One of CIOMS' main areas of focus is bioethics. CIOMS has played an important international role in this area, particularly in the design of medical research in developing countries. In 1982, CIOMS (in conjunction with WHO) published the International Ethical Guidelines for Biomedical Research Involving Human Subjects. This was followed by the Proposed Ethical Guidelines (1982, 1993). The International Ethical Guidelines for Biomedical Research Involving Human Subjects were revised over the period 1999–2002, and published in 2002.
The revised edition addressed new challenges that had mostly arisen after 1993. This particularly applied to the placebo-controlled trials financed by external private companies and conducted in developing countries by researchers from industrialized countries, and without the availability of comparator drugs. Some of the HIV/AIDS research are examples of such practices.
Research communities are divided on such research, with one side arguing that poor countries need special, cheap drugs, and that intervention studies would be more suitable than the standard placebo method. The same side argues that the country's special context must be considered, and that paternalism on the part of the richer countries should be avoided. The other side asserts that financial considerations should not affect medical trials or our ethical criteria. There is a risk of exploiting poor countries at the expense of ethics.
These contradictory views could not be completely set aside in the latest CIOMS Guidelines. Despite the introductory ethical principles and 21 specific guidelines on specific issues, room has been allowed for contradictory remarks in connection with guideline 11, "Choice of control in clinical trials".
CIOMS' ethical principles are fundamentally inspired by Beauchamp and Childress' classic text, Principles of Biomedical Ethics (Beauchamp and Childress 2001).
CIOMS has also published ethical guidelines for epidemiological studies (1991, 2003, 2008). CIOMS' paper on "Principles of Medical Ethics Relevant to the Protection of Prisoners Against Torture" was adopted by the UN in 1983. CIOMS' website can be viewed at: http://www.cioms.ch/
This article has been translated from Norwegian by Cristina Pulido Ulvang, Akasie språktjenester AS.