An ethics-based approach to global child health research

Abstract

Despite the increasing attention paid to ethical conduct in cross-border health initiatives, the ethical concerns arising specifically from paediatric research in developing countries have not been widely discussed in the medical literature. This does not necessarily imply that such issues are not being addressed by those who are involved with child health care and research in developing countries, but it does suggest that there is a lack of formal discourse or study in this area. An ethical approach to child health research should be formally incorporated into future North-South collaborative projects. This comprises a research agenda that promotes equity in child health, as well as research methodologies that are culturally sensitive yet adhere to universal ethical standards. Particular emphasis should be placed on distributive justice and a valid process for obtaining informed parental/guardian consent and child assent. A tacit indifference toward global inequities is a frequent feature of unethical research studies in developing countries. Unethical research does not benefit children in developing countries, because it ignores the underlying causes of lower paediatric standards of care, namely social and economic inequity. Research priorities should reflect the health issues of developing countries, and should address, a priori, the challenge of implementing research findings in resource-poor settings. Child health research initiatives need to continue to be broadened in the developing world, but it must be recognized that their impact will only be truly beneficial for children if investigators promote an ethical approach in both the design and conduct of their research.