Lev Ori, Wilfond Benjamin S, McBride Colleen M
Sapir Academic College, Israel.
Public Health Ethics. 2013 Jul;6(2):197-206. doi: 10.1093/phe/pht006.
Health behaviors such as tobacco use contribute significantly to poor health. It is widely recognized that efforts to prevent poor health outcomes should begin in early childhood. Biomedical enhancements, such as a nicotine vaccine, are now emerging and have potential to be used for primary prevention of common diseases. In anticipation of such enhancements, it is important that we begin to consider the ethical and policy appropriateness of their use with children. The main ethical concerns raised by enhancing children relate to their impact on children's well-being and autonomy. These concerns are significant, however they do not appear to apply in the case of the nicotine vaccine; indeed the vaccine could even further these goals for children. Nevertheless, concerns about broadly applying this enhancement may be more challenging. The vaccine may be less cost-effective than alternative public efforts to prevent tobacco use, utilizing it could distract from addressing the foundational causes of smoking and it might not be publically acceptable. Empirical research about these concerns is needed to ascertain their likelihood and impact as well as how they could be minimized. This research could help determine whether behavior-related enhancements hold promise for improving children's health.
吸烟等健康行为是导致健康状况不佳的重要因素。人们普遍认识到，预防健康问题的努力应从幼儿期开始。生物医学增强手段，如尼古丁疫苗，正在出现，并有可能用于常见疾病的一级预防。鉴于此类增强手段的出现，我们必须开始思考在儿童中使用这些手段的伦理和政策适宜性。增强儿童能力引发的主要伦理问题涉及其对儿童福祉和自主性的影响。这些问题很重要，但在尼古丁疫苗的情况下似乎并不适用；事实上，该疫苗甚至可能进一步推动儿童实现这些目标。然而，广泛应用这种增强手段可能面临更多挑战。与预防吸烟的其他公共措施相比，该疫苗的成本效益可能较低，使用它可能会分散对吸烟根本原因的关注，而且可能不被公众接受。需要对这些问题进行实证研究，以确定其可能性和影响，以及如何将其降至最低。这项研究有助于确定与行为相关的增强手段是否有望改善儿童健康。
