Denny Colleen C, Grady Christine
Department of Clinical Bioethics, National Institutes of Health, 10 Center Drive, 10/1C118, Bethesda, MD 20892-1156, USA.
J Med Ethics. 2007 Jul;33(7):382-5. doi: 10.1136/jme.2006.017681.
Concerns about exploiting the poor or economically disadvantaged in clinical research are widespread in the bioethics community. For some, any research that involves economically disadvantaged individuals is de facto ethically problematic. The economically disadvantaged are thought of as "vulnerable" [corrected] to exploitation, impaired decision making, or both, thus requiring either special protections or complete exclusion from research. A closer examination of the worries about vulnerabilities among the economically disadvantaged reveals that some of these worries are empirically or logically untenable, while others can be better resolved by improved study designs than by blanket exclusion of poorer individuals from research participation. The scientific objective to generate generalisable results and the ethical objective to fairly distribute both the risks and benefits of research oblige researchers not to unnecessarily bar economically disadvantaged subjects from clinical research participation.
在生物伦理学界，对在临床研究中剥削穷人或经济上处于不利地位者的担忧普遍存在。对一些人来说，任何涉及经济上处于不利地位者的研究实际上都存在伦理问题。经济上处于不利地位者被认为 “容易” 受到剥削、决策能力受损，或两者兼而有之，因此需要特殊保护或完全排除在研究之外。对经济上处于不利地位者的脆弱性担忧进行更深入的审视后发现，其中一些担忧在经验或逻辑上站不住脚，而其他一些担忧可以通过改进研究设计得到更好的解决，而不是全面禁止较贫困者参与研究。产生可推广结果的科学目标以及公平分配研究风险和益处的伦理目标，要求研究人员不要不必要地禁止经济上处于不利地位的受试者参与临床研究。
