| 2. Clinical Research
Regulations and Supervision |
page
80 |
Investigators,
sponsors and institutional authorities share equal responsibility for
producing high-quality data and following ethical recommendations for the
conduct of biomedical research involving human subjects. The Declaration
of Helsinki - first proposed in Finland in 1964 and later revised by the
World Medical Assembly in Hong Kong in 1989 - is a universally accepted
ethical code.
In 1987 the
Medical Research Council of Canada (MRC) approved guidelines for research
involving human subjects. The latest guidelines for good clinical research
practices are stipulated in a document entitled "Conduct of Clinical
Investigations"; they were officially adopted by the Health
Protection Branch (HPB) of the Canadian government in 1989.
In the
United States, federal regulations concerning the development of new drugs
and their subsequent admissibility for clinical investigation were in
place as early as 1938. Following the tragic events surrounding the use of
thalidomide in the 1950s, important amendments were adopted: review of
preclinical data, the informed consent of patients and the reporting of
preclinical findings became mandatory in 1962. In an attempt to
standardize compliance with regulatory requirements, good clinical
practice (GCP) rules for sponsors (1977) and for investigators (1978) were
developed by industry. The investigational new drug (IND) regulation was
established in 1987.
The most
recent and comprehensive set of guidelines for drug trials emerged in
October 1990 as a result of a meeting where the tenets of good practice
were compared by scientists from the European Community and North America.
Uniform standards were subsequently defined.
Although
some differences exist among countries in the government regulations
governing clinical research in humans, these guidelines are becoming more
uniform. |