Hellman Samuel
Department of Radiation and Cellular Oncology, University of Chicago, 5841 South Maryland Avenue, MC 9006, Chicago, IL 60637-1470, USA.
Perspect Biol Med. 2010 Spring;53(2):304-14. doi: 10.1353/pbm.0.0155.
Contested Medicine examines the experiments done at the University of Cincinnati by Eugene Saenger and his colleagues during the 1960s, a time of great fear that the Cold War between the United States and the Soviet Union would become a hot war using nuclear weapons. These studies were to provide the Department of Defense information relevant to the consequences of exposure of military personnel to ionizing radiation in such circumstances. Kutcher, a radiation physicist turned historian of science, is especially well prepared to put these studies into the context of the evolving bioethics of the time. He reviews the essential ethical reviews, beginning with the Nuremberg Code and extending to those of the Advisory Committee on Human Radiation Experiments appointed by President Clinton. These evolving ethical standards provide a cautionary note to today's methods of clinical experimentation in search of proper evidence-based medicine. There has been an ascendance of the priority of patient rights over societal good except in increasingly limited special circumstances. Some of what was considered good and necessary science in the 1960s and 1970s is no longer considered proper. Similarly, future ethical norms may well find current trial methodology to be flawed.
《有争议的医学》审视了尤金·桑格及其同事于20世纪60年代在辛辛那提大学所做的实验，那是一个人们极度担心美国与苏联之间的冷战会演变成使用核武器的热战的时期。这些研究旨在为国防部提供与军事人员在这种情况下遭受电离辐射的后果相关的信息。库彻，一位从辐射物理学家转型为科学史学家的人，特别有能力将这些研究置于当时不断演变的生物伦理学背景中。他回顾了重要的伦理审查，从《纽伦堡法典》开始，一直延伸到克林顿总统任命的人类辐射实验咨询委员会的审查。这些不断演变的伦理标准为当今寻求恰当循证医学的临床实验方法敲响了警钟。除了在越来越有限的特殊情况下，患者权利的优先级已高于社会利益。20世纪60年代和70年代一些被认为是良好且必要的科学，如今已不再被视为恰当。同样，未来的伦理规范很可能会发现当前的试验方法存在缺陷。
