Community engagement and the human infrastructure of global health research

BMC Medical Ethics

James V Lavery¹  Maria W Merritt²  Pamela Kolopack¹  Katherine F King³ 

[1] Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto, Toronto, Canada;Department of International Health (Health Systems Program), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Center for Ethical, Social, and Cultural Risk, LiKaShing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada

关键词: Global health;    Legitimacy;    Respect;    Ethics;    Community engagement;   

Others  :  1089962
DOI  :  10.1186/1472-6939-15-84

 received in 2014-03-17, accepted in 2014-12-05,  发布年份 2014

【 摘 要 】

Background

Biomedical research is increasingly globalized with ever more research conducted in low and middle-income countries. This trend raises a host of ethical concerns and critiques. While community engagement (CE) has been proposed as an ethically important practice for global biomedical research, there is no agreement about what these practices contribute to the ethics of research, or when they are needed.

Discussion

In this paper, we propose an ethical framework for CE. The framework is grounded in the insight that relationships between the researcher and the community extend beyond the normal bounds of the researcher-research participant encounter and are the foundation of meaningful engagement. These relationships create an essential “human infrastructure” – a web of relationships between researchers and the stakeholder community—i.e., the diverse stakeholders who have interests in the conduct and/or outcomes of the research. Through these relationships, researchers are able to address three core ethical responsibilities: (1) identifying and managing non-obvious risks and benefits; (2) expanding respect beyond the individual to the stakeholder community; and (3) building legitimacy for the research project.

Summary

By recognizing the social and political context of biomedical research, CE offers a promising solution to many seemingly intractable challenges in global health research; however there are increasing concerns about what makes engagement meaningful. We have responded to those concerns by presenting an ethical framework for CE. This framework reflects our belief that the value of CE is realized through relationships between researchers and stakeholders, thereby advancing three distinct ethical goals. Clarity about the aims of researcher-stakeholder relationships helps to make engagement programs more meaningful, and contributes to greater clarity about when CE should be recommended or required.

【 授权许可】

   
2014 King et al.; licensee BioMed Central.

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