The volume under review, edited by James V Lavery of the Department of Public Health Sciences and the Joint Center for Bioethics, University of Toronto, Canada, and colleagues is a welcome addition in this era of global health in which boundaries, including those surrounding the sites of clinical research, continually dissolve. These boundaries are not only geographical ones, but also those within science and medicine itself. As the case studies in this book illustrate, all of us in the diverse fields of health, medicine, philosophy or the social sciences face hard work to comprehend the scientific and ethical parameters of a drug or practice under study, as well as the social, cultural, political, economic and professional milieu in which research trials and studies are conducted. The majority of the formulations of guidelines for clinical research emerged in American and European institutions of medicine; the transposition of these models to the rest of the world is neither a clear, or self-evident, nor an easy process.