A capacity-based approach for addressing ancillary care needs: implications for research in resource limited settings

A paediatric clinical trial conducted in a developing country is likely to encounter conditions or illnesses in participants unrelated to the study. Since local healthcare resources may be inadequate to meet these needs, research clinicians may face the dilemma of deciding when to provide ancillary...

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Bibliographic Details
Published in:Journal of medical ethics 2012-11, Vol.38 (11), p.672-676
Main Authors: Bright, Patricia L, Nelson, Robert M
Format: Article
Language:English
Subjects:
Bioethics
Budgets
children
Clinical trials
Clinical Trials as Topic - ethics
Company business management
Decision Trees
Delivery of Health Care - ethics
Delivery of Health Care - methods
Delivery of Health Care - standards
Developing Countries
Ethics
Ethics, Research
Fiduciaries
Health aspects
Health care
Health care industry
Health Care Rationing - ethics
Health Resources
Health Services Accessibility - economics
Health Services Accessibility - ethics
Health Services Accessibility - standards
Health Services Needs and Demand - economics
Health Services Needs and Demand - ethics
HIV
Human immunodeficiency virus
Humans
Illnesses
Infrastructure
LDCs
Management
Medical care
Medical care (Private)
Medical research
Medication administration
Modeling
Moral Obligations
Patient care
Patient Care Planning - ethics
Patient Care Planning - standards
Research ethics
Research facilities
research on special populations
Research Personnel - ethics
Research Subjects
Researcher-Subject Relations - ethics
Researchers
Studies
United States
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Summary:A paediatric clinical trial conducted in a developing country is likely to encounter conditions or illnesses in participants unrelated to the study. Since local healthcare resources may be inadequate to meet these needs, research clinicians may face the dilemma of deciding when to provide ancillary care and to what extent. The authors propose a model for identifying ancillary care obligations that draws on assessments of urgency, the capacity of the local healthcare infrastructure and the capacity of the research infrastructure. The model lends itself to a decision tree that can be adapted to the local context and resources so as to provide procedural guidance. This approach can help in planning and establishing organisational policies that govern the provision of ancillary care.
ISSN:0306-6800
1473-4257
DOI:10.1136/medethics-2011-100205