report, 47(5), 28-29. Web.