Biomedical Research on Vulnerable Subjects in Bosnia and Herzegovina

Igor Milinkovic

University of Banja Luka , Bosnia and Herzegovina
https://orcid.org/0000-0002-7804-3866


Abstract

Medical research involving human subjects can enhance the well-being of individual patients and provide enormous social benefits. It enables the acquisition of new scientific knowledge and the development of novel therapeutic and diagnostic procedures but also raises significant ethical and legal issues. This kind of medical research is controversial and implies a clash of values that are not always easy to balance. Particularly contentious is research on subjects who are incapable of giving consent or are in a position of subordination and more susceptible to manipulation and mistreatment. Such subjects are considered vulnerable and under special protection. The paper deals with the legal framework of medical research on vulnerable subjects in Bosnia and Herzegovina (its entities: the Republic of Srpska and the Federation of Bosnia and Herzegovina). In the first part of the paper, the notion and basic forms of medical research will be explored, as well as the concept of vulnerability. Reference will be made to relevant international documents defining the standards of medical research on vulnerable subjects. The paper will also provide a comparative overview of provisions governing vulnerable subjects research adopted in different national legislations. In the second part of the paper, the legal framework of medical research on vulnerable subjects in Bosnia and Herzegovina will be analyzed, and suggestions for possible changes will be made.

Keywords:

medical research, therapeutic, non-therapeutic, dignity, vulnerability, children, legal incapacity, Bosnia and Herzegovina, informed consent

Bell, Leanne. Medical Law and Ethics. Harlow: Pearson Education, 2012.

Beyleveld, Deryck, and Roger Brownsword. Human Dignity in Bioethics and Biolaw. Oxford – New York: Oxford University Press, 2001.

Bielby, Philip. Competence and Vulnerability in Biomedical Research. Springer, 2008.

Burns, Lawrence. “What is the Scope for the Interpretation of Dignity in Research Involving Human Subjects?.“ Medicine, Health Care and Philosophy 11, no. 2 (2008): 191–208.

Coleman, Carl H. “Introduction to Research with Human Participants.” In The Oxford Handbook of Comparative Health Law, edited by David Orentlicher and Tamara K. Hervey, 607–12. New York: Oxford University Press, 2022.

Coleman, Carl H. “Vulnerability as a Regulatory Category in Human Subjects Research.” The Journal of Law, Medicine & Ethics 37, no. 1 (2009): 12–8.

Foster, Clair. The Ethics of Medical Research on Humans. Cambridge: Cambridge University Press, 2004.

Horner, Stuart J. “Retreat from Nuremberg: Can We Prevent Unethical Medical Research?.” Public Health 113, no. 5 (1999): 205–10.

Hottois, Gilbert. “A Philosophical and Critical Analysis of the European Convention of Bioethics.” Journal of Medicine and Philosophy 25, no. 2 (2000): 133–46.

Kelly, David F, Gerald Magill, and Henk ten Have. Contemporary Catholic Health Care Ethics. Georgetown University Press, 2013.

Knoppers, Bartha Maria, and Dominique Sprumont. “Human Subjects Research, Ethics, and International Codes on Genetic Research.” In Encyclopedia of Ethical, Legal and Policy Issues in Biotechnology Vol. II, edited by Thomas H. Murray and Maxwell J. Mehlman, 566–76. New York – Chichester – Weinheim – Brisbane – Singapore – Toronto: John Wiley and Sons, 2000.

Krleza-Jeric, Karmela, and Trudo Lemmens. “7th Revision of the Declaration of Helsinki: Good News for the Transparency of Clinical Trials.” Croatian Medical Journal 50, no. 2 (2009): 105–10.

Levine, Carol, Ruth Faden, Christine Grady, Dale Hammerschmidt, Lisa Eckenwiler, and Jeremy Sugarman. “The Limitations of ‘Vulnerability’ as a Protection for Human Research Participants.” The American Journal of Bioethics 4, no. 3 (2004): 44–9.

Levine, Robert J. “The Need to Revise the Declaration of Helsinki.” The New England Journal of Medicine 341, no. 7 (1999): 531–4.

Miola, Jose. Medical Ethics and Medical Law. A Symbiotic Relationship. Oxford – Portland, Oregon: Hart Publishing, 2007.

Orzechowski, Marcin, Katarzyna Woniak, Cristian Timmermann, and Florian Steger. “Normative framework of informed consent in clinical research in Germany, Poland, and Russia.” BMC Medical Ethics 22, no. 1 (2021), accessed February 27, 2024, https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-021-00622-6.

Radisic, Jakov. Medicinsko pravo (Medical Law). Beograd: Nomos, 2008.

Rice, Todd W. “The Historical, Ethical, and Legal Background of Human-Subjects Research.” Respiratory Care 53, no. 10 (2008): 1325–9.

Rosenau, Henning. “Legal Prerequisites for Clinical Trials under the Revised Declaration of Helsinki and the European Convention on Human Rights and Biomedicine.” European Journal of Health Law 7, no. 2 (2000): 105–21.

Ruof, Mary C. “Vulnerability, Vulnerable Populations and Policy.” Kennedy Institute of Ethics Journal 14, no. 4 (2004): 411–25.

Schmidt, Ulf. “From Nuremberg to Helsinki: Historicizing the Codification of the Post-War Research Ethics.“ In Ethical Innovation for Global Health: Pandemic, Democracy and Ethics in Research, edited by Chieko Kurihara, Dirceu Greco, and Ames Dhai, 149–74, Springer, 2023.

Shrestha, Badri, and Louese Dunn. “The Declaration of Helsinki on Medical Research involving Human Subjects: A Review of Seventh Revision.” Journal of Nepal Health Research Council 17, no. 4 (2019): 548–52.

Toulouse, Elisabeth, Christophe Massequin, Brigitte Lafont, Gordon McGurk, Anna Harbonn, Jason A. Roberts, Sophie Granier, Arnaud Dupeyron, and Jan Etienne Bazin. “French Legal Approach to Clinical Research.” Anaesthesia Critical Care & Pain Medicine 37, no. 6 (2018): 607–14.

White, Michael G. “Why Human Subjects Research Protection is Important.” Ochsner Journal 20, no. 1 (2020): 16–33.

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Published
2024-06-28


Milinkovic, I. (2024). Biomedical Research on Vulnerable Subjects in Bosnia and Herzegovina. Review of European and Comparative Law, 57(2), 77–96. https://doi.org/10.31743/recl.17299

Igor Milinkovic  igormilinkovic@yahoo.com
University of Banja Luka https://orcid.org/0000-0002-7804-3866



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