Department of Psychiatry, Huashan Hospital, Fudan University, School of Medicine, No. 12 Wulumuqi Road (middle), Shanghai 200040, People's Republic of China.
BMC Med Ethics. 2012 May 17;13:8. doi: 10.1186/1472-6939-13-8.
Adherence to ethical principles in clinical research and practice is becoming topical issue in China, where the prevalence of mental illness is rising, but treatment facilities remain underdeveloped. This paper reports on a study aiming to understand the ethical knowledge and attitudes of Chinese mental health professionals in relation to the process of diagnosis and treatment, informed consent, and privacy protection in clinical trials.
A self-administered survey was completed by 1110 medical staff recruited from Shanghai's 22 psychiatric hospitals. Simple random selection methods were used to identify target individuals from the computerized registry of staff.
The final sample for analysis consisted 1094 medical staff (including 523 doctors, 542 nurses, 8 pharmacologists and 21 other staff). The majority reported that their medical institutions had not established an Ethics Committee (87.8%) and agreed that Ethics Committees should be set up in their institutions (72.9%). Approximately half (52%) had not received systematic education in ethics, and almost all (89.1%) of the staff thought it was necessary. Nearly all participants (90.0%) knew the Shanghai Mental Health Regulations which was the first local regulations relating to mental health in China, but only 11% and 16.6% respectively knew of the Nuremberg Code and the Declaration of Helsinki. About half (51.8%) thought that the guardian should make the decision as to whether the patient participated in clinical trials or not.
The study indicates that most psychiatric hospitals in Shanghai have no Medical Ethics Committee. More than half the medical staff had not received systematic education and training in medical ethics and they have insufficient knowledge of the ethical issues related to clinical practice and trials. Training in ethics is recommended for medical staff during their training and as ongoing professional development.
在中国，随着精神疾病发病率的上升，而治疗设施仍不发达，临床研究和实践中坚持伦理原则的问题日益受到关注。本文报告了一项旨在了解中国精神卫生专业人员在诊断和治疗、知情同意和临床试验中的隐私保护过程方面的伦理知识和态度的研究。
采用简单随机抽样方法，从上海市 22 家精神病院的计算机工作人员登记册中确定目标人员，对 1110 名医务人员进行了自填式调查。
最终分析样本包括 1094 名医务人员（包括 523 名医生、542 名护士、8 名药剂师和 21 名其他工作人员）。大多数人报告说，他们的医疗机构没有设立伦理委员会（87.8%），并同意在机构中设立伦理委员会（72.9%）。约有一半（52%）的人没有接受过系统的伦理学教育，几乎所有人（89.1%）都认为有必要。几乎所有的参与者（90.0%）都知道《上海市精神卫生条例》，这是中国第一部有关精神卫生的地方性法规，但只有 11%和 16.6%的人分别知道《纽伦堡法典》和《赫尔辛基宣言》。约有一半（51.8%）的人认为监护人应决定患者是否参加临床试验。
该研究表明，上海的大多数精神病院都没有医学伦理委员会。超过一半的医务人员没有接受过系统的医学伦理学教育和培训，他们对与临床实践和试验相关的伦理问题知之甚少。建议对医务人员进行伦理培训，作为其培训和持续专业发展的一部分。
