Ethical fractures of the globalized model: ethical standards in clinical practice and biomedical research

A debate is proposed in this article about the so-called standards for clinical practice and for biomedical research, both the technical-scientific and the ethical standards. The background of the research ethics field is reviewed, as are the events which in the 1990s changed the conditions under which new knowledge is generated and biomedical research is implemented, in a globalized world. Then, the two main ethical fractures generated by this model are considered. On the one hand in medical practice, in relation to the validity of biomedical knowledge and its impact on Medicine's duty of beneficence. On the other hand, in the ethics of biomedical research questions have been raised concerning the universal ethical standard. The contextual conditions under which the debate is being developed are reviewed in relation to the growing importance of multinational research in the Third World, both in relation to its future impact on human health and well-being and to the degree of vulnerability of the populations taking part in that research. A reflection is thus left open on the goals of science, medicine, and biomedical research, while attempting at the same time to answer the question about the goals of Bioethics and the ethics of research.