Gordon Matthew P
Food Drug Law J. 2009;64(1):225-60.
Research that utilizes human subjects is a large and growing enterprise. Tens of millions of individuals have already participated as subjects in one or more research protocols, and millions more participate each year. Government and industry combined spend billions annually to support as many as 20,000 research studies, many of which are individually large and complex enterprises in their own right.These numbers are, if anything, likely to increase even further. Besides the growth in research, two other trends are apparent. First, research-related litigation is on the rise and appears likely to become even more widespread. Sparked at least in part by recent widely publicized instances of harm befalling research subjects, plaintiffs' attorneys are suing both more often and more creatively. Related to this is the second trend: public trust in research is declining and, as a result, at least some types of research are struggling to find adequate numbers of human subjects.As a result of these trends, exposure to potential liability and public perception are both increasingly important. Concomitant with all of this research is the discovery and generation of tremendous quantities of data specific to individual subjects, including--but not limited to--genetic information. Much of this data is irrelevant to subjects' interests because it lacks predictive value, has uncertain meaning, or is otherwise uninformative. Some, however, is different--some of the personal data learned during the course of research with human subjects bears directly on individuals' health. Despite the fact that much individual data has already been generated and that both the quantity and the quality of data generated seem likely to increase, there is a lack of clear guidance for researchers regarding whether and when such information should be divulged to the subjects on whom it bears.In this environment, the potential exists for litigation alleging that a researcher was negligent for failure to disclose to a subject an individual research finding of medical significance. Such litigation would raise a heretofore-unanswered question: should a researcher have a legal duty to disclose medically significant individual research findings to a subject?
利用人类受试者开展的研究是一个规模庞大且仍在不断发展的事业。数以千万计的人已经作为受试者参与了一项或多项研究方案,而且每年还有数百万人参与。政府和企业每年总计花费数十亿美元来支持多达20,000项研究,其中许多研究本身就是规模庞大且复杂的项目。这些数字即便有变化,也很可能会进一步增加。除了研究规模的扩大,另外两个趋势也很明显。首先,与研究相关的诉讼呈上升趋势,而且似乎有可能变得更加普遍。至少部分是由于近期广为宣传的研究受试者遭受伤害的事件引发的,原告律师提起诉讼的频率更高,方式也更具创造性。与此相关的是第二个趋势:公众对研究的信任在下降,因此,至少某些类型的研究难以找到足够数量的人类受试者。由于这些趋势,面临潜在责任和公众认知变得越来越重要。与所有这些研究相伴而来的是发现并生成了大量特定于个体受试者的数据,包括但不限于基因信息。这些数据中的许多与受试者的利益无关,因为它缺乏预测价值、含义不确定或在其他方面没有信息价值。然而,有些数据则不同——在对人类受试者进行研究的过程中获取的一些个人数据直接关系到个人的健康。尽管已经生成了大量的个人数据,而且所生成数据的数量和质量似乎都可能增加,但对于研究人员而言,在是否以及何时应将此类信息透露给相关受试者方面,缺乏明确的指导。在这种环境下,有可能出现诉讼,指控研究人员因未向受试者披露具有医学意义的个体研究结果而存在过失。此类诉讼将引发一个此前未得到解答的问题:研究人员是否有法律义务向受试者披露具有医学意义的个体研究结果?