Dubois James M, Carroll Kelly, Gibb Tyler, Kraus Elena, Rubbelke Timothy, Vasher Meghan, Anderson Emily E
Bander Center for Medical Business Ethics, Saint Louis University.
Ethics Behav. 2012 May 9;22(3):163-188. doi: 10.1080/10508422.2011.641832. Epub 2011 Nov 29.
In this paper we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research.
在本文中，我们描述了我们理解医学研究与实践中不当行为的方法，该方法涉及对大量已发表案例的编码数据进行统计分析。我们专注于理解那些能够预测医学中不当行为的类型和严重程度的环境因素。通过回顾实证和理论文献、咨询专家、应用犯罪学理论以及对我们最初的60个案例进行持续分析，我们假设医学环境的10个背景特征（包括经济奖励、监督不力以及弱势群体患者）可能导致职业不当行为。我们定义了每个变量，审视支持我们假设的数据，并给出我们研究中的一个简短案例概要，以说明该变量的潜在影响。最后，我们讨论了所得框架的局限性以及未来研究的方向。
