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Comment by gumby | Hacker News Reader

At one of my companies we were encouraged by our investors to do Phase I (and some Phase II) clinical trials in the Dominican Republic, Mexico, Angola, and other such places.

Back then we did do device studies in Germany because the regulations were at the time quite lax (basically you just needed a German MD to decide it was OK and to actually use the device). They've since tightened up the rules.

Interestingly, in the device case, people who were squeamish about doing studies in poor countries with poor IRBs and such were perfectly happy to do the device studies in Germany. Not sure what to make of that.

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Isn't it obvious? Germany is a respected western country, what goes there must be OK, even if not according to other western country's laws. And surely there are sanity checks at place there. Angola, on the other hand, is a poor developing country in third world and that just signals that something nefarious is going on. The participants probably felt doing stuff there would have no such sanity checks and it would also taint their reputation.

> Isn't it obvious?

Well isn't it condescending to assume that Angola can't have reasonable safety laws while Germany can?

Germany is hardly immune to corruption (as a German speaker I am well aware of this) and that indeed was part of the reason why this loophole (placed there at the behest of German medical device manufacturers) was ultimately removed (thanks, EU!) while plenty of poor countries manage to have non-corrupt governments and reasonable protections in place in particular against the depredations of foreign companies.

As it happens Angola this week removed the laws barring same sex relations, making them more liberal than bigger and so-called "more developed" countries like Russia, China, et al.

> Well isn't it condescending to assume that Angola can't have reasonable safety laws while Germany can?

No. Germany is rich and has a high HDI, both of which correlate with safety laws that would be too expensive in poor countries.

Nobody made a superiority judgement, just stating the most probable thinking of those people. Past impressions inform present actions.

Few independent observers claim that Russia or China are places with legitimate governments that serve their people well. China is rather well known for its ethics-laundering industry, doing unsafe and polluting manufacturing work for others.

> isn't it condescending

Perhaps. So? Just because an observation is condescending doesn't mean that it's false.

> As it happens Angola this week removed the laws barring same sex relations, making them more liberal than bigger and so-called "more developed" countries like Russia, China, et al.

Liberalism doesn't directly correlate with lack of corruption.

I think it was sarcasm to satirise the hypocrisy.

“Isn’t it obvious? Black is white.”

“Isn’t it obvious? Germany > Angola because.”

Doing trials on people who don't have the protection of strong consent laws feels pretty unethical as it's got a good chance of doing direct harm to those people.

Testing a device in Germany has only indirect harm, if those substandard devices go on to hurt people later.

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