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在发育神经毒物评估中,伦理评估作为风险评估的辅助手段。

Ethics assessment as an adjunct to risk assessment in the evaluation of developmental neurotoxicants.

作者信息

Weiss B

机构信息

Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA 14642, USA.

出版信息

Environ Health Perspect. 2001 Dec;109 Suppl 6(Suppl 6):905-8. doi: 10.1289/ehp.01109s6905.

Abstract

The conduct of experimental studies in humans is governed by a body of principles whose main precepts have evolved over the past few decades. Three of these provide the foundations for judging the ethical adequacy of such an experiment. One addresses the question of who receives the benefits of the research and who bears its burdens (justice). A second requires that the research maximize the potential benefits to the subjects and minimize the risk of harm (beneficence). The third, the source of guidelines for informed consent, requires that subjects enter into the research voluntarily and with adequate information (respect for persons). Unlike research conducted to evaluate drugs, however, environmental exposures to potentially toxic chemicals do not survey those exposed for their consent, nor do they provide an appropriate calculus for measuring risks and benefits, which typically involve two different populations. Especially for exposure to developmental neurotoxicants, where the risk-benefit incompatibility can be so striking, another element may need to be incorporated into risk characterization: a process of ethics assessment. A scheme for doing so can be derived from the procedures of fuzzy logic, which allow rules to be formulated that are applicable to ethical principles. Such an approach incorporates some of the tenets of the precautionary principle.

摘要

人体实验研究受一系列原则的规范,这些原则的主要戒律在过去几十年中不断演变。其中三条原则为判断此类实验的伦理适当性提供了基础。一条原则解决了谁从研究中受益以及谁承担研究负担的问题(公正)。第二条原则要求研究最大限度地提高对受试者的潜在益处,并将伤害风险降至最低(行善)。第三条原则是知情同意准则的来源,要求受试者自愿并在充分了解信息的情况下参与研究(尊重人)。然而,与评估药物的研究不同,对潜在有毒化学物质的环境暴露既不征求暴露者的同意,也没有提供衡量风险和益处的适当计算方法,而风险和益处通常涉及两个不同的人群。特别是对于发育性神经毒物的暴露,风险与益处的不相容性可能非常明显,因此在风险特征描述中可能需要纳入另一个要素:伦理评估过程。这样做的一个方案可以从模糊逻辑程序中推导出来,该程序允许制定适用于伦理原则的规则。这种方法纳入了预防原则的一些信条。

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