Okonta PI.Author information: Depar

Okonta PI.

Author information:
Department of Obstetrics and Gynaecology, Delta State University, Abraka, Delta,
Nigeria.

The conduct of clinical trials for the development and licensing of drugs is a
very important aspect of healthcare. Drug research, development and promotion
have grown to a multi-billion dollar global business. Like all areas of human
endeavour involving generation and control of huge financial resources, it could
be subject to deviant behaviour, sharp business practices and unethical
practices. The main objective of this review is to highlight potential ethical
challenges in the conduct of clinical trials in Nigeria and outline ways in which
these can be avoided. Current international and national regulatory and ethical
guidelines are reviewed to illustrate the requirements for ethical conduct of
clinical trials. Past experiences of unethical conduct of clinical trials
especially in developing countries along with the increasing globalisation of
research makes it imperative that all players should be aware of the ethical
challenges in clinical trials and the benchmarks for ethical conduct of clinical
research in Nigeria.

PMCID: PMC4089044
PMID: 25013247 [PubMed]
2. J Med Internet Res. 2001 Apr-Jun;3(2):E23.

Ethical challenges of medicine and health on the Internet: a review.

Dyer KA.

Author information:
Kaiser Permanente, Walnut Creek, CA, USA. griefdoc@kirstimd.com

Knowledge and capabilities, particularly of a new technology or in a new area of
study, frequently develop faster than the guidelines and principles needed for
practitioners to practice ethically in the new arena; this is particularly true
in medicine. The blending of medicine and healthcare with e-commerce and the
Internet raises many questions involving what sort of ethical conduct should be
expected by practitioners and developers of the medical Internet. Some of the
early pioneers in medical and healthcare Web sites pushed the ethical boundaries
with questionable, even unethical, practices. Many involved with the medical
Internet are now working to reestablish patient and consumer trust by
establishing guidelines to determine how the fundamentals of the medical code of
ethical conduct can best be adapted for the medical/healthcare Internet.
Ultimately, all those involved in the creation, maintenance, and marketing of
medical and healthcare Web sites should be required to adhere to a strict code of
ethical conduct, one that has been fairly determined by an impartial
international organization with reasonable power to regulate the code. This code
could also serve as a desirable, recognizable label-of-distinction for ethical
Web sites within the medical and healthcare Internet community. One challenge for
those involved with the medical and healthcare Internet will be to determine what
constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the
definition of medical ethics can vary from country to country. Therefore, the
emerging field of Medical/ Healthcare Internet Ethics will require careful
thought and insights from an international collection of ethicists in many
contributing areas. This paper is a review of the current status of the evolving
field of Medical/Healthcare Internet Ethics, including proposed definitions and
identification of many diverse areas that may ultimately contribute to this
multidisciplinary field. The current role that medicine and health play in the
growing area of Internet communication and commerce and many of the ethical
challenges raised by the Internet for the medical community are explored and some
possible ways to address these ethical challenges are postulated.

PMCID: PMC1761893
PMID: 11720965 [PubMed - indexed for MEDLINE]













3. BMC Med Ethics. 2014 Jun 17;15:47. doi: 10.1186/1472-6939-15-47.

How "moral" are the principles of biomedical ethics?--a cross-domain evaluation
of the common morality hypothesis.

Christen M(1), Ineichen C, Tanner C.

Author information:
(1)University Research Priority Program Ethics, University of Zurich, Zurich,
Switzerland. christen@ethik.uzh.ch.

BACKGROUND: The principles of biomedical ethics - autonomy, non-maleficence,
beneficence, and justice - are of paradigmatic importance for framing ethical
problems in medicine and for teaching ethics to medical students and
professionals. In order to underline this significance, Tom L. Beauchamp and
James F. Childress base the principles in the common morality, i.e. they claim
that the principles represent basic moral values shared by all persons committed
to morality and are thus grounded in human moral psychology. We empirically
investigated the relationship of the principles to other moral and non-moral
values that provide orientations in medicine. By way of comparison, we performed
a similar analysis for the business & finance domain.
METHODS: We evaluated the perceived degree of "morality" of 14 values relevant to
medicine (n1 = 317, students and professionals) and 14 values relevant to
business & finance (n2 = 247, students and professionals). Ratings were made
along four dimensions intended to characterize different aspects of morality.
RESULTS: We found that compared to other values, the principles-related values
received lower ratings across several dimensions that characterize morality. By
interpreting our finding using a clustering and a network analysis approach, we
suggest that the principles can be understood as "bridge values" that are
connected both to moral and non-moral aspects of ethical dilemmas in medicine. We
also found that the social domain (medicine vs. business & finance) influences
the degree of perceived morality of values.
CONCLUSIONS: Our results are in conflict with the common morality hypothesis of
Beauchamp and Childress, which would imply domain-independent high morality
ratings of the principles. Our findings support the suggestions by other scholars
that the principles of biomedical ethics serve primarily as instruments in
deliberated justifications, but lack grounding in a universal "common morality".
We propose that the specific manner in which the principles are taught and
discussed in medicine - namely by referring to conflicts requiring a balancing of
principles - may partly explain why the degree of perceived "morality" of the
principles is lower compared to other moral values.

PMCID: PMC4071216
PMID: 24938295 [PubMed - in process]