Ethical Issues in HIV Vaccine Trials

THOMAS A. KERNS

Preface - Introduction - Where Stands the Pandemic Now? - It's Not Just Another Disease - Will it Ever Slow Down? - Is a Vaccine Possible? - The Human Immunodeficiency Virus - How the Immune System Works - How Vaccines Work - Human Trials - Criteria of Effectiveness -Ethical Principles - Real Risks - Whom do You Want for Volunteers? - Compensating Volunteers for Injury - Informed Consent (1) - Assessing Comprehension - Informed Consent (2) - Ethics Review Committees - Protecting Individual Subjects - Proxy Consent? - Undue Inducement - Motivations to Volunteer - Still More Questions - Data from Unethical Experiments? - The Great Simple Solution - Thesis/Antithesis: Synthesis? - Smallpox and Guinea Worm Disease as Metaphors - So... - Appendix I: The Nuremberg Code - Appendix II: WHO/CIOMS International Ethical Guidelines - Appendix III: A Proposed Bill of Rights and Responsibilities - Appendix IV: A Test of Understanding for HIV Vaccine Trials - Appendix V: Application Forms for Ethical Review - Selected Bibliography - Notes - Index