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Health‐related Research Ethics and Social Value: Antibiotic Resistance Intervention Research and Pragmatic Risks

Journal article
Authors Christian Munthe
Niels Nijsingh
Karl Persson de Fine Licht
D. G. Joakim Larsson
Published in Bioethics
Volume 33
Issue 3
Pages 335-342
ISSN 0269-9702
Publication year 2019
Published at Department of Philosophy, Linguistics and Theory of Science
Centre for antibiotic resistance research, CARe
Institute of Biomedicine, Department of Infectious Medicine
Pages 335-342
Language en
Keywords Antimicrobial resistance, Bioethics, CIOMS, Drug resistance, Helsinkki Declaration, Public health ethics, Wicked problems,
Subject categories Technology and social change, Research policy, Public Health, Global Health, Social Medicine and Epidemiology, Medical Ethics, Ethics, Practical philosophy


We consider the implications for the ethical evaluation of research programs of two fundamental changes in the revised research ethical guideline of the Council for International Organizations of Medical Sciences. The first is the extension of scope that follows from exchanging “biomedical” for “health-related” research, and the second is the new evaluative basis of “social value,” which implies new ethical requirements of research. We use the example of antibiotic resistance interventions to explore the need to consider what we term the pragmatic risks of such interventions to evaluate the so- cial value of certain kinds of health-related research. These (pragmatic) risks severely threaten the social value of interventions in every area where human and social re- sponses significantly impact on their effectiveness. Thus, the social value of health-re- lated research needed to demonstrate its effectiveness depends on the successful management of such risks. Research designed to take into account pragmatic risks also gives rise to similar types of risks, and the potential for social value in light of those risks needs to be considered in ethical reviews based on the new guidelines. We argue that, to handle this new expanded task, the international system of research ethical review addressed by the guidelines needs institutional development. In particular, we consider lifting research ethical review to a level closer to actual health policy making.

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