Muthuswamy Vasantha
Indian Council of Medical Research, Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110 029, India.
Indian J Med Res. 2005 Apr;121(4):601-10.
Globally the HIV/AIDS epidemic has presented unique health challenges to populations, including a host of ethical and moral issues related to human life and dignity. The disease has most affected the vulnerable groups of people in the world often leading to stigma and discrimination. Currently the critical areas of concern include access to treatment and developing newer, more effective therapeutic and prevention methods while taking care of ethical values in health care and research. The ethical issues mainly revolve around the standard of care, informed consent across cultures, privacy and confidentiality, stigma and discrimination, protection of vulnerable groups, community consultation, ethical review mechanisms, international collaboration, epidemiological studies, clinical trials and also sociobehavioural studies on HIV/AIDS. In addition major concerns are raised regarding HIV/AIDS vaccine trials, microbicidal trials as well as prevention of parent-to-child transmission (PPTCT) trials especially in resource-poor countries. For international collaborative research appropriate standard of care, community benefits, and host country needs must be kept in mind. Improving our understanding of the various ethical and societal concerns related to HIV/AIDS treatment and research would help in development of appropriate policies for disease control and prevention.
在全球范围内,艾滋病毒/艾滋病疫情给人们带来了独特的健康挑战,包括一系列与人类生命和尊严相关的伦理和道德问题。这种疾病对世界上的弱势群体影响最大,常常导致污名化和歧视。目前,关注的关键领域包括获得治疗以及开发更新、更有效的治疗和预防方法,同时在医疗保健和研究中兼顾伦理价值观。伦理问题主要围绕医疗护理标准、跨文化的知情同意、隐私和保密、污名化和歧视、弱势群体保护、社区咨询、伦理审查机制、国际合作、流行病学研究、临床试验以及关于艾滋病毒/艾滋病的社会行为研究。此外,对于艾滋病毒/艾滋病疫苗试验、杀微生物剂试验以及预防母婴传播(PPTCT)试验,尤其是在资源匮乏国家进行的此类试验,人们也提出了重大关切。对于国际合作研究,必须牢记适当的医疗护理标准、社区利益和东道国需求。增进我们对与艾滋病毒/艾滋病治疗和研究相关的各种伦理和社会问题的理解,将有助于制定适当的疾病控制和预防政策。