Herbal medicine research and global health: an ethical analysis.
Governments, international agencies and corporations are increasingly investing in traditional herbal medicine research. Yet little literature addresses ethical challenges in this research. In this paper, we apply concepts in a comprehensive ethical framework for clinical research to international traditional herbal medicine research. We examine in detail three key, underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal medicine research: social value, scientific validity and favourable risk-benefit ratio. Significant challenges exist in determining shared concepts of social value, scientific validity and favourable risk-benefit ratio across international research collaborations. However, we argue that collaborative partnership, including democratic deliberation, offers the context and process by which many of the ethical challenges in international herbal medicine research can, and should be, resolved. By "cross-training" investigators, and investing in safety-monitoring infrastructure, the issues identified by this comprehensive framework can promote ethically sound international herbal medicine research that contributes to global health.
Tilburt
Jon C
JC
Department of Clinical Bioethics, National Institutes of Health, Bethesda, MD, United States of America. jontilburt@yahoo.com
Kaptchuk
Ted J
TJ
D035843:Biomedical Research / Q000941:ethics* / Q000379:methods / Q000458:organization & administration; D003299:Cooperative Behavior; D003469:Culture; D003659:Decision Making, Organizational; D032984:Ethics, Research; D014943:Global Health; D029001:Herbal Medicine; D006801:Humans; D038622:Internationality; D008519:Medicine, Traditional; D009938:Organizations; D011057:Politics; D011634:Public Health / Q000941:ethics*; D015203:Reproducibility of Results; D012107:Research Design; D018570:Risk Assessment; D012945:Social Values / Q000208:ethnology
J Clin Epidemiol. 2001 Jun;54(6):541-9
11377113
JAMA. 2004 Feb 4;291(5):599-604
14762039
Pharmacol Ther. 2000 May;86(2):191-8
10799714
Ann Intern Med. 2006 Mar 7;144(5):364-7
16520478
Clin Pharmacol Ther. 2001 Dec;70(6):497-504
11753265
Hypertension. 2006 Nov;48(5):838-45
17015784
J Altern Complement Med. 2005 Dec;11(6):1005-13
16398591
N Engl J Med. 2005 Jul 28;353(4):341-8
16049208
Am J Chin Med. 2005;33(6):897-902
16355446
Monash Bioeth Rev. 2005 Jul;24(3):52-60
16302320
Perspect Biol Med. 2002 Summer;45(3):395-415
12114833
J Epidemiol Community Health. 2001 Oct;55(10):762-5
11553662
J Intern Med. 2002 Aug;252(2):107-13
12190885
Dev World Bioeth. 2007 Apr;7(1):25-34
17355329
J Infect Dis. 2004 Mar 1;189(5):930-7
14976611
Toxicol Pathol. 2006;34(4):319-26
16787890
BMJ. 2004 Nov 13;329(7475):1156-9
15539672
JAMA. 1998 Nov 11;280(18):1585-9
9820260