Clinical trials in developing countries: a review of the moral issues.

Several ethicists have raised criticisms of various placebo-controlled clinical trials conducted in developing countries between 1995 and 1998. This essay reviews and rejects the arguments that these trials violated basic canons of medical ethics, or constituted exploitation by scientists in advanced countries of subjects in developing countries. A uniform international standard for the evaluation of such trials is proposed, replacing the old standard of voluntary and informed consent with a more focused standard of uncoerced and undeceived consent.