von Schroeder H P
CM Kleinert Institute, One Medical Plaza, Suite 850, Louisville, KY 40202, USA.
Ann R Coll Physicians Surg Can. 1997 Sep;30(6):353-8.
With increasing economic, political, and bureaucratic involvement in research, there is little focus on the medical researcher's idealistic and benevolent intentions. Benevolence is a pillar of ethical human-subjects research, and altruism is a form of benevolence that is difficult to quantify. It is interest in the welfare of others without personal benefit. This article examines the extent of altruism in medical research from philosophical, psychological, and practical points of view. With the emergence of experimental human trials in the first half of the century, the fame and recognition of physicians largely precluded altruistic motivation. From the philosophical perspective, altruism is at best an optional moral principle. It is not evident in ethical guidelines. In the scientific process, altruism can exist only in ethical and properly designed research. Egoism, scientific misconduct, and conflicts of interest undermine it; but altruism is also a potential solution for these problems. Research is not globally oriented and has an unjust distribution. In an evolutionary model, altruism cannot thrive due to its lack of rewards and feedback, particularly in the economic climate of today's science. Anonymity is decreasing, selfishness is increasing. Research has become an industry, and virtuous ideals are a romantic notion. If we use altruism as an indicator, then its rarity and fragility indicate research's unhealthy state.
随着经济、政治和官僚机构对研究的参与日益增加，医学研究者理想化且仁慈的意图很少受到关注。仁慈是符合伦理的人体研究的一大支柱，而利他主义是一种难以量化的仁慈形式。它是对他人福祉的关注且不涉及个人利益。本文从哲学、心理学和实践的角度审视了医学研究中利他主义的程度。随着本世纪上半叶实验性人体试验的出现，医生的声誉和认可度在很大程度上排除了利他主义动机。从哲学角度看，利他主义充其量只是一种可选择的道德原则。它在伦理准则中并不明显。在科学过程中，利他主义仅能存在于符合伦理且设计合理的研究中。利己主义、科研不端行为和利益冲突会破坏它；但利他主义也是解决这些问题的一种潜在办法。研究并非面向全球，且分布不均。在一个进化模型中，利他主义由于缺乏回报和反馈而无法蓬勃发展，尤其是在当今科学的经济环境下。匿名性在降低，自私自利在增加。研究已成为一个产业，而高尚的理想只是一个浪漫的概念。如果我们将利他主义作为一个指标，那么它的稀缺性和脆弱性表明研究处于不健康状态。
