245 © Springer International Publishing AG 2017 H. Silverman (ed.), Research Ethics in the Arab Region, Research Ethics Forum 5, https://doi.org/10.1007/978-3-319-65266-5_24 M.M. Al Kassar (*) Human Research Protection Program, Weill Cornell Medicine in Qatar, Ar-Rayyan, Qatar American University of Beirut, Beirut, Lebanon e-mail: Mak2095@qatar-med.cornell.edu B. Azakir Beirut Arab University, Beirut, Lebanon Research Ethics Governance in the Arab Region: Lebanon May M. Al Kassar and Bilal Azakir Introduction Lebanon is a low to middle income country situated within the Middle East and the North African region. The country experienced a civil war from 1975 to 1990 and witnessed intermittent disturbances afterwards. Lebanon is usually viewed as an attractive site to conduct clinical trials due to a very short startup time and the avail- ability of many competent physicians (Kumar 2014). Health Care System Lebanon has a modern set-up in terms of hospitals’ infrastructure and advance- ments in medical education and in technology, which have enabled Lebanese hospi- tals to compete with other countries in the region. It is estimated that there are 3.54 doctors per 1,000 people, which is more than double the average in the Arab region. Lebanon spends 8.3% of its GDP on health services (Ammar 2009). However, the Lebanese health sector is highly fragmented and pluralistic. Widely dominated by the private sector, a total of 163 hospitals contract with the Ministry of Public Health (MoPH), out of which only 28 are public hospitals, representing 16.6% of the total capacity of hospitals in Lebanon (MoPH 2014). Thus, the health care system mainly depends on the highly developed and equipped private hospi- tals, including a total of 12,648 beds (Private Hospitals Syndicate 2011) distributed