At an international meeting devoted to ethics in research, one participant from a developing country remarked: “It is important to specify that research should be conducted in developing countries only when it cannot reasonably be carried out in developed countries. Research should not be carried out in developing countries solely for economic reasons.”

A participant from the United States replied: “It's proving useful to conduct studies on allergy and depression in developing countries. The people who do the studies do them well. Do people want to discourage that sort of thing? It's going on now, with consent of the countries.”

These comments illustrate two responses to a question that has given rise to international debate and controversy: Should medical research be conducted in Third World countries when it could equally well be carried out in the United States or Western Europe? According to one view, the answer is a probable “no”:

This position considers populations in developing countries to be vulnerable, and therefore it is inappropriate to involve them in research when the same studies could be done in an industrialized country.

An opposing view maintains that requiring research to be conducted in industrialized countries before initiating a similar study in a developing country is an unacceptable form of paternalism.