London Leslie
Department of Public Health and Primary Health Care, University of Cape Town, Cape Town, South Africa.
Am J Public Health. 2002 Jul;92(7):1079-84. doi: 10.2105/ajph.92.7.1079.
Controversies in the conduct of international research continue to pose challenges for the system of ethical review, particularly for developing countries. Although the concept of vulnerability is key to addressing these challenges, ethical review has typically ignored the agency of vulnerable participants and groups in determining what kind of review process is needed. Concurrent with developments shaping the new public health that seek to operationalize empowerment of communities by placing them as initiators and organizers of their own health, ethical review of public health research must find ways to recognize the agency of vulnerable individuals, groups, and communities in the review process if it is to address effectively the ethical dilemmas currently evident in collaborative international research.
国际研究开展过程中的争议继续给伦理审查体系带来挑战,尤其是对发展中国家而言。尽管脆弱性概念是应对这些挑战的关键,但伦理审查通常忽视了脆弱参与者和群体在确定所需审查程序类型方面的能动性。随着塑造新公共卫生的发展趋势试图通过将社区作为自身健康的发起者和组织者来实现社区赋权,公共卫生研究的伦理审查必须找到方法,在审查过程中承认脆弱个体、群体和社区的能动性,以便有效应对当前国际合作研究中明显存在的伦理困境。