Protecting communities in health research from exploitation.

Guidelines for health research focus on protecting individual research subjects. Yet several commentators have argued that protecting individual subjects, while undoubtedly important, is not sufficient to ensure ethical research. It is also vital to protect the communities involved in health research. In particular, a number of studies have been criticized on the grounds that they exploited host communities. Although these criticisms have received a good deal of attention, there has been no systematic analysis of what constitutes community exploitation in health research, nor an assessment of what safeguards are needed to protect against it. This is a serious deficiency. The absence of an analysis of community exploitation makes it impossible to ensure that host communities are protected against exploitation. The absence of an analysis also raises the possibility that charges of exploitation may block important research, without any way of assessing whether the charges are warranted. The present paper attempts to address these concerns by providing an analysis of community exploitation and, based on this analysis, determining what safeguards are needed to protect communities in health research against exploitation.