Página 229 - Dimensiones éticas de las regulaciones en salud

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What is too often the case is that relativism holds great attraction for those
who fear that anything other than acceptance of other cultures’ norms is a
declaration of intolerance, or worse. In fact, even the most clever relativist
must go to great pains both to carry the relativist flag while at the same
time disdaining racism, sexism, exploitation and so on. The anti-relativist
or universalist argues that these positions and actions are wrong no mat-
ter where they occur or who is guilty of them – and whether they believe
the positions and actions to be wrong or not. That is, the rightness or
wrongness of an action is independent of the beliefs of the actor, or his or
her culture. In a global research environment shaped by varying customs
and values, the duty to identify unified, international standards is one of
the greatest and most interesting challenges in the history of science. It
is surely not too much to ask research ethics committees to familiarize
themselves with this issue.
Vulnerable populations
This point could not be more important than with regard to discussions
about vulnerable populations. The definition of, responsibilities to and
needs of “vulnerable populations” constitute important and, alas, interest-
ing undertakings for the international bioethics and human subjects pro-
tection communities(7,11,12). Even the most rudimentary conceptions
of justice require both that the world’s scientific community devote more
attention to the needs of indigenous peoples, poor people and others, and
that these populations not be (over)burdened by the very research de-
signed, one hopes, to help them.
While the concept of vulnerability implies vulnerability in terms of in-
creased risk and harm, the regulatory emphasis on risk tends to overshad-
ow what is arguably at least as important: the duty to reduce the dispari-
ties that in many cases established populations as vulnerable in the first
place. We can put this another way: Given (the widespread agreement)
that research should incorporate and respond to the needs of populations,
including vulnerable populations; and given that poor health and/or poor