An ethical case concerns a 16-year-old girl suffering from systemic scleroderma with a poor prognosis and her father's cultural beliefs, which do not allow for discussions about end-of-life care.
The Declaration of Helsinki was recently revised to require that the control arm of a trial use the current standard of care, even if that standard is not generally available in developing nations where the research is being conducted.
Those conducting Western-style clinical trial research in developing countries must consider the manner in which ethical principals are implemented within local standards of care.