The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm

With increasing calls for global health research there is growing concern regarding the ethical challenges encountered by researchers from high-income countries (HICs) working in low or middle-income countries (LMICs). There is a dearth of literature on how to address these challenges in practice. In this article, we conduct a critical analysis of three case studies of research conducted in LMICs.We apply emerging ethical guidelines and principles specific to global health research and offer practical strategies that researchers ought to consider. We present case studies in which Canadian health professional students conducted a health promotion project in a community in Honduras; a research capacity-building program in South Africa, in which Canadian students also worked alongside LMIC partners; and a community-university partnered research capacity-building program in which Ecuadorean graduate students, some working alongside Canadian students, conducted community-based health research projects in Ecuadorean communities.We examine each case, identifying ethical issues that emerged and how new ethical paradigms being promoted could be concretely applied.We conclude that research ethics boards should focus not only on protecting individual integrity and human dignity in health studies but also on beneficence and non-maleficence at the community level, explicitly considering social justice issues and local capacity-building imperatives.We conclude that researchers from HICs interested in global health research must work with LMIC partners to implement collaborative processes for assuring ethical research that respects local knowledge, cultural factors, the social determination of health, community participation and partnership, and making social accountability a paramount concern.

The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm

With increasing calls for global health research there is growing concern regarding the ethical challenges encountered by researchers from high-income countries (HICs) working in low or middle-income countries (LMICs). There is a dearth of literature on how to address these challenges in practice. In this article, we conduct a critical analysis of three case studies of research conducted in LMICs.We apply emerging ethical guidelines and principles specific to global health research and offer practical strategies that researchers ought to consider. We present case studies in which Canadian health professional students conducted a health promotion project in a community in Honduras; a research capacity-building program in South Africa, in which Canadian students also worked alongside LMIC partners; and a community-university partnered research capacity-building program in which Ecuadorean graduate students, some working alongside Canadian students, conducted community-based health research projects in Ecuadorean communities.We examine each case, identifying ethical issues that emerged and how new ethical paradigms being promoted could be concretely applied.We conclude that research ethics boards should focus not only on protecting individual integrity and human dignity in health studies but also on beneficence and non-maleficence at the community level, explicitly considering social justice issues and local capacity-building imperatives.We conclude that researchers from HICs interested in global health research must work with LMIC partners to implement collaborative processes for assuring ethical research that respects local knowledge, cultural factors, the social determination of health, community participation and partnership, and making social accountability a paramount concern.

Biopolítica y gran relato nacional: presencia espectral del mundo aborigen en tres novelas de la selva (Estudios)

Escritas durante la primera mitad del siglo XX, Canaima, La vorágine, y Sangama son tres novelas de la selva en las cuales aparece una representación del mundo indígena del Amazonas o del Orinoco. Se ha repetido que se trataba de novelas progresistas, que encerraban una crítica del sistema social de la época, y más particularmente del genocidio acarreado por la explotación del caucho durante el “ciclo da borracha”. Sin embargo estas ficciones nos proporcionan un enfoque ambiguo de la realidad indígena. Una visión impregnada por las mismas concepciones del siglo XIX que favorecieron los excesos, maltratos y masacres que dichas novelas pretenden denunciar. Este ensayo se propone analizar la matriz científica de estas representaciones, insistiendo en el paradigma racialista decimónico, derivado de la teoría evolucionista y de la ideología del progreso. Los indios de las ficciones se desplazan como fantasmas en un universo mágico, embrujado, o infernal que carece de realidad. Este “flor” romántico es la proyección literaria de una estrategia biopolítica que se da en las sociedades de la época: la cuestión gira en torno a la construcción del pueblo nacional. Los “aparecidos” del espacio novelesco son un momento de unas estrategias discursivas más globales: se trata de construir una homegeneidad nacional a partir de una etnicidad ficticia que requiere el rechazo del “otro atrasado”. El espectro es la huella o el testigo de esta violencia fundadora.

State Policies, Territories and Rights of Indigenous Peoples in Ecuador (1983-2012)

This work seeks to reconstruct the dynamics of the agreements and disagreements between the State and the indigenous peoples in Ecuador, emphasising particularly on two key elements: first, the indigenous peoples participation and exercise of their political rights, in particular the right to self-government and autonomy within their jurisdictions; and secondly, indigenous peoples’ degree of direct influence on public policies’ formulation and implementation, specially those directly affecting their territories, including the exploitation of natural resources. In Ecuador, during this historical period, the state has gone through three major moments in its relationship with indigenous peoples: neo - indigenism associated to developmentalism (1980-1984); multiculturalism associated to neoliberalism (1984- 2006) as one of the dominant trends over the period; and the crisis of neoliberalism and the search for national diversity and interculturalism associated to post- neoliberalism (2007-2013). Each has had a particular connotation, as to the scope and methods to respond to indigenous demands. In this context, this research aims to answer the central question: how has the Ecuadorian State met the demands of the indigenous movement in the last three decades, and how has it ensured the validity of their gradually recognized rights? And how and to what extent by doing so, it contradicts and alters the existing economic model based on the extraction of primary resources?