Página 69 - Dimensiones éticas de las regulaciones en salud

68
in a paper in the Annals of Internal Medicine cleansing the literature of
tainted fruit is an extremely difficult task(16). However, it is the obliga-
tion of all in the scientific community to play this role.
What is striking about this is two issues:
1) that current existing research oversight mechanisms would not be
able to detect or prevent any of these issues that have been just dis-
cussed,
2) there is evidence that those who are found guilty of research miscon-
duct are often treated in a very favourable away compared to those
who have blown the whistle on them. For example, Nature published
a misconduct special, “Where Are They Now?,” where they followed
up on the outcomes of prominent research ethics scandals. The re-
sults of this inquiry make sobering reading(17).
Emerging issues
There are also new trends in the scientific world which expose the inad-
equacies of current methods of research ethics review. I will address three
of these: 1) the consideration of determinants of health, 2) globalization
of research, and 3) ethics of information.
As we move into the 21st century, it is important that our lenses or frame-
works for the assessment of human subjects research be attentive to and
nimble enough to respond to current research. On a conceptual level, it is
important that initiatives such as the World Health Organization’s Com-
mission on Social Determinants of Health be integrated into research eth-
ics deliberations. As health research globalizes, there is a need to integrate
the broader determinants of health and their impact on health outcomes.
This means consideration of socioeconomic and political contexts, gover-
nance and government structures in nations, macroeconomic, social and
health policy, cultural and social norms and values be considered as effects
on social position, education, occupation, income, and gender, and how