McCullough Laurence B, Coverdale John H, Chervenak Frank A
Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
Am J Obstet Gynecol. 2006 May;194(5):1221-7. doi: 10.1016/j.ajog.2005.10.818. Epub 2006 Apr 21.
We present a preventive ethics approach for including women of childbearing potential in clinical trials.
We explain the concept of preventive ethics and identify its implications for study design, the informed consent process, and study management.
We identify and address ethically significant questions for investigators and institutional review boards to address, to responsibly enroll women of childbearing potential in clinical trials. These questions concern preventive ethics for study design, for the informed consent process, and for study management. Distinctive components of this preventive ethics approach include the distinction between directive and nondirective counseling, the recognition of the concept of moral risk for women as research subjects, and the distinction between professional and individual conscience. We identify ethical considerations for physicians considering referral of their patients to clinical trials.
A comprehensive, preventive ethics approach to the ethical challenges in clinical trials related to the prevention and occurrence of pregnancy is essential for responsibly enrolling women of childbearing potential.
我们提出一种预防性伦理方法,用于将有生育潜力的女性纳入临床试验。
我们解释预防性伦理的概念,并确定其对研究设计、知情同意过程和研究管理的影响。
我们识别并解决了调查人员和机构审查委员会在道德层面上需要解决的重要问题,以便在临床试验中负责任地招募有生育潜力的女性。这些问题涉及研究设计、知情同意过程和研究管理的预防性伦理。这种预防性伦理方法的独特组成部分包括指导性咨询与非指导性咨询之间的区别、将女性作为研究对象时对道德风险概念的认识,以及专业良知与个人良知之间的区别。我们确定了医生在考虑将患者转诊至临床试验时的伦理考量因素。
对于与预防和发生妊娠相关的临床试验中的伦理挑战,采用全面的预防性伦理方法对于负责任地招募有生育潜力的女性至关重要。