Wendler Dave, Martinez Rick A, Fairclough Diane, Sunderland Trey, Emanuel Ezekiel
Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892-1156, USA.
Am J Psychiatry. 2002 Apr;159(4):585-91. doi: 10.1176/appi.ajp.159.4.585.
The authors' goal was to assess healthy individuals' attitudes toward five of the most prominent proposed safeguards regarding the consent process for research with adults unable to consent.
Telephone interviews were conducted with 246 individuals with a family history of Alzheimer's disease who had participated in clinical research.
The majority of respondents said that they were willing to participate in research if they lost the ability to consent. Few completed a research advance directive. Many had discussed their preferences with their families, and the majority would allow their families to make research decisions for them.
Enrolling individuals who are unable to consent in research that offers no potential for medical benefit is consistent with the preferences of at least some individuals. This suggests that such research should not be prohibited, provided there is sufficient evidence that it is consistent with the preferences of individual subjects. Requiring that such evidence be provided in a formal research advance directive may be unnecessarily restrictive. More research is needed to assess whether the findings in this group of subjects generalize to other groups.
作者的目标是评估健康个体对针对无法给出知情同意的成年人开展研究的同意过程中五项最突出的拟议保障措施的态度。
对246名有阿尔茨海默病家族史且参与过临床研究的个体进行了电话访谈。
大多数受访者表示,如果他们失去了给出知情同意的能力,愿意参与研究。很少有人完成研究预先指示。许多人已与家人讨论过自己的偏好,且大多数人会允许家人为他们做出研究决策。
将无法给出知情同意的个体纳入没有医疗获益潜力的研究符合至少部分个体的偏好。这表明,此类研究不应被禁止,前提是有充分证据表明其符合个体受试者的偏好。要求在正式的研究预先指示中提供此类证据可能限制过多。需要开展更多研究以评估这组受试者的研究结果是否适用于其他群体。