Food and Drug Administration, Silver Spring, MD 20993-0002, USA.
J Med Ethics. 2012 Nov;38(11):672-6. doi: 10.1136/medethics-2011-100205. Epub 2012 May 5.
A paediatric clinical trial conducted in a developing country is likely to encounter conditions or illnesses in participants unrelated to the study. Since local healthcare resources may be inadequate to meet these needs, research clinicians may face the dilemma of deciding when to provide ancillary care and to what extent. The authors propose a model for identifying ancillary care obligations that draws on assessments of urgency, the capacity of the local healthcare infrastructure and the capacity of the research infrastructure. The model lends itself to a decision tree that can be adapted to the local context and resources so as to provide procedural guidance. This approach can help in planning and establishing organisational policies that govern the provision of ancillary care.
在发展中国家进行的儿科临床试验可能会遇到与研究无关的参与者的情况或疾病。由于当地的医疗保健资源可能不足以满足这些需求,研究临床医生可能面临决定何时提供辅助护理以及在何种程度上提供的困境。作者提出了一种确定辅助护理义务的模型,该模型借鉴了对紧急情况、当地医疗保健基础设施能力和研究基础设施能力的评估。该模型适用于决策树,可以根据当地情况和资源进行调整,以提供程序指导。这种方法有助于规划和制定组织政策,以规范辅助护理的提供。