Picture the faces of children, lined up against chipped walls while sitting on stained cement floors. One after the other awaiting the needle, with the unknown fluid, that has passed along the line ahead of them. This image may provoke thoughts of barbaric war times, however, what if this image exhibits cases from the 20th and 21st century? Clinical trials have unquestionably been a cornerstone in extremely rewarding medical advancements. However, when major ethical barriers are breached, the value of these advancements decreases. This is exceptionally important when examining healthcare and the humane responsibility that one has over human life in this field. Wherever the implementation, the practice of human clinical trials is a very delicate and complex affair which demands the highest standards of moral proficiency. For this reason, prohibiting clinical trials in developing countries is critical to restrict unethical procedures by pharmaceutical companies as well as to ensure secure and equitable
research progression.
Subjects taking part in clinical trials found in developing nations are left more exposed and defenseless. Patients in need of healthcare epitomize vulnerability, especially where healthcare is found to be inaccessible in countries such as Low/Middle-Income Countries (LMICs). These regions supply more vulnerable subjects, who are unaware of the nature and risks of the trials due to their low education, and economic standards. As a result of these factors, as well as a desperate need for basic healthcare, an indisputable path of consent violations emerges which risks the chances of a fair and ethical trial. Considering that “‘the principle of informed consent flows out of a Western philosophy of individual autonomy” (Weigmann), one must understand the varying differences between developed and underdeveloped nations. While keeping in mind their economic and social standings. What one may expect to be basic, such as these rights, may not be the same around the world. This rather distorted world view of equality is especially significant in healthcare where human lives are at risk. Therefore, patients who have given consent cannot be regarded as dependable when the risks are not fully comprehended by the subjects in question. Moreover, in many cases, subjects do not even have the chance to provide consent. For instance in India “[m]ore than 400 women who had been trying in vain to conceive were enrolled in 2003 without their knowledge or consent to take part in clinical trials conducted at nine or more centres across [the country].”(Weyzig & Schipper 8). Clinical trials must involve informed consent to ensure the effective protection of human subjects. However, in this case, the safety of these women was completely violated. Further highlighting the lack of evidence available to suggest their willingness to participate when they were entirely unaware of their contributions in the first place. When the concept of autonomy and informed consent are not registered, there is no possible way for these trials to be considered ethical. Hence, unless the country itself has a strong and stable framework- that is developed enough to fight for its citizens against mistreatment- fair and ethical trials can never be ensured.
Pharmaceutical companies, which have already proven to blur the lines between ethics and corporate agenda, cannot be trusted to self-regulate trials in areas where they have more economic power and flexibility. LMICs attract pharmaceutical companies due to their less stringent regulations and more cost-effective locations- in comparison to More Economically Developed Countries (MEDCs)- creating more incidents of ethical misconduct. For example in the US (an MEDC) regulatory bodies such as the FDA (Food and Drug Administration) played a major role “[w]hen clinical trials started to move abroad in the 1980s”(Weigmann). The FDA’s

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