A third potential reason for a deluge of controversies over the text must be considered. Has the document highlighted ethical practices? Recently, bioethicist H. Tristram Englehardt  talks about the possible insult to ethics. The aspects of his discussion could be paraphrased in this sense; say that someone is wrong actually has the potential to cause some degree of insult, but to say that someone is wrong ethically is a much deeper criticism and can cause a much deeper degree of insult. If the controversy over statements such as paragraph 30 is due to the fact that the DoH text has led some parts of the research community to feel very uncomfortable with the ethics of certain types of research, it is important that the guiding principles are not altered or diluted by clarification notes, but that it is the behaviour of the research community that needs to change. General Assembly of the World Medical Association. 2013. Helsinki Declaration. Ethical principles for medical research with human themes. Fortaleza, Brazil. Copyright, World Medical Association. All rights reserved.
Https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-researchinvolving-human-subjects/. Access 7, 2018. 32. For medical research involving identifiable human materials or data, such as research. B on equipment or data contained in similar biobanks or repositories, physicians must obtain informed consent for their collection, storage and/or reuse. There may be exceptional situations where approval of such research would be impossible or impossible. In such situations, research can only be conducted after review and approval by a research ethics commission. There is little doubt that the influence of the DoH remains a central guide to the practice of research. This is illustrated, at least in part, by the use of the statement by other important documents relating to the ethics of research .
For example, the Council for International Medical Organizations (CIOMS) guidelines on research ethics include the full DoH as an appendix and refer in detail to the DoH in the text. In the longer term, influence may be “watered down” by the confusing dissemination of international guidelines, codes of conduct and other instruments such as those recently developed by CIOMS, the International Conference on Harmonization (ICH) and the Council of Europe. However, none of the above points is the same kind of document as the DoH. Everyone is much longer and tries to deal with questions about what to do in certain practical situations. The DoH, on the other hand, tries to articulate a principle of principles, to function as a code of ethics. The debate on the ethics of placebo control is still present. It influenced discussions on the review of AIDS drugs in developing countries [10, 11] and the retention of active drugs in patients with schizophrenia or depression in favour of controlled versus placebo studies [12,13,14,15] and many other applications. The 2000 Helsinki version of the placebo paragraph (Table 1) took a clear position by allowing controlled versus placebo studies only in cases where there was no proven effective treatment. Clarification was made in 2002 (Table 1) due to several non-response reactions to this clear wording of the paragraph, and the exceptions that allowed controlled versus placebo studies were expanded.
The latest version of the placebo paragraph indicates that the 2000 version of the DoH is completely restructured. There is now a section entitled “Introduction,” which contains paragraphs 1 to 9 and outlines the scope of the document and some of the underlying principles. Although many of the statements contained in the introduction were included in previous versions of the statement, they were reorganized to present a more logical order of argument.