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Explore the establishment and support of research ethics infrastructure in developing countries with the Nuffield Council on Bioethics. Understand key issues like consent, care standards, and post-research considerations. Learn from global bioethics bodies and the UK regulatory model.
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GF8 – Vilnius, June 2007 Hugh Whittall Director Nuffield Council on Bioethics Establishing and supporting research ethics infrastructure and networking
Nuffield Council on Bioethics • Independent body that examines ethical questions raised by advances in biology and medicine • Contributes to policy making and stimulates debate
Themes of presentation • Nuffield Reports on research in developing countries • Infrastructures for ethical advice and review • Support and networking
Key issues • Consent • Standards of care • Ethical review of research • What happens once research is over? • Strengthen capacity in developing countries
Consent • Purpose is to inform and protect • Should fit local context • Simple consent forms • Innovative ways of providing information • Trust of participants is crucial
Standards of care • Potentially beneficial research may be prevented by unrealistic requirements • Guidelines say local standard of care is often acceptable • Discussion with stakeholders in planning stage • Longer term sustainability
After the research is over • Need mechanism for early discussions • Consequences of resource limitations • Unrealistic requirements to provide post-trial interventions • Not always clear when research is complete • Recognise enduring benefits of research
Ethical review • RECs to review both ethical and scientific aspects? • Need to increase efficiency • Local expertise of host REC can be crucial • Developing country RECs face serious difficulties • Particularly lack of expertise
Bioethics: advisory and ethical review bodies • Different models in different countries • Model influenced by: • Impact / timing of scientific development • Cultural / political environment • Existing regulatory framework
UK model • Government advisory bodies • Regulatory authorities • Independent advisory bodies • Research / clinical ethics committees
Governmental advisory bodies • Human Genetics Commission (HGC) • Genetics and Insurance Committee (GAIC) • Gene Therapy Advisory Committee (GTAC) • Animal :Procedures Committee (APC) • National Research Ethics Service (NRES)
Regulatory authorities • Human Fertilisation and Embryology Authority (HFEA) • Human Tissue Authority (HTA) • Medicines and Healthcare Products Regulatory Agency (MHRA)
Independent advisory bodies • British Medical Association Medical Ethics Committee • Medical Royal Colleges Ethics Committees • Nuffield Council on Bioethics
Support and networking • Formal activities • Global Forum • UNESCO Guides and ABC project • MRC CURE • Informal activities • Informal contacts • Sharing of experience • Building an ‘ethics community’