Defining Standard of Care in the Developing World
The Intersection of International Research Ethics and Health Systems Analysis
Bibliographic Data
| ID | 19516645 |
|---|---|
| Authors | Adnan A Hyder (0000-0002-7292-577X, Johns Hopkins University), Liza Dawson (0000-0002-0980-4107, National Institutes of Health) |
| Year | 2005 |
| Volume | 5 |
| Issue | 2 |
| Pages | 142-152 |
| Publication date | 2005-05-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Developing World Bioethics (JOURNAL) |
| Journal identifiers | ISSN: 1471-8731 • E-ISSN: 1471-8847 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/j.1471-8847.2005.00109.x |
| PMID | 15842723 |
| OpenAlex | W2029444609 |
| Language | EN |
| Citations received | 4 |
| References cited | 13 |
In recent years there has been intense debate regarding the level of medical care provided to 'standard care' control groups in clinical trials in developing countries, particularly when the research sponsors come from wealthier countries. The debate revolves around the issue of how to define a standard of medical care in a country in which many people are not receiving the best methods of medical care available in other settings. In this paper, we argue that additional dimensions of the standard of care have been hitherto neglected, namely, the structure and efficiency of the national health system. The health system affects locally available medical care in two important ways: first, the system may be structured to provide different levels of care at different sites with referral mechanisms to direct patients to the appropriate level of care. Second, inefficiencies in this system may influence what care is available in a particular locale. As a result of these two factors locally available care cannot be equated with a national 'standard'. A reasonable approach is to define the national standard of care as the level of care that ought to be delivered under conditions of appropriate and efficient referral in a national system. This standard is the minimum level of care that ought to be provided to a control group. There may be additional moral arguments for higher levels of care in some circumstances. This health system analysis may be helpful to researchers and ethics committees in designing and reviewing research involving standard care control groups in developing country research
Developing country · Economic growth · Economics · Health care · Medical care · Political science · Referral · Standard of care · Biomedical Ethics and Regulation · Ethics in Clinical Research · Health Systems, Economic Evaluations, Quality of Life · Law · Medicine · Nursing
| Unique citing works | 4 |
|---|---|
| Citations per year | 0,21 |
| Citation span | 2007 - 2013 (7) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 2 |