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6_Ethical Variability - Petryna

6_Ethical Variability - Petryna - American Ethnologist n...

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followed it—highlights the role of crisis in the considera- tion of differences in ethical standards in the area of hu- man research; indeed, that crisis conditions legitimate variability in ethical standards. Historically, some crises have led perhaps inescapably to experimentation (Petryna 2002; Smith 1990). But one can also ask, are crises states of exception or are they the norm? To what extent does the language of crisis become instrumental, granting le- gitimacy to experimentation when it otherwise might not have any? The debate over the ethics of the AZT trial prompted the sixth revision of the Helsinki declaration, first issued in 1964. The declaration deals with all dimensions of hu- man biomedical research, furnishing guidelines for con- duct in research involving human subjects. 18 The 2000 revision reiterated a position against placebo use when standards of treatment are known: ‘‘The benefits, risks, burdens, and effectiveness of a new method should be tested against those of the best current prophylactic, diagnostic, and therapeutic methods. This does not ex- clude the use of placebo, or no treatment, in studies where no proven prophylactic, diagnostic, or therapeutic method exists’’ (World Medical Association 2000:3044). 19 Although the ethics was unambiguous, the regulatory weight of the declaration was not. In this latter domain the winners and losers of the placebo debate would be named.
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