Caux Chantal, Roy David J, Guilbert Louise, Viau Claude
Faculté des Sciences Infirmières, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montréal, Quebec, Canada.
Soc Sci Med. 2007 Jul;65(2):344-54. doi: 10.1016/j.socscimed.2007.03.041. Epub 2007 May 15.
This research aimed to understand how occupational health stakeholders represented the various ethical concerns raised by the use of biomarkers of exposure, effects and susceptibility to harmful agents. These representations were investigated by seven homogeneous focus group interviews and an Internet discussion forum. The following stakeholders took part in this research: workers, physicians, nurses, researchers, employers, industrial hygienists, trade-union representatives and employees of the Quebec Board of Health and Safety in the Workplace. The data were analyzed qualitatively using a constant comparison technique. The main ethical problems raised by the stakeholders were organized around three emergent themes: a narrative of science, the validation of biomarkers and the protection of workers. From these themes emanate the principal ethical problems raised by the stakeholders: confidentiality, the interpretation of data, consent and information, as well as an advantages/disadvantages ratio. These problems are described as ethical tension zones. The analysis also takes into account the impact of the representations that each group of stakeholders has of each other and the ethical problems that can arise. Because it is drawn from a study of stakeholders' representations, the resulting analytical model might also be used to anticipate the root of ethical problems generated by the use of the biomarkers in an occupational health context.
本研究旨在了解职业健康领域的利益相关者如何看待使用接触、效应和易感性生物标志物所引发的各种伦理问题。通过七次同质性焦点小组访谈和一个互联网讨论论坛对这些观点进行了调查。参与本研究的利益相关者包括：工人、医生、护士、研究人员、雇主、工业卫生学家、工会代表以及魁北克工作场所健康与安全委员会的员工。采用持续比较技术对数据进行了定性分析。利益相关者提出的主要伦理问题围绕三个新出现的主题展开：科学叙事、生物标志物的验证以及工人保护。从这些主题中衍生出利益相关者提出的主要伦理问题：保密、数据解读、同意与信息，以及利弊比。这些问题被描述为伦理张力带。分析还考虑了每组利益相关者对彼此的看法所产生的影响以及可能出现的伦理问题。由于该分析模型源自对利益相关者观点的研究，因此也可用于预测职业健康背景下使用生物标志物所产生的伦理问题的根源。
