Although medical research in developing countries is essential, it needs to be accompanied by a sound ethical framework, says a report from the UK’s Nuffield Council on Bioethics. However, it would be impractical to argue that participants should receive the same standard of care as patients in first world countries. One problem is that stringent ethical guidelines could end up stifling research because they are simply impossible to observe.

Some controversial areas include: consent forms which are too complex for uneducated people to understand; uncertainty about whether participants should receive the best care possible or the best care available; the use of placebos; and whether drug companies should continue to provide treatment once the trial ends.

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