PubMed · 15362242
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J Last, M Angell, P Woolf, B Squires, N Kenny. 1993. Professional integrity.. https://pubmed.ncbi.nlm.nih.gov/15362242/
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The Declaration of Helsinki (2000) helped trigger a major debate on many ethical aspects of research with human subjects. Topics under discussion include the use of placebos, the application of equipoise, the distinction between research ethics and clinical ethics, and the difference between therapeutic and non-therapeutic trials. This article supports tenets that serve to protect patients involved in research, especially in those aspects concerning maintenance of best existing therapy, the rejection of using placebos, support of equipoise, the assurance that required medication shall be available beyond the termination of the research project, and that appropriate compensation will obtain to host communities inasmuch as they may have facilitated and supported the project. The current proposal of introducing a double ethical standard, aspirational for developed countries and pragmatic for poor nations, should be rejected, since it contravenes the universalizability of prescriptive ethics.
The criticism of the pharmaceutical industry is growing while the confidence of the general population seems to be decreasing. The industry functions on the boundary between two worlds: the world of healthcare as a social system and that of a worldwide competitive industry providing employment to nearly 600,000 people in Europe. The two worlds are connected by clinicians who are engaged in the development of new drugs. The conflict between making a profit and providing care also exists in healthcare and science. The criticism should be taken seriously. The solution lies in the ability of the industry to purify itself and not in a new role for government or new regulations.