Loue Sana
Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH 44106-4945, USA.
Care Manag J. 2004 Winter;5(4):245-57. doi: 10.1891/cmaj.2004.5.4.245.
It is critical that cognitively impaired adults be permitted to participate in research in order to develop a greater understanding of the underlying causes of the impairments and strategies to prevent or ameliorate their impact. Significant ethical and legal issues may arise in the recruitment and enrollment of these persons as study participants, due to difficulties in understanding information, uncertainty regarding the existence of sufficient mental capacity to provide informed consent to participate, and the potential for coercion to participate as a function of limited capacity and dependence on others for care. This article explores these issues and suggests mechanisms to maximize the understanding of information and facilitate the cognitively impaired elders' expression of choice during incapacity.
至关重要的是，应允许认知受损的成年人参与研究，以便更深入地了解损伤的潜在原因以及预防或减轻其影响的策略。在招募和登记这些人作为研究参与者时，可能会出现重大的伦理和法律问题，这是由于他们在理解信息方面存在困难、对于是否有足够的心理能力来提供参与研究的知情同意存在不确定性，以及由于能力有限和依赖他人照顾而存在被胁迫参与的可能性。本文探讨了这些问题，并提出了一些机制，以最大限度地增进对信息的理解，并在无行为能力期间促进认知受损老年人表达选择。
