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Other states, in the case of medical research, mandate that a more stringent standard is applied -- that of the reasonable person standard (Edwards 2008). In other words, would a reasonable person consider the nature of the research ethical and acceptable? This seems fairer -- but is also more intensely subjective. And when conducting research in a different cultural context, it may be difficult for the researcher to evaluate the subject's conception of justice within the subject's own culture.
When research is performed upon minors or patients whose lucidity may vary from day-to-day, a medical surrogate may be legally required or advisable, in terms of giving consent for the use of research. Confidentiality at all times should be respected for minors and adults alike. The patient must, to the maximum of his or her ability, be able to understand his or her situation and the implications of the benefits and the risks of participation, even if his or her identity is kept confidential (Edwards 2008).
The benefits of treatment or the study may not be fully available to the patient and the question of who the research...
Using test subjects for drugs which may be too expensive for them to afford, for an academic community outside of their culture, or for drugs that will only benefit patients far in the future are further unresolved ethical debates. A patient may not be able to appreciate, in their current mental state, the limits of what the research trial may bring to them. A patient must also fully understand what it means to be part of the control group of an experiment, and not benefit at all.
Asking for such a high level of research literacy may seem like an impossible task, particularly in different cultural environments. In such situations, translation is necessary: translation of cultural or medical terminology and the experimental and research process itself.
References
DePoy, Elizabeth & Laura N. Gitlin. (2005) Research: Understanding and applying multiple strategies. Mosby.
Edwards, Kelly. a. (2008, April 11) Informed consent. The University of Washington.
http://depts.washington.edu/bioethx/topics/consent.html#ques1
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