Developing Countries and Bioethical Research
http://www.100md.com
《新英格兰医药杂志》
To the Editor: According to some estimates, less than 10 percent of the world's biomedical research-and-development funds are dedicated to addressing problems that are responsible for 90 percent of the world's burden of disease. What is more, some observers think that the focus of bioethical discussions is biased toward ethical problems that affect wealthy, developed nations.1 This imbalance could be explained in part by the scarcity of authors who live in developing countries. Our research has looked into whether there is a serious underrepresentation of investigators from the developing world in publications in the field of bioethics.
We categorized countries on the basis of the World Bank's classification of high-income economies and developing economies. Thereafter, we hunted for research articles in nine international, peer-reviewed journals in the field of bioethics (Bioethics, the Cambridge Quarterly of Healthcare Ethics, the Hastings Center Report, the Journal of Clinical Ethics, the Journal of Medical Ethics, the Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics) that were published from 1990 to 2003. The country of the first author's affiliation was indexed. A total of 4029 research articles were retrieved from the nine journals under study (Table 1). Investigators from high-income economies contributed to 3873 of the publications (96.1 percent), and those from developing economies contributed to 156 (3.9 percent).
Table 1. Number of Biomedical Research Articles Published by Investigators in High-Income Countries and in Developing Countries.
In addition, the findings suggest that there has been no significant upward trend in the number of publications from developing countries. The results of the chi-square test for two independent samples (2 = 2.6775, P=0.10) indicate that from 1997 to 2003, the number of studies coming from developing countries (96) did not increase significantly over that from 1990 to 1996 (60). There were no publications at all from 123 of 154 developing countries (79.9 percent). Most publications from developing economies come from China (24 [15.4 percent]), Turkey (18 [11.5 percent]), and South Africa (17 [10.9 percent]).
Our research documented a low input from researchers in developing countries to the scientific bioethical literature. This finding corresponds with those of similar studies on the geography of biomedical publications.2 Although peer-reviewed journals in the field of bioethics present themselves as international in scope, they certainly do not live up to what one would expect from an "international" journal. They remain mainly European and American. As potential remedies, the inclusion of internationally representative members on editorial boards, partnerships between researchers from high-income countries and researchers from developing countries, and twinning arrangements3 should be considered. This effort could shift the focus much more to ethical problems that arise in developing countries and give bioethics a real international scope.
Pascal Borry, M.A.
Paul Schotsmans, Ph.D.
Kris Dierickx, Ph.D.
Katholieke Universiteit Leuven
3000 Leuven, Belgium
pascal.borry@med.kuleuven.be
References
Turner L. Bioethics needs to rethink its agenda. BMJ 2004;328:175-175.
Sumathipala A, Siribaddana S, Patel V. Under-representation of developing countries in the research literature: ethical issues arising from a survey of five leading medical journals. BMC Med Ethics 2004;5:E5-E5.
Certain E. FAME: an initiative to promote local medical research publishing in Africa. Saudi Med J 2004;25:Suppl:S46-S46.
We categorized countries on the basis of the World Bank's classification of high-income economies and developing economies. Thereafter, we hunted for research articles in nine international, peer-reviewed journals in the field of bioethics (Bioethics, the Cambridge Quarterly of Healthcare Ethics, the Hastings Center Report, the Journal of Clinical Ethics, the Journal of Medical Ethics, the Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics) that were published from 1990 to 2003. The country of the first author's affiliation was indexed. A total of 4029 research articles were retrieved from the nine journals under study (Table 1). Investigators from high-income economies contributed to 3873 of the publications (96.1 percent), and those from developing economies contributed to 156 (3.9 percent).
Table 1. Number of Biomedical Research Articles Published by Investigators in High-Income Countries and in Developing Countries.
In addition, the findings suggest that there has been no significant upward trend in the number of publications from developing countries. The results of the chi-square test for two independent samples (2 = 2.6775, P=0.10) indicate that from 1997 to 2003, the number of studies coming from developing countries (96) did not increase significantly over that from 1990 to 1996 (60). There were no publications at all from 123 of 154 developing countries (79.9 percent). Most publications from developing economies come from China (24 [15.4 percent]), Turkey (18 [11.5 percent]), and South Africa (17 [10.9 percent]).
Our research documented a low input from researchers in developing countries to the scientific bioethical literature. This finding corresponds with those of similar studies on the geography of biomedical publications.2 Although peer-reviewed journals in the field of bioethics present themselves as international in scope, they certainly do not live up to what one would expect from an "international" journal. They remain mainly European and American. As potential remedies, the inclusion of internationally representative members on editorial boards, partnerships between researchers from high-income countries and researchers from developing countries, and twinning arrangements3 should be considered. This effort could shift the focus much more to ethical problems that arise in developing countries and give bioethics a real international scope.
Pascal Borry, M.A.
Paul Schotsmans, Ph.D.
Kris Dierickx, Ph.D.
Katholieke Universiteit Leuven
3000 Leuven, Belgium
pascal.borry@med.kuleuven.be
References
Turner L. Bioethics needs to rethink its agenda. BMJ 2004;328:175-175.
Sumathipala A, Siribaddana S, Patel V. Under-representation of developing countries in the research literature: ethical issues arising from a survey of five leading medical journals. BMC Med Ethics 2004;5:E5-E5.
Certain E. FAME: an initiative to promote local medical research publishing in Africa. Saudi Med J 2004;25:Suppl:S46-S46.