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1_Seth Glickman et al, Ethical and Scientific Implications of the Globalization of Clinical Research

1_Seth Glickman et al, Ethical and Scientific Implications of the Globalization of Clinical Research

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s o u n di ng b o a r d T h e ne w engl a nd jour na l o f medicine n engl j med 360;8 nejm.org february 19, 2009 816 Economic globalization is an important develop- ment of the past half century. Proponents of glo- balization highlight the benefits of greater eco- nomic growth and prosperity; critics point to the exacerbation of economic disparities and the ex- ploitation of workers, particularly in developing (i.e., low- and middle-income) countries. 1,2 Phar- maceutical and device companies have embraced globalization as a core component of their busi- ness models, especially in the realm of clinical trials. This phenomenon raises important ques- tions about the economics and ethics of clinical research and the translation of trial results to clin- ical practice: Who benefits from the globalization of clinical trials? What is the potential for exploi- tation of research subjects? Are trial results ac- curate and valid, and can they be extrapolated to other settings? In this article, we discuss recent
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