Book contents
- Frontmatter
- Contents
- List of contributors
- Acknowledgements
- 1 Introduction
- Section I Information problems
- Section II End of life care
- Section III Pregnant women and children
- Section IV Genetics and biotechnology
- Section V Research ethics
- Section VI Health systems and institutions
- Section VII Using clinical ethics to make an impact in healthcare
- Section VIII Global health ethics
- Introduction
- 43 Global health ethics and cross-cultural considerations in bioethics
- 44 Physician participation in torture
- 45 Access to medicines and the role of corporate social responsibility: the need to craft a global pharmaceutical system with integrity
- 46 Global health and non-ideal justice
- Section IX Religious and cultural perspectives in bioethics
- Section X Specialty bioethics
- Index
- References
43 - Global health ethics and cross-cultural considerations in bioethics
Published online by Cambridge University Press: 30 October 2009
Book contents
- Frontmatter
- Contents
- List of contributors
- Acknowledgements
- 1 Introduction
- Section I Information problems
- Section II End of life care
- Section III Pregnant women and children
- Section IV Genetics and biotechnology
- Section V Research ethics
- Section VI Health systems and institutions
- Section VII Using clinical ethics to make an impact in healthcare
- Section VIII Global health ethics
- Introduction
- 43 Global health ethics and cross-cultural considerations in bioethics
- 44 Physician participation in torture
- 45 Access to medicines and the role of corporate social responsibility: the need to craft a global pharmaceutical system with integrity
- 46 Global health and non-ideal justice
- Section IX Religious and cultural perspectives in bioethics
- Section X Specialty bioethics
- Index
- References
Summary
The AIDS Clinical Trials Group Study 076 (ACTG 076) made an important contribution to prevention of HIV infection when it established that mother-to-child transmission of HIV (MTCT) in the USA and France could be significantly reduced by giving antiretroviral drugs to pregnant women orally for 8 weeks or more prior to childbirth (median 14 weeks) and intravenously during labor, as well as to the newborn child for 6 weeks in the absence of breast feeding (Connor et al., 1994). A major controversy developed when in subsequent studies of MTCT in developing countries shorter courses of treatment were compared with placebo. Although there is no reason to believe that the ACTG 076 regimen would not work in developing countries if it could be applied, placebo studies were undertaken instead. The rationale was that use of the ACTG 076 regimen was precluded in developing countries, not only by its extremely high cost but, more relevantly, because women do not present early enough in pregnancy to receive this prolonged and intensive regimen. In addition they are anemic and malnourished, unable to stop breast feeding, and have difficulty providing treatment to a child for a six-week period (Varmus and Satcher, 1997). Consequently, cheaper and more easily applied preventive methods needed to be studied to enable rapid application of this preventive method to save many lives in developing countries.
What is global health ethics?
Global health ethics is a suggested means through which to promote widely values that include meaningful respect for human life, human rights, equity, freedom, democracy, environmental sustainability, and solidarity (Benatar et al., 2003).
- Type
- Chapter
- Information
- The Cambridge Textbook of Bioethics , pp. 341 - 349Publisher: Cambridge University PressPrint publication year: 2008
References
(2003). A defense of the common morality. Kennedy Inst Ethics J 13: 259–74.CrossRefGoogle ScholarPubMed
(1998). Global disparities in health and human rights. Am J Public Health 88: 295–300.CrossRefGoogle ScholarPubMed
Benatar, S. R. (2001). Health in developing countries. In International Encyclopedia of the Social and Behavioral Sciences, ed. and . Amsterdam: Elsevier, pp. 6566–70.Google Scholar
(2002). Some reflections and recommendations on research ethics in developing countries. Soc Sci Med 54: 1131–41.CrossRefGoogle ScholarPubMed
(2004a). Towards progress in resolving dilemmas in international research ethics. J Law Med Ethics 32: 574–82.CrossRefGoogle Scholar
(2004b). Rationally defensible standards for research in developing countries. Review of “Double Standards in Medical Research in Developing Countries” by Ruth Macklin, Cambridge University Press. Health Human Rights 8: 197–202.CrossRefGoogle Scholar
, , and (2003). Global health ethics: the rationale for mutual caring. Int Affairs 79: 101–38.CrossRefGoogle Scholar
and (2006). Developing sustainability: a new metaphor for progress. Theor Med Bioethics 27: 59–79.CrossRefGoogle ScholarPubMed
(1998). Culture and ethnicity in clinical care. Arch Intern Med 158: 2085–90.CrossRefGoogle ScholarPubMed
, , , et al. (2003). Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA 289: 1–9.CrossRefGoogle ScholarPubMed
(2004). What are the limits of bioethics in a culturally pluralistic society?J Law Med Ethics 32: 664–9.CrossRefGoogle Scholar
(1992). Ethics are local: engaging cross-cultural variations in the ethics for clinical research. Soc Sci Med 35: 1079–91.CrossRefGoogle Scholar
, , , et al. (1994). Reduction of maternal–infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 331: 1173–80.CrossRefGoogle ScholarPubMed
(2003). Common morality, coherence, and the principles of biomedical ethics. Kennedy Inst Ethics J 13: 219–30.CrossRefGoogle ScholarPubMed
, , and (2003). Is time running out? The case of global warming. Daedalus Spring: 98–107.Google Scholar
Fogarty International Center (2005). International Research Ethics Education and Curriculum Development Award. http://www.fic.nih.gov/programs/training_grants/ bioethics/index.htm. Accessed June 2007.
and (1985). Medical morality is not bioethics: medical ethics in China and the United States. Perspect Biol Med 27: 337–60.Google Scholar
and (2005). Examining American bioethics: its problems and perspectives. Camb Q Healthc Ethics 14: 361–73.CrossRefGoogle Scholar
(2001). Humanity: a Moral History of the 20th Century. New Haven, CT: Yale University Press.Google Scholar
Hinman, L. M. (2006). Internet philosophical sources on moral relativism. Ethics Updates (http://ethics.sandiego.edu/theories/Relativism) accessed 26 July 2006.
Hoffmeister, B. (1990). Morality and the social sciences. In Social Science Perspectives on Medical Ethics, ed. . Dordrecht, the Netherlands: Kluwer, pp. 241–60.CrossRefGoogle Scholar
Horton, R. (1995). African traditional thought and Western science. In African Philosophy, ed. . Englewood Cliff, NJ: Prentice Hall, pp. 310–38.Google Scholar
Kaiser Network (2006). Global Challenges: Life Expectancy in Sub-Saharan Africa Decreases. http://www.kaisernetwork.org/daily_reports-rep_index.cfm?DR_ID=38068. Accessed 26 July 2006.
, , , et al. (2003). A major outbreak of severe respiratory distress syndrome in Hong Kong. N Engl J Med 348: 1986–94.CrossRefGoogle Scholar
Lieban, R. W. (1990). Medical anthropology and the comparative study of medical ethics. In Social Science Perspectives on Medical Ethics, ed. . Dordrecht the Nehtherlands: Kluwer, pp. 221–39.CrossRefGoogle Scholar
(2000). The ambiguity and the exigency: clarifying ‘standard of care’ arguments in international research. J Med Philos 25: 379–97.CrossRefGoogle ScholarPubMed
(2001). Equipoise and international human-subjects research. Bioethics 15: 312–32.CrossRefGoogle ScholarPubMed
, , and (1996). Research bioethics in the Ugandan context. J Law Med Ethics 24: 47–53.CrossRefGoogle ScholarPubMed
(1999). Against Relativism: Cultural Diversity and the Search for Ethical Universals in Medicine. New York: Oxford University Press.Google Scholar
and (2004). Accounting for culture in a globalized bioethics. J Law Med Ethics 32: 252–66.CrossRefGoogle Scholar
Nairn, T. (1998). The use of Zairian children in HIV vaccine experimentation: a cross-cultural study in medical ethics. In On Moral Medicine, 2nd edn, ed. and . Grand Rapids MI: Eerdmans, pp. 919–31.Google Scholar
Nixon, S., Upshur, R., Robertson, A., et al. (2005). Public health ethics. In Public Health and Law Policy in Canada, ed. , , . Toronto: Lexis Nexis, pp. 39–58.Google Scholar
(1997). Cultivating Humanity: A Classical Defense of Reform in Liberal Education. Cambridge, MA: Harvard University Press.Google Scholar
and (2005). HIV prevention research and global inequality: towards improved standards of care. J Med Ethics 31: 39–47.CrossRefGoogle ScholarPubMed
, , , et al. (2003). Ethics and SARS: lessons from Toronto. BMJ 327: 1342–4.CrossRefGoogle ScholarPubMed
(1995). Worldviews: Cross-cultural Explorations of Human Beliefs, 2nd edn. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
and (eds.) (2001). Methods in Medical Ethics. Washington, DC: Georgetown University Press.Google Scholar
(2000). The traditional African perception of a person: some implications for bioethics. Hastings Cent Rep 30: 39–43.CrossRefGoogle ScholarPubMed
(2002). International regulations and medical research in developing countries: double standards or differing standards?. Notizie di Politeia XVIII: 46–50.Google Scholar
(2003). Zones of consensus and zones of conflict: questioning the “common morality” presumption in bioethics. Kennedy Inst Ethics J 13: 193–218.CrossRefGoogle ScholarPubMed
and (1997). Ethical complexities of conducting research in developing countries. N Engl J Med 337: 1003–5.CrossRefGoogle ScholarPubMed
(ed.) (1990). Social Science Perspectives on Medical Ethics. Dordrecht, the Netherlands: Kluwer, pp. 221–39.CrossRefGoogle Scholar
- 2
- Cited by