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1、Chapter13ConclusionAntonioUgaldeandNuriaHomedesThecollectionofarticlesincludedinthisbookprovideanoverviewoftheevolutionoftheregulatoryframeworkthatguidestheimplementationofclinicaltrialsinfiveLatinAmericancountriesand,throughthedescriptionandanalysisofseveralcasesstu
2、dies,highlightsthemainethicalissuesthathavearisenduringtheimplementa-tionofthetrials.Morethan80%ofallclinicaltrialsthattakeplaceintheregionareconductedinArgentina,Brazil,CostaRica,MexicoandPeru;therefore,whatisdescribedinthisbookcanbeconsideredrepresentativeofwhatoc
3、cursintheregion.Thelackoftransparencythatsurroundsclinicaltrialsprecludesusfromhavinganaccuratepictureofthemagnitudeoftheproblemsthathavebeendescribedinthisvolume.Theauthorsofthedifferentchaptersonlyhadaccesstolegislativeandcourtdocuments,afewthesisanddissertations,
4、informationdiscoveredafterahumantragedyoccurredduringtheimplementationofatrialandreportsfrominvestigativereportersthattookthetimetostudycomplainsfromphysiciansandotherhealthcareproviderswhoreportedabuses.Wecanonlyassumethatthecasespresentedarenotisolatedexamples.Oft
5、hefivecountriesincludedinthebook,CostaRicaandArgentinahaveastrongtraditionofinvestigativereportsanditisforthisreasonthatthereismoreinformationabouttrialsinthesecountriesthanelsewhere.Wehavetokeepinmindthatittookalmost40yearstouncoverbyincrediblechancetheclinicaltrial
6、sabuses/atrocitiesthatUSAresearcherswiththeassistanceoflocalphysicianscommittedinGuatemala.Perhapsoneday,iffilesoftheindustryandthearchivesofgovernmentsareopened,researcherswillbeabletoestablishtheextentoftheproblemwithgreateraccuracy.Inthisclosingchapter,wewillprese
7、ntthemainsimilaritiesanddifferencesregard-ingtheregulatoryprocessandtheimplementationofclinicaltrialsthathavebeenA.UgaldeDepartmentofSociology,UniversityofTexas,Austin,TX,USAN.Homedes(*)SchoolofPublicHealth,DivisionofManagementPolicyandCommunityHealth,UniversityofTe
8、xasHoustonHealthScienceCenter,ElPaso,TX,USAe-mail:nhomedes@utep.eduN.HomedesandA.Ugalde(eds.),ClinicalTrialsinLatinAmerica:WhereEthics275a
