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退出研究参与的伦理问题。

The ethics of withdrawal from study participation.

作者信息

Gordon Elisa J, Prohaska Thomas R

机构信息

Alden March Bioethics Institute, Albany Medical Center, 47 New Scodand Avenue, MC 153, Albany, New York 12208-3478, USA.

出版信息

Account Res. 2006 Oct-Dec;13(4):285-309. doi: 10.1080/08989620600848645.

Abstract

We investigated whether consent forms adhere to Federal Common Rule regulations pertaining to withdrawal from research, described the language of withdrawal provisions, and assessed differences in studies by withdrawal provisions. A random sample of 114 consent forms from a midwestern, academic medical center were examined for descriptive content of withdrawal parameters stated within consent forms. All consent forms included the required statement about withdrawal pursuant to the Code of Federal Regulations (CFR) 45 CFR (46.116(a)(8)), and all adhered to regulation 45 CFR (46.116(b)(4)) by including a statement that withdrawal will have no affect on care provided. Of 114 studies, thirty (26%) studies explicitly requested subjects/participants to engage in a further behavior before withdrawing from the study. Safety was mentioned in only 4 (13%) instances as the reason for an additional visit or test. None of the consent forms provided information about the consequences to the subject's health or well being by withdrawing from study participation. Consent forms generally conform to current regulations. Future research should examine subjects' experiences of withdrawing from research in order to help clinical investigators and Institutional Review Boards (IRBs) assess the extent to which consent forms indicate barriers to withdrawal and for compliance with Federal Common Rule regulations.

摘要

我们调查了同意书是否符合联邦通用规则中关于退出研究的规定,描述了退出条款的措辞,并评估了不同研究在退出条款方面的差异。从一家位于中西部的学术医疗中心随机抽取了114份同意书,检查其中关于退出参数的描述性内容。所有同意书都包含了根据联邦法规(CFR)第45编(46.116(a)(8))要求的关于退出的声明,并且所有同意书都遵守了第45编CFR(46.116(b)(4))的规定,即声明退出不会影响所提供的护理。在114项研究中,有30项(26%)研究明确要求受试者/参与者在退出研究之前进行进一步的行为。只有4例(13%)提到安全是进行额外就诊或检查的原因。没有一份同意书提供关于退出研究参与对受试者健康或福祉的影响的信息。同意书总体上符合现行规定。未来的研究应调查受试者退出研究的经历,以帮助临床研究人员和机构审查委员会(IRB)评估同意书在多大程度上表明了退出的障碍以及是否符合联邦通用规则的规定。

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