Radicalizing Clinical Trial Ethics through Partnership: Limitations and Strategies for Change

Clinical trials are crucial in developing safe medical treatments and combating diseases. However, the ethical considerations surrounding research involving human subjects have been an ongoing topic of debate. Existing ethical policies aim to ensure the accuracy of research findings and protect the well-being of participants. Nevertheless, these policies have been rooted in Western scientific and medical systems, which historically exploited communities for the benefit of privileged individuals and capital accumulation, perpetuating domination and settler colonialism. While ethical policies alone cannot erase these harmful legacies, they have globally failed at holding researchers, companies, and institutions accountable for their impact on communities. This failure has led to exploitation and unintended harm in disenfranchised communities with under-resourced health systems and limited access to healthcare resources. To address these challenges, this literature review proposes integrating stricter regulations, transparent disclosure of trial results, and comprehensive post-trial care. Additionally, it advocates for including community partnerships in clinical trial ethics policies to prioritize community needs and promote accountability. By examining qualitative studies on the perspectives of patients, researchers, and clinicians involved in clinical trials, as well as the current state of clinical trial ethics policies, this paper suggests a partnership-based approach that can facilitate the development of new treatments while addressing historical legacies of exploitation and harm in disenfranchised communities worldwide.