Wise Robert A
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
Proc Am Thorac Soc. 2007 May;4(2):200-5; discussion 205. doi: 10.1513/pats.200701-006GC.
Pulmonary clinical research possesses no unique ethical issues compared with other areas of medicine, but the range of disease states and conditions in pulmonary clinical research are broad. The ethical values guiding clinical research in pulmonary medicine are defined by the Belmont Report (i.e., patient autonomy, justice, and beneficence). This article uses some of the most well-known clinical trials in pulmonary medicine to illustrate these issues and the numerous perspectives that must be considered. Ethical issues covered include introduction of new surgical procedures, placebo controls and drug withdrawal designs, smoking status in trials of patients with chronic obstructive pulmonary disease, and the tensions between community practice, clinical care guidelines, and evidence-based medicine.
与医学的其他领域相比，肺部临床研究不存在独特的伦理问题，但肺部临床研究中的疾病状态和情况范围很广。指导肺部医学临床研究的伦理价值由《贝尔蒙报告》界定（即患者自主权、公正和 beneficence）。本文运用肺部医学中一些最著名的临床试验来说明这些问题以及必须考虑的众多观点。涵盖的伦理问题包括新手术程序的引入、安慰剂对照和撤药设计、慢性阻塞性肺疾病患者试验中的吸烟状况，以及社区实践、临床护理指南和循证医学之间的矛盾。
