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Mississippi Governor Haley Barbour announced the release of Jamie and Gladys Scott on December 29, 2010 (1) This decision indefinitely suspended their double life sentences and freed them after sixteen [...]

Bioethical debate has been characterized from the beginning by the central importance placed on autonomy. This is because bioethics has, until now, been concerned with the relationship between doctor and patient in a clinical context or, alternatively, with the rights of individuals involved in biomedical research. The increased involvement of bioethics in the domain of public health, however, makes it necessary to refer to other principles and values, thus shaping a new responsibility-focused bioethics that extends itself beyond the early boundaries of this discipline. (doi: 10.2105/AJPH.2007.127514)

An apparent consensus governs the management of carrier status information generated incidentally through newborn screening: results cannot be withheld from parents. This normative stance encodes the focus on autonomy and distaste for paternalism that characterize the principles of clinical bioethics. However, newborn screening is a classic public health intervention in which paternalism may trump autonomy and through which parents are--in effect--required to receive carrier information. In truth, the disposition of carrier results generates competing moral infringements: to withhold information or require its possession. Resolving this dilemma demands consideration of a distinctive body of public health ethics to highlight the moral imperatives associated with the exercise of collective authority in the pursuit of public health benefits. (Am J Public Health. 2008;99:210-215. doi: 10.2105/AJPH.2008. 136614)

ABSTRACT Codifying, and then implementing, an international right to health, health care, or protection is beset with serious roadblocks--foremost among them being contentious issues of indeterminacy, justiciability, and progressive realization. [...]

Byline: I. D. Pestov (1) Abstract: The author considers the specific features of applying the universally accepted standards of biomedical ethics to human research in aerospace and maritime medicine. The extreme factors that act on human subjects may be a menace to their health and physical and mental well-being. Therefore, medical information that comes from human studies is important not only scientifically, but also practically as the basis for revealing and preventing the risks related to such factors and for ensuring the safety of both human subjects and members of missions who may be exposed to such impacts in the future. This makes it necessary to not only strictly adhere to the basic standards of biomedical ethics, but also adapt some of them to the priority task of ensuring human safety under extreme conditions. Among other problems, the author discusses possible ways of correcting the scope of application of bioethical principles, such as confidentiality, voluntariness, and the right to refuse from or stop taking part in an experiment. Author Affiliation: (1) Russian Academy of Sciences, State Research Center Institute of Biomedical Problems, Khoroshevskoe sh. 76a, Moscow, 123007, Russia Article History: Registration Date: 11/10/2004

The text of the European Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine, 1997, is presented. Topics covered include consent, private life and right to information, human genome, scientific research, organ and tissue removal from living donors for transplantation, prohibition of financial gain, disposal of a removed part of the human body, infringements of the provisions, and public debate.

This article provides a critical overview of the most important issues pertaining to the ongoing debate on international research ethics. It critically describes three problems of continuing concern: 1) the question of whether the distinction between therapeutic and non-therapeutic research should be upheld; 2) the questions of whether the currently demanded best proven diagnostic and therapeutic method of treatment for all research subjects is feasible both in developed and in developing counties, and whether it should be upheld; 3) the questions of who owns international research ethics guidelines and regulatory frameworks and, how decisions about changes to such international guidelines can possibly be achieved, given that it seems to be the case that genuine disagreement about issues of content is possible and likely.

For bioethicists, challenges are presented by HIV clinical trials in less-developed countries. The same standards should prevail, no matter where the trials take place and the interests f the research subjects should be primary. Clinical trials are profitable for pharmaceutical companies and for clinical researchers. They want to do them as quickly as possible with as few obstacles as possible and that often means going to developing countries. Medical pluralism would suggest that non-Western medical systems could have a role in managing HIV infection and that that should be explored. Non-market forces might facilitate treatment. David B. Resnik has not identified all of the scientific/ethical issues.

David B. Resnik has concluded that perinatal HIV transmission studies in developing countries are justified. He may have missed the essence of the criticism of the trials and may have missed the essence of the defense. To defend the trials, it is said that no other way of establishing the effectiveness of short-term AZT treatment exists. The controversy actually is over whether it is likely that the experimental treatment will cut perinatal transmission to that found in the AIDS Clinical Trial Group (ACTG) 076 regimen and whether reliable judgements about perinatal transmission rate if no treatment is given can be made. It is not ethical to knowingly design a trial in which some women get treatment less effective than is given to others.

Clinical trials that took place in developing countries for testing zidovudine effectiveness in cutting the perinatal HIV transmission rate have been defended by David B. Resnik. The trials are unethical and establish bad precedent. It would not even be defensible to carry out tests on using levels of the drug lower than the AIDS Clinical Trial Group (ACTG) 076 levels. The placebo control groups are not necessary, based on the judgement of a number of eminent scientists who conduct such trials.

Many contemporary moral theorists concern themselves with the question of whether a universal model of ethical reasoning exists. In more political fields that question is of interest as well. Theoretical frameworks are challenged by the practical problems coming from the field of bioethics. Responses tend to fall into the categories of universalist and relativists. An example of a question to be considered is that of female genital mutilation, which is viewed differently from a legal standpoint in different countries and cultures.

Standards of ethical medical research on humans are universal, but they are not absolute. Each situation must be evaluated separately. A dispute has arisen over ethics of research in developing countries on preventing perinatal transmission of HIV. There is no other way to see whether short-term AZT treatment is better than a placebo one and to see whether the AIDS Clinical Trial Group (ACTG) 076 protocol is the only good one. Some argue that the research is unethical on the grounds that the placebo-control group is denied a treatment that is effective. Others argue that that point of view omits the ethical complexities of research in developing countries and that studies can be designed to take into account economic, social and scientific research factors.