Pappas Gregory, Hyder Adnan A
Department of Community Health Science, Aga Khan University, 3500 Stadium Road, Karachi, Pakistan.
Global Health. 2005 Nov 28;1:16. doi: 10.1186/1744-8603-1-16.
The health information needs of developing countries increasingly include population-based estimates determined by biological and physiological measures. Collection of data on these biomarkers requires careful reassessment of ethical standards and procedures related to issues of safety, informed consent, reporting, and referral policies. This paper reviews the survey practices of health examination surveys that have been conducted in developed nations and discusses their application to similar types of surveys proposed for developing countries.
The paper contends that a unitary set of ethical principles should be followed for surveys around the world that precludes the danger of creating double standards (and implicitly lowers standards for work done in developing countries). Global ethical standards must, however, be interpreted in the context of the unique historical and cultural context of the country in which the work is being done. Factors that influence ethical considerations, such as the relationship between investigators in developed and developing countries are also discussed.
The paper provides a set of conclusions reached through this discussion and recommendations for the ethical use of biomarkers in populations-based surveys in developing countries.
发展中国家的健康信息需求越来越多地包括基于生物和生理测量得出的人群估计数。收集这些生物标志物的数据需要仔细重新评估与安全、知情同意、报告和转诊政策等问题相关的伦理标准和程序。本文回顾了在发达国家进行的健康检查调查的调查实践，并讨论了它们在为发展中国家提议的类似类型调查中的应用。
本文认为，全球范围内的调查应遵循一套统一的伦理原则，以避免产生双重标准的风险（并含蓄地降低发展中国家所做工作的标准）。然而，全球伦理标准必须在开展工作的国家独特的历史和文化背景下进行解读。文中还讨论了影响伦理考量的因素，如发达国家和发展中国家研究人员之间的关系。
本文给出了通过此次讨论得出的一系列结论，以及关于在发展中国家基于人群的调查中伦理使用生物标志物的建议。
