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Ethical issues in HIV/AIDS research

Ethics is the study of morals. It is concerned with the rights and wrongs of any particular decision or course of action.

 

Globally the HIV/AIDS epidemic has presented unique health challenges to populations, including a host of ethical and moral issues related to human life and dignity.

 

Currently, the critical areas of concern include access to treatment and developing newer, more effective therapeutic and prevention methods while taking care of ethical values in health care and research.

 

The ethical issues mainly revolve around the standard of care, informed consent across cultures, privacy and confidentiality, stigma and discrimination, protection of vulnerable groups, community consultation, ethical review mechanisms, international collaboration, epidemiological studies, clinical trials and also sociobehavioural studies on HIV/AIDS.

 

In addition, major concerns are raised regarding HIV/AIDS vaccine trials, microbicidal trials, as well as prevention of parent-to-child transmission (PPTCT) trails, especially in resource-poor countries.

 

For international collaborative research appropriate standard of care, community benefits, and host country needs must be kept in mind.

 

Improving our understanding of the various ethical and societal concerns related to HIV/AIDS treatment and research would help in the development of appropriate policies for disease control and prevention.

 

Some issues such as the right of people with HIV-related dementia or the mentally handicapped with HIV infection have attracted little attention from doctors.

 

Other issues such as making AIDS a notifiable disease, and the anonymous and voluntary screening of general population and antenatal patients, are vigorously debated. 

 

The ethical issues which impinge most directly on the personal relationship between patient and practitioner are the duty to care, consent and confidentiality.

 

Seven requirements for ethical research

Value

  • A research question designed to enhance health or provide useful knowledge addressing health problems and priorities of participants.

 

Validity

  • An appropriate and feasible design and methodological rigour.

 

Fair subject selection

  • Selection of subjects and sites based on scientific appropriateness and minimization of vulnerability and risk.

 

Favourable risk:benefit ratio

  • Maximization of benefits and minimization of risks.

 

Independent review

  • Independent evaluation of adherence to ethical guidelines in design, conduct and analysis of research.

 

Informed consent

  • Processes for providing adequate information and promoting the voluntary enrollment of subjects.

 

Respect for enrolled participants

  • Respect for, and protection of, subjects' rights throughout and at the conclusion of the study.

 

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