{"id":3746,"date":"2017-01-20T11:53:31","date_gmt":"2017-01-20T11:53:31","guid":{"rendered":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/01\/MacMillan.pdf"},"modified":"2017-01-20T11:53:31","modified_gmt":"2017-01-20T11:53:31","slug":"macmillan-2","status":"inherit","type":"attachment","link":"https:\/\/www.wma.net\/fr\/macmillan-2\/","title":{"rendered":"MacMillan"},"author":2,"comment_status":"open","ping_status":"closed","template":"","meta":[],"acf":[],"description":{"rendered":"<p class=\"attachment\"><a href='https:\/\/www.wma.net\/wp-content\/uploads\/2017\/01\/MacMillan.pdf'>MacMillan<\/a><\/p>\n<p>Ancillary care, the Declaration of<br \/>\nHelsinki and the obligations of global<br \/>\nresearch<br \/>\nAssociate Professor John McMillan<br \/>\nJohn.mcmillan@flinders.edu.au<br \/>\n\u2022 14. \u201cThe research protocol should describe<br \/>\narrangements for post-study access by study<br \/>\nsubjects to interventions identified as<br \/>\nbeneficial in the study or access to other<br \/>\nappropriate care or benefits.\u201d<br \/>\n\u2022 33. Patients are entitled to share \u201cother<br \/>\nappropriate care or benefits.\u201d<br \/>\nAncillary care<br \/>\n\u2022 Care that researchers might provide to<br \/>\nresearch subjects when they become unwell<br \/>\nduring, but not because of, participation in<br \/>\nresearch.<br \/>\n\u2022 Particularly relevant in a developing world<br \/>\ncontext where care may be not unavailable<br \/>\nWeijer and LeBlanc<br \/>\n\u2022 Researchers don\u2019t have a moral obligation to<br \/>\nprovide ancillary care.<br \/>\n\u2022 An obligation to consult, negotiate and gain<br \/>\nthe consent of the communities in the<br \/>\ndeveloping world. The Journal of Law<br \/>\nMedicine and Ethics<br \/>\nUN Aids (2003): beneficence<br \/>\n\u2026beneficence proposes to maximize benefits and minimize<br \/>\nharm to subjects. The obligation to maximize benefits goes<br \/>\nbeyond the design of a trial and the conduct of a trial itself.<br \/>\nWeijer and LeBlanc respond<br \/>\n\u2022 An unrestricted moral obligation to \u201cmaximize<br \/>\nbenefits\u201d leads to an unstoppable chain of demands<br \/>\nupon researchers: if treating HIV for free is good,<br \/>\nthen, surely building hospitals and staffing them in<br \/>\nperpetuity with free doctors and medical supplies is<br \/>\nbetter. And if that is better, then making everyone not<br \/>\nmerely healthy but rich and happy is best of all. Right<br \/>\naction, according to this view, comes with a hefty<br \/>\nprice tag.<br \/>\nUN Aids (2003): reciprocity<br \/>\n\u2022 With respect to the principle of reciprocity, subjects<br \/>\nwho become infected contribute importantly to the<br \/>\ntrial. Without such data, an efficacy trial could draw<br \/>\nno conclusions about the intervention studied. People<br \/>\nwho contribute to this effort deserve something in<br \/>\nreturn<br \/>\nWeijer and LeBlanc respond<br \/>\n\u2022 The determination of the efficacy of an HIV<br \/>\nprevention intervention rests no more on those who<br \/>\nbecome HIV infected than those who do not. Thus,<br \/>\nthe contribution to the determination of efficacy of<br \/>\nthose who do and those who do not become infected<br \/>\nis equal. According to the principle of reciprocity,<br \/>\neither no group is deserving of reward, or both<br \/>\ngroups are.<br \/>\nThomas Pogge: A human<br \/>\nrights based approach<br \/>\n\u2022 Diachronic vs subjunctive harms.<br \/>\nThomas Pogge: A human rights<br \/>\nbased approach<br \/>\n\u2022 First: responsibility for institutional harms is sensitive<br \/>\nonly to human rights deficits.<br \/>\n\u2022 Second, the human rights deficits must be causally<br \/>\ntraceable to a social institution.<br \/>\n\u2022 Third, responsibility for the deficit is assignable only<br \/>\nto those who actively cooperate in designing or<br \/>\nimposing the relevant institutions.<br \/>\n\u2022 Fourth, it\u2019s harming only if it is foreseeable that this<br \/>\norder results in deficits.<br \/>\n\u2022 Fifth: rights deficits are reasonably avoidable.<br \/>\n\u2022 Six: avoidability must be knowable.<\/p>\n"},"caption":{"rendered":"<p>MacMillan Ancillary care, the Declaration of Helsinki and the obligations of global research Associate Professor John McMillan John.mcmillan@flinders.edu.au \u2022 14. \u201cThe research protocol should describe arrangements for post-study access by study subjects to interventions identified as beneficial in the study or access to other appropriate care or benefits.\u201d \u2022 33. Patients are entitled to share [&hellip;]<\/p>\n"},"alt_text":"","media_type":"file","mime_type":"application\/pdf","media_details":{},"post":null,"source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/01\/MacMillan.pdf","_links":{"self":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/media\/3746"}],"collection":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/media"}],"about":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/types\/attachment"}],"author":[{"embeddable":true,"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/comments?post=3746"}]}}