Ethics, Research, Treatment and Care

ASHM, Ethical issues in HIV/AIDS research and care

The issues surrounding research were debated in this seminar. Dr Greg Dore from the National Centre in HIV Epidemiology and Clinical Research, Sydney presented a research proposal designed as a three arm comparison of different monitoring strategies for people receiving triple ARV therapy in a resource poor setting. It was stated that there was virtually no access to therapy for people at present in the proposed setting. The three arms were monitoring with total lymphocyte count, with CD4 count or with CD4 count and viral load. This presentation provided the focal point around which the discussion moved. Further presentations were given by Dr Marc Lallemont regarding the Helsinki Declaration and Belmont Report and Dr Nita Mawar from the National AIDS Research Institute in India on the nature of consent, particularly the use of community advisory boards to provide a form of community consent. Bebe Loff, a Melbourne lawyer describing the process of ethical assessment of the proposal, followed this. She stated,"Good ethics depends on good science". David Menenger, from PLWHA in Melbourne, gave the last presentation. He emphasised the importance of ensuring that people consenting to enter the study actually know what consent is. Dr Sanjay Pujari (from the floor) asked whether consent would be better sought by an independent party given the power imbalance between patient and clinician and bias in the researcher towards the study.