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Public Health Ethics Advance Access published online on June 14, 2008
Public Health Ethics, doi:10.1093/phe/phn027
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The Author 2008. Published by Oxford University Press. Available online at www.phe.oxfordjournals.org

Assuring Adequate Protections in International Health Research: A Principled Justification and Practical Recommendations for the Role of Community Oversight

David Buchanan*

University of Massachusetts, Amherst

Sibusiso Sifunda

Medical Research Council, Capetown, South Africa

Nasheen Naidoo

Medical Research Council, Capetown, South Africa

Shamagonam James

Medical Research Council, Durban, South Africa

Priscilla Reddy

Medical Research Council, Capetown, South Africa

* Corresponding author: 306 Arnold House, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA 01003, USA. Tel.: (413) 545 1005; Email: Buchanan{at}schoolph.umass.edu.


  Abstract

The analysis presented here lays out the ethical warrants for requiring community oversight of health research conducted in international settings. It reviews the inadequacies with the current standards of individual informed consent and research ethics committee review, and then, shows how a broader population-based public health perspective raises new demands on justice involving due consideration of the rights, harms and benefits to the community as a whole. As developed here, an ethical standard that requires community oversight of health research is justified on three principled grounds: respect for community autonomy and their right to self-determination; due consideration of the consequences of the research for the community as a whole; and, a more complete understanding of human autonomy. The paper concludes with practical recommendations regarding the composition of Community Advisory Boards to ensure that they have legitimate decision-making authority in diverse socio-cultural contexts.


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