Roberts L W, Roberts B
Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque 97131, USA.
Biol Psychiatry. 1999 Oct 15;46(8):1025-38. doi: 10.1016/s0006-3223(99)00205-x.
The field of psychiatry has an opportunity to construct a more refined, perhaps more enduring understanding of the ethical basis of mental illness research. The aim of this paper is to help advance this understanding by 1) tracing the evolution of the emerging ethic for biomedical experimentation, including recent recommendations of the President's National Bioethics Advisory Commission, and 2) reviewing data and concepts related to compelling ethical questions now faced in the study of mental disorders. Empirical findings on informed consent, the ethical safeguards of institutional review and surrogate decision making, and the relationship between scientific and ethical imperatives are outlined. Psychiatric researchers will increasingly be called upon to justify their scientific approaches and to seek ways of safeguarding the well-being of people with mental illness who participate in experiments. Most importantly, psychiatric investigators will need to demonstrate their appreciation and respect for ethical dimensions of investigation with special populations. Further empirical study and greater sophistication with respect to the distinct ethical issues in psychiatric research are needed. Although such measures present many challenges, they should not interfere with progress in neuropsychiatric science so long as researchers in our field seek to guide the process of reflection and implementation.
精神病学领域有机会构建一种对精神疾病研究伦理基础更为精确、或许更为持久的理解。本文旨在通过以下方式推动这一理解：1）追溯生物医学实验新兴伦理的演变，包括总统国家生物伦理咨询委员会最近的建议；2）审视与精神障碍研究中当前面临的紧迫伦理问题相关的数据和概念。文中概述了关于知情同意、机构审查和替代决策的伦理保障以及科学与伦理要求之间关系的实证研究结果。精神病学研究人员将越来越多地被要求为其科学方法辩护，并寻求保障参与实验的精神疾病患者福祉的方法。最重要的是，精神病学研究人员需要表明他们对特殊人群研究伦理层面的认识和尊重。需要针对精神病学研究中独特的伦理问题进行进一步的实证研究并使其更加完善。尽管这些措施带来诸多挑战，但只要我们领域的研究人员寻求引导反思和实施过程，它们就不应妨碍神经精神科学的进展。
