International research ethics: the problem of the justice toward the less developed countries
Today, in order to protect the population of developing countries from the risk of exploitation by international research sponsors, we must recur to the concepts of "distributive justice" and "justice as reciprocity". "Distributive justice" requires that the risks and benefits of research be distributed with equity (give to everyone what he/she needs) among all persons and groups in society. "Justice and reciprocity" requires that all research subjects receive benefits because of their participation. It will not be justified that if one subject patient has received placebo, at the end of the study he/she will not receive the drug that was therapeutically proved by the research. There is exploitation when rich or powerful persons or agencies take advantage of the poverty, weakness or dependency of others using them for their own goals (those of the rich or powerful) without adequate benefits to compensate the individuals or groups depending or less powerful. The International Ethical Guidelines CIOMS and the Document UNAIDS establish that the products of research must be made reasonably available in the country where the research takes place. UNAIDS document specifies that an AIDS vaccine must be made available to other populations with a high risk for VIH infection, but there is no legal empowerment to guarantee that this takes place. Nevertheless, human rights could be used as an instrument to justify the existence of justice obligations. This is the case of the International Treaty for Economical, Social and Cultural Rights article 12: "Right to the highest level of physical and mental health that could be reached". It requires that the nations take specific steps, including prevention, treatment and control of various types of diseases, and the creation of the conditions that assure medical care and services to all.