The Ethics of Clinical Trials in the Third World

In “The Ethics of Clinical Trials in the Third World” Marcia Angell likens the AZT clinical trials to the infamous Tuskegee Study. Her core argument is that it is wrong to use a placebo-controlled study when a state of clinical equipoise does not obtain. First, what is clinical equipoise? Why does Angell think the shorter course should have been tested against the standard (or full) course of AZT?

Don Marquis rejects clinical equipoise as the standard for judging the merits of a study. He argues that informed consent is the key to assessing the morality of a study. Do you think pregnant HIV+, scientifically illiterate African women in the study conducted by Bagenda and Mudido were capable of giving informed consent? (Be careful here—to say women in such circumstances are incapable of giving informed consent smacks of paternalism.)

Brody defends the study. On his view, there is a key difference between the study conducted by Bagenda and Mudido and the Tuskegee Study. In the latter, medication that was readily available was intentionally withheld. In Uganda, AZT is not readily available. One point is clear. The shorter course of AZT was effective. Do you think the study by Bagenda and Mudido is morally permissible? Defend your answer.

Core question: Is Angell’s comparison of the AZT Studies comparable with the Tuskegee Study? Defend your answer.

(Minimum World Count: 500 Words)