HIV positive refugees/asylum seekers and clinical trials: some ethical issues

Abstract

The aim of this thesis was to identify some of the ethical issues of HIV positive asylum seekers and refugees participating in clinical trials in Britain. While all individuals are to some degree vulnerable in clinical trials, I have shown in this thesis that this group is particularly vulnerable in a number of areas. Many will not have English as a first language and while they may be able to understand everyday language, the participant information sheet (PIS) may be difficult to comprehend both in terms of language and content. Cultural aspects may also influence the individuals’ participation in a clinical trial. Many will have come from a hierarchical culture where it would be unthinkable to refuse to participate if requested to do so by someone of a higher social status, such as physicians. Individuals may also be reluctant to decline an invitation to participate in a clinical trial if asked to do so by their own clinician, if they are reliant on him/her to provide letters of support for the immigration authorities.