为什么预防医学不受伦理约束？
Why is preventive medicine exempted from ethical constraints?
作者信息
Skrabanek P
机构信息
University of Dublin.
出版信息
J Med Ethics. 1990 Dec;16(4):187-90. doi: 10.1136/jme.16.4.187.
Abstract
It is a paradox that medical experimentation on individuals, whether patients or healthy volunteers, is now controlled by strict ethical guidelines, while no such protection exists for whole populations which are subjected to medical interventions in the name of preventive medicine or health promotion. As many such interventions are either of dubious benefit or of uncertain harm-benefit balance, such as mass screening for cancers or for risk factors associated with coronary heart disease, there is no justification for maintaining the ethical vacuum in which preventive medicine finds itself at present.
摘要
这是一个自相矛盾的现象
针对个体（无论是患者还是健康志愿者）的医学实验如今受到严格的伦理准则的管控，然而对于那些以预防医学或健康促进之名接受医学干预的全体人群，却不存在这样的保护措施。由于许多此类干预要么益处存疑，要么危害与益处的平衡不确定，比如癌症的大规模筛查或与冠心病相关风险因素的筛查，所以没有理由维持预防医学目前所处的这种伦理真空状态。
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3
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5
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