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Equitably Sharing the Benefits and Burdens of Research: Covid-19 Raises the Stakes
ABSTRACT: One of the central principles of research ethics is that the benefits and burdens of research with human participants should be equitably distributed. This principle has important implications for where research will be conducted, how participants will be recruited, what questions will be investigated, and who will control the distribution of any innovations that result. In the context of Covid-19, key issues include providing support to clinical trials in low- and middle-income countries, without taking needed resources away from other critical clinical and public health needs; designing recruitment strategies likely to generate sufficient enrollment from groups that have been disproportionately burdened by the virus, such as African Americans; supporting studies designed to improve outcomes in high-risk environments, such as nursing homes and group homes for the developmentally disabled; and ensuring that the medical products resulting from research are made available throughout the world at an affordable price. If clinical trials are not designed with equity considerations consciously in mind, the response to the pandemic may further exacerbate disparities in health status between population groups.