Haramati Linda B
Albert Einstein College of Medicine, Department of Radiology, Montefiore Medical Center, Bronx, NY 10467, USA.
J Am Coll Radiol. 2008 Oct;5(10):1073-6. doi: 10.1016/j.jacr.2008.05.004.
This essay discusses the ethical implications of medical research using ionizing radiation in the diagnostic imaging range. Coronary CT angiography will be used as an example. Since coronary artery disease is the most common cause of death in the United States, any change in the work-up or management of patients with coronary artery disease has enormous clinical and economic implications. Risks of diagnostic radiation differ from those encountered in routine medical research as radiation-related cancers and heritable genetic damage can manifest in the irradiated individual or in subsequent generations. The risk to research subjects is ethically troubling because the research may not offer direct benefit to participants, although the benefits to society and future patients could be considerable. The American College of Radiology has a mandate to lead in the discussion of how to best minimize the risks of diagnostic radiation exposure in clinical research while encouraging studies likely to maximize benefits for future patients.
本文讨论了在诊断成像范围内使用电离辐射进行医学研究的伦理问题。将以冠状动脉CT血管造影为例。由于冠状动脉疾病是美国最常见的死亡原因，因此冠状动脉疾病患者检查或治疗方法的任何改变都具有巨大的临床和经济意义。诊断性辐射的风险与常规医学研究中遇到的风险不同，因为与辐射相关的癌症和可遗传的基因损伤可能在受辐射个体或后代中显现出来。研究对象面临的风险在伦理上令人困扰，因为该研究可能不会给参与者带来直接益处，尽管对社会和未来患者的益处可能相当大。美国放射学会的职责是带头讨论如何在临床研究中最大程度地降低诊断性辐射暴露的风险，同时鼓励开展可能为未来患者带来最大益处的研究。
