Albin R L
4412D Kresge III, 200 Zina Pitcher Place, Ann Arbor, MI 48109-0585, USA.
J Med Ethics. 2005 Mar;31(3):149-52. doi: 10.1136/jme.2003.006155.
Debate continues about the ethics of sham surgery controls. The most powerful argument for sham surgery controls is that rigorous experiments are needed to demonstrate safety and efficacy of surgical procedures. Without such experiments, there is danger of adopting worthless procedures in clinical practice. Opponents of sham surgery controls argue that sham surgery constitutes unacceptable violation of the rights of research subjects. Recent philosophical discussion has used two thought experiments-the transplant case and the trolley problem-to explore the circumstances under which individuals may be harmed to benefit a larger group. The transplant case is felt to exemplify circumstances that forbid harming some to benefit a larger group while the trolley problem exemplifies circumstances that permit harming some to benefit others. I argue that sham surgery controls satisfy criteria derived from the trolley problem and are morally permissible.
关于假手术对照的伦理问题，争论仍在继续。支持假手术对照的最有力论据是，需要进行严格的实验来证明手术程序的安全性和有效性。没有这样的实验，就有在临床实践中采用毫无价值的手术程序的风险。假手术对照的反对者认为，假手术构成了对研究对象权利的不可接受的侵犯。最近的哲学讨论使用了两个思想实验——移植案例和电车难题——来探讨在哪些情况下，为了使更大的群体受益，个体可能会受到伤害。移植案例被认为是禁止伤害一些人以使更大的群体受益的情况的例证，而电车难题则是允许伤害一些人以使其他人受益的情况的例证。我认为，假手术对照符合从电车难题中得出的标准，在道德上是允许的。
