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HIV Vaccine Trial participation in the Third World : an ethical assessment

Thesis (M.Phil.) -- University of Stellenbosch, 1999.

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Main Author: Moodley, Keymanthri
Other Authors: Van Niekerk, Anton A.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2012
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access_status_str Open Access
author Moodley, Keymanthri
author2 Van Niekerk, Anton A.
author_browse Moodley, Keymanthri
Van Niekerk, Anton A.
author_facet Van Niekerk, Anton A.
Moodley, Keymanthri
author_sort Moodley, Keymanthri
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (M.Phil.) -- University of Stellenbosch, 1999.
format Thesis
id oai:scholar.sun.ac.za:10019.1/51287
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:44:18.274Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2012
publishDateRange 2012
publishDateSort 2012
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
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source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/51287 HIV Vaccine Trial participation in the Third World : an ethical assessment Moodley, Keymanthri Van Niekerk, Anton A. Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy. AIDS vaccines -- Research -- Moral and ethical aspects -- Developing countries AIDS vaccines -- Testing -- Moral and ethical aspects -- South Africa Human experimentation in medicine -- Moral and ethical aspects -- Developing countries Human experimentation in medicine -- Moral and ethical aspects -- South Africa Dissertations -- Philosophy Thesis (M.Phil.) -- University of Stellenbosch, 1999. ENGLISH SUMMARY: This essay examines the issue of trial participation in the proposed my Vaccine Trials in South Arica. It is set against the backdrop of ethical issues relating to research in the Third World in general. Trial participation is examined in the context of the ethical tension that exists between international ethical research standards based on Liberal Individualism and local standards of care and cultural norms in the Third World. Two areas of conflict are inherent here: universality versus particularity on the one hand and individualism versus communitarianism, on the other. The Tuskegee Syphilis Study as well as the HIV Vertical Transmission Trials are used as a point of departure to set the stage for the controversy surrounding the proposed HIV Vaccine Trials. The important concepts of informed consent, the risk-benefit ratio and fair treatment of trial participants are framed within the Four Principle Approach of autonomy, beneficence, non-maleficence and justice. These principles form the cornerstone of the Declaration of Helsinki. This Western ethical guideline - grounded in universality - has become the mantra of all liberal democracies the world over and is chanted slavishly by the international research community. It bears the hallmark of liberal individualism with its mandate that "the concern for the interest of the individual must always prevail over the interests of science and society". Followed to its logical conclusion, any infringements of the moral interests of trial participants must be viewed using a subject-oriented approach. Such an approach sees the trial participant as being of paramount importance and views research as "highly desirable but morally optional". Clearly, this would mean the end of the road for medical research, especially in the Third World, where a truly subject oriented approach would render research tantamount to exploitation of vulnerable, educationally disadvantaged persons. In Africa, in traditional, rural communities, a moderate form of communitarianism referred to as "Ubuntu" or "communalism" is still prevalent. In such communities, the concept of personhood is embedded in the community or society. In these communities, a balancing approach, in which infringements on the rights of trial participants are permissible in the name of science or society, provided the subject is not placed at significant risk, would be acceptable. However, liberal individualism is making inroads here too. As such, the ethical tension between liberal individualism and communitarianism, which is unavoidable in research settings, is growing. This essay highlights many internal contradictions in liberal individualism - especially where research ethics is concerned in Third World countries. One of the outcomes of such contradiction is the attempt by the World Medical Association to amend the Declaration of Helsinki - in the name of ethical relativism: different standards for different countries or cultures. Surely, such liberal individualism cannot be seen as the "endpoint of mankind's ideological evolution" as Fukuyama phrases it, nor can it be the final solution to the problems of the world and, as such, "the end of history". In the context of the HIV Vaccine Trials, individual good clashes with societal good, universality with particularity and ultimately, modernism with postmodernism. In Western cultures, the individual enjoys priority; in other cultures, society is more important - somewhere in between, we need to find common ground which can be incorporated into a balancing approach with minimal risk to the individual when infringement of rights is unavoidable. Master 2012-08-27T11:34:25Z 2012-08-27T11:34:25Z 1999-12 Thesis http://hdl.handle.net/10019.1/51287 en_ZA Stellenbosch University 64 pages application/pdf Stellenbosch : Stellenbosch University
spellingShingle AIDS vaccines -- Research -- Moral and ethical aspects -- Developing countries
AIDS vaccines -- Testing -- Moral and ethical aspects -- South Africa
Human experimentation in medicine -- Moral and ethical aspects -- Developing countries
Human experimentation in medicine -- Moral and ethical aspects -- South Africa
Dissertations -- Philosophy
Moodley, Keymanthri
HIV Vaccine Trial participation in the Third World : an ethical assessment
title HIV Vaccine Trial participation in the Third World : an ethical assessment
title_full HIV Vaccine Trial participation in the Third World : an ethical assessment
title_fullStr HIV Vaccine Trial participation in the Third World : an ethical assessment
title_full_unstemmed HIV Vaccine Trial participation in the Third World : an ethical assessment
title_short HIV Vaccine Trial participation in the Third World : an ethical assessment
title_sort hiv vaccine trial participation in the third world an ethical assessment
topic AIDS vaccines -- Research -- Moral and ethical aspects -- Developing countries
AIDS vaccines -- Testing -- Moral and ethical aspects -- South Africa
Human experimentation in medicine -- Moral and ethical aspects -- Developing countries
Human experimentation in medicine -- Moral and ethical aspects -- South Africa
Dissertations -- Philosophy
url http://hdl.handle.net/10019.1/51287
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