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Title: The ethics of community effectiveness research in developing countries
Author: Lignou, S.
ISNI:       0000 0004 7230 3027
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2016
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The aim of the thesis is to explore and discuss the distinct ethical issues raised by the conduct of health-related cluster randomised trials in developing countries, in particular those related to informed consent and representation. The thesis has four objectives: First, it seeks to identify ethical issues and their importance arising in CRTs and present how they are currently being addressed in published trial reports and papers on the ethics of CRTs. Second, it aims to discuss the limitations of addressing such ethical issues within the existing research ethics framework. Third, by relying on a human right to health, it aims to suggest a broader research ethics framework, beyond the existing clinical ethics paradigm, that takes into account the variety of health studies conducted in developing settings, as well as the broader socio-political context where collaborative health research takes place. Fourth, by examining the common moral features between cluster health studies and public health interventions, it aims to inform current research ethics guidelines and discussions on the ethics of cluster research by suggesting solutions to the problem of informed consent and cluster representation in developing countries, as well as to demonstrate the strength of the suggested research ethics framework in dealing with such complex issues. I argue that under specific conditions a cluster trial is morally legitimate to proceed despite the absence of informed consent and that a decision regarding the conduct of research should be within the responsibilities of the legitimate political authorities of the host country. I conclude that collaborative health research, which aims to improve the health status of a developing population, should be part of a country’s policy, similarly to decisions concerning the implementation of public health measures, and that human subjects should be protected at individual, social and institutional level.
Supervisor: Wolff, J. ; Edwards, S. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available