Lie R K
Department of Clinical Bioethics, National Institutes of Health, Bethesda, MD 20852, USA.
J Med Ethics. 2004 Apr;30(2):122-5. doi: 10.1136/jme.2003.007203.
In this paper, the author argues that the requirement to conduct randomised clinical trials to inform policy in cases where one wants to identify a cheaper alternative to known effective but expensive interventions raises an important ethical issue. This situation will eventually arise whenever there are resource constraints, and a policy decision has been made not to fund an intervention on cost effectiveness grounds. It has been thought that this is an issue only in extremely resource poor settings. This paper gives an example from the United Kingdom illustrating that this is also a problem faced by richer countries.
在本文中，作者认为，在人们想要确定一种比已知有效但昂贵的干预措施更便宜的替代方案以指导政策制定的情况下，进行随机临床试验的要求引发了一个重要的伦理问题。只要存在资源限制，并且基于成本效益的理由做出了不资助某项干预措施的政策决定，这种情况最终就会出现。人们一直认为这只是资源极端匮乏地区才存在的问题。本文给出了一个来自英国的例子，说明这也是富裕国家面临的一个问题。
