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Az Gelişmiş Ülkelerde Klinik Araştırmalar ve Etik İhlaller: Nijerya Faz III Antibiyotik Deneyi Örneği

Yıl 2017, , 212 - 219, 25.09.2017
https://doi.org/10.21673/anadoluklin.336697

Öz

Dünyadaki en büyük ilaç şirketlerinden biri olan X, yeni
bir antibiyotik ajanı test etmek için 1996’da Nijerya’da çocuklar üzerinde
kanuna ve tıp ahlakına aykırı faz III bir klinik deney gerçekleştirmiş olmakla suçlanmıştır.
Uluslararası medyada yer bulan bu iddialar sonrasında şiddetli tepkilere neden
olmuş ve mahkemeye taşınmıştır. Vakaya dair Nijerya hükumetince hazırlatılan
inceleme raporunda varılan ve yıllarca gizli tutulan sonuç, X’in Helsinki
Bildirgesi’ne ve Birleşmiş Milletler Çocuk Hakları Sözleşmesi’ne aykırı bir
araştırma gerçekleştirdiği olmuştur. Nitekim yalnızca sözlü onam almış olduğunu
kabul eden X, dava edilince, denek çocukların ailelerine tazminat niteliğinde
ödemeler yapmıştır. Bu retrospektif çalışmada, yirminci yüzyıl ortalarındaki
gayriahlaki klinik deneylerin yinelenmemesi için geliştirilmiş olan tüm çağdaş etikolegal
mevzuata karşın doksanlar gibi yakın bir tarihte yine de gerçekleşmiş olan bu olay,
dönemin belge, rapor ve haberleri üzerinden sunulmaktadır. Söz konusu skandal,
ahlaken yol gösterici metinlerin varlığı kadar bu metinlerde yazanı yapmayı
ya da yapmamayı seçecek olan ahlaki öznenin karakterinin de önemli olduğuna
dair, tarihten bir başka örnek niteliğindedir. 

Kaynakça

  • Phillips B. Nigeria’s drug trial fears. BBC News, 14.3.2001.
  • Stephens J. The body hunters: where profits and lives hang in balance. The Washington Post, 17.12.2000.
  • Ford J, Tomossy GF. Globalization and clinical trials: compensating subjects in developing countries. In: Bennet B, Tomossy GF (ed.), Globalization and Health: Challenges for Health Law and Bioethics. New York: Springer Science+Business Media; 2006:32–33.
  • US Supreme Court rejects Pfizer Nigeria lawsuit appeal. BBC News, 29.6.2010.
  • Pfizer: Nigeria drug trial victims get compensation. BBC News, 11.8.2011.
  • Loue S. Forensic epidemiology in the global context: a case study of Pfizer and the trovafloxacin trial. In: Loue S. (ed.), Forensic Epidemiology in the Global Context. New York: Springer Science+Business Media; 2013:4–8.
  • Murray S. Anger at deadly Nigerian drug trials. BBC News, 20.6.2007.
  • Wise J. Pfizer accused of testing new drug without ethical approval. BMJ. 2001;322:194.
  • Annas GJ. Worst Case Bioethics: Death, Disaster, and Public Health. Oxford: Oxford University Press; 2010:192–94.
  • Panel faults Pfizer in '96 clinical trial in Nigeria. The Washington Post, 7.5.2006.
  • Lenzer J. Secret report surfaces: Pfizer was at fault in Nigerian drug tests. BMJ. 2006;332:1233.
  • Sané P. Concluding words. In: ten Have HJ, Jean MS (ed.), The UNESCO Universal Declaration on Bioethics and Human Rights: Background, Principles and Application. Paris: UNESCO; 2009:349–50.
  • The Nigerian Federal Ministry of Health [Nijerya Federal Sağlık Bakanlığı]. Report of the Investigation Committee on the Clinical Trial of Trovafloxacin (Trovan) by Pfizer, Kano, 1996. Mart 2001.
  • Pfizer, Inc. Trovan, Kano State Civil Case—Statement of Defense. Erişim: www.pfizer.com/files/news/trovan_statement_defense_summary.pdf (erişildi: 10.6.2017).
  • Bairu M. Bioethical considerations in global clinical trials. In: Chin R, Bairu M (ed.), Global Clinical Trials: Effective Implementation and Management. Londra: Academic Press (Elsevier); 2011:22.
  • Smith D. Pfizer pays out to Nigerian families of meningitis drug trial victims. The Guardian, 12.8.2011.
  • Stephens J. Pfizer to pay $75 million to settle Trovan-testing suit. The Washington Post, 31.7.2009.
  • Charrow RP. Law in the Laboratory: A Guide to the Ethics of Federally Funded Science Research. Chicago: University of Chicago Press; 2010:156.
  • Erhun WO, Babalola OO, Erhun MO. Drug regulation and control in Nigeria: the challenge of counterfeit drugs. J Health Popul Dev Ctries. 2001;4(2):23–34.
  • Currency Converter Using Official Exchange Rates. Erişim: http://fxtop.com/en/currency-converter-past.php (erişildi: 20.7.2017).
  • WaterAid Nigeria. Erişim: http://www.wateraid.org/ng (erişildi: 12.7.2017).
  • Dünya Sağlık Örgütü. Guidelines for Medicine Donations [İlaç Bağışlarına Yönelik Kılavuz]. Cenevre: Dünya Sağlık Örgütü; 2010.
  • Bero L, Carson B, Moller H, Hill S. To give is better than to receive: compliance with WHO guidelines for drug donations during 2000–2008. Bull World Health Organ. 2010;88(12):922–92.
  • UNESCO. Countries: Nigeria. Erişim: http://en.unesco.org/countries/nigeria (erişildi: 5.7.2017).
  • Trovan’ın üretimi ve ithalatı durduruldu. Türk Tabipleri Birliği. Erişim: www.ttb.org.tr/TD/TD45/trovan.html (erişildi: 25.6.2017).
  • O’Meara A. Chasing Medical Miracles: The Promise and Perils of Clinical Trials. New York: Walker Publishing Company; 2009:132.
  • Ertin H, Temel MK. İnsan üzerindeki deneyler ve ilgili etik–yasal metinler. Anadolu Kliniği. 2016;21(3):223–34.
  • Ertin H. Gen Teknolojisi ile İlgili Etik Bildirgeler ve Yasal Düzenlemeler [doktora tezi]. İstanbul: İstanbul Üniversitesi İstanbul Tıp Fakültesi Tıp Tarihi ve Etik Anabilim Dalı; 2003.

Clinical Trials in Underdeveloped Countries and Ethical Violations: the Nigerian Case of a Phase III Antibiotic Trial

Yıl 2017, , 212 - 219, 25.09.2017
https://doi.org/10.21673/anadoluklin.336697

Öz

X, one of the globally leading pharmaceutical companies, has
been accused of having performed an illegal and unethical phase III clinical
trial on Nigerian children to test its new antibiotic agent in 1996. The allegations
reported by the international media subsequently met with intense reaction and
were brought to court. The conclusion arrived at in the long-obscured
investigation report ordered by the Nigerian government was that the company X
conducted a clinical trial violating the Helsinki Declaration and the United
Nations Convention on the Rights of the Child. Indeed, the company admitting having
obtained only verbal consent made, when litigated, compensatory payments to the
families of the child subjects. The present retrospective study reviewing the contemporaneous
reports and documents aims to present this case that did occur as recently as
the mid-1990s despite the vast body of contemporary ethicolegal regulations developed
to prevent the reoccurrence of unethical clinical trials similar to those in
the mid-20th century. The discussed scandal constitutes another
historical example indicating that what is as important as the presence of a
body of established ethical guidelines is the character of the moral agent who
is to choose to follow or not to follow what has been recommended in these
texts. 

Kaynakça

  • Phillips B. Nigeria’s drug trial fears. BBC News, 14.3.2001.
  • Stephens J. The body hunters: where profits and lives hang in balance. The Washington Post, 17.12.2000.
  • Ford J, Tomossy GF. Globalization and clinical trials: compensating subjects in developing countries. In: Bennet B, Tomossy GF (ed.), Globalization and Health: Challenges for Health Law and Bioethics. New York: Springer Science+Business Media; 2006:32–33.
  • US Supreme Court rejects Pfizer Nigeria lawsuit appeal. BBC News, 29.6.2010.
  • Pfizer: Nigeria drug trial victims get compensation. BBC News, 11.8.2011.
  • Loue S. Forensic epidemiology in the global context: a case study of Pfizer and the trovafloxacin trial. In: Loue S. (ed.), Forensic Epidemiology in the Global Context. New York: Springer Science+Business Media; 2013:4–8.
  • Murray S. Anger at deadly Nigerian drug trials. BBC News, 20.6.2007.
  • Wise J. Pfizer accused of testing new drug without ethical approval. BMJ. 2001;322:194.
  • Annas GJ. Worst Case Bioethics: Death, Disaster, and Public Health. Oxford: Oxford University Press; 2010:192–94.
  • Panel faults Pfizer in '96 clinical trial in Nigeria. The Washington Post, 7.5.2006.
  • Lenzer J. Secret report surfaces: Pfizer was at fault in Nigerian drug tests. BMJ. 2006;332:1233.
  • Sané P. Concluding words. In: ten Have HJ, Jean MS (ed.), The UNESCO Universal Declaration on Bioethics and Human Rights: Background, Principles and Application. Paris: UNESCO; 2009:349–50.
  • The Nigerian Federal Ministry of Health [Nijerya Federal Sağlık Bakanlığı]. Report of the Investigation Committee on the Clinical Trial of Trovafloxacin (Trovan) by Pfizer, Kano, 1996. Mart 2001.
  • Pfizer, Inc. Trovan, Kano State Civil Case—Statement of Defense. Erişim: www.pfizer.com/files/news/trovan_statement_defense_summary.pdf (erişildi: 10.6.2017).
  • Bairu M. Bioethical considerations in global clinical trials. In: Chin R, Bairu M (ed.), Global Clinical Trials: Effective Implementation and Management. Londra: Academic Press (Elsevier); 2011:22.
  • Smith D. Pfizer pays out to Nigerian families of meningitis drug trial victims. The Guardian, 12.8.2011.
  • Stephens J. Pfizer to pay $75 million to settle Trovan-testing suit. The Washington Post, 31.7.2009.
  • Charrow RP. Law in the Laboratory: A Guide to the Ethics of Federally Funded Science Research. Chicago: University of Chicago Press; 2010:156.
  • Erhun WO, Babalola OO, Erhun MO. Drug regulation and control in Nigeria: the challenge of counterfeit drugs. J Health Popul Dev Ctries. 2001;4(2):23–34.
  • Currency Converter Using Official Exchange Rates. Erişim: http://fxtop.com/en/currency-converter-past.php (erişildi: 20.7.2017).
  • WaterAid Nigeria. Erişim: http://www.wateraid.org/ng (erişildi: 12.7.2017).
  • Dünya Sağlık Örgütü. Guidelines for Medicine Donations [İlaç Bağışlarına Yönelik Kılavuz]. Cenevre: Dünya Sağlık Örgütü; 2010.
  • Bero L, Carson B, Moller H, Hill S. To give is better than to receive: compliance with WHO guidelines for drug donations during 2000–2008. Bull World Health Organ. 2010;88(12):922–92.
  • UNESCO. Countries: Nigeria. Erişim: http://en.unesco.org/countries/nigeria (erişildi: 5.7.2017).
  • Trovan’ın üretimi ve ithalatı durduruldu. Türk Tabipleri Birliği. Erişim: www.ttb.org.tr/TD/TD45/trovan.html (erişildi: 25.6.2017).
  • O’Meara A. Chasing Medical Miracles: The Promise and Perils of Clinical Trials. New York: Walker Publishing Company; 2009:132.
  • Ertin H, Temel MK. İnsan üzerindeki deneyler ve ilgili etik–yasal metinler. Anadolu Kliniği. 2016;21(3):223–34.
  • Ertin H. Gen Teknolojisi ile İlgili Etik Bildirgeler ve Yasal Düzenlemeler [doktora tezi]. İstanbul: İstanbul Üniversitesi İstanbul Tıp Fakültesi Tıp Tarihi ve Etik Anabilim Dalı; 2003.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm DERLEME
Yazarlar

M. Kemal Temel

Yayımlanma Tarihi 25 Eylül 2017
Kabul Tarihi 22 Eylül 2017
Yayımlandığı Sayı Yıl 2017

Kaynak Göster

Vancouver Temel MK. Clinical Trials in Underdeveloped Countries and Ethical Violations: the Nigerian Case of a Phase III Antibiotic Trial. Anadolu Klin. 2017;22(3):212-9.

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