Charles Anna, Rid Annette, Davies Hugh, Draper Heather
Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Institute of Biomedical Ethics, University of Zürich, Zürich, Switzerland Department of Social Science, Health and Medicine, King's College London, London, UK.
J Med Ethics. 2016 Apr;42(4):246-52. doi: 10.1136/medethics-2012-101059. Epub 2014 Jun 23.
The use of prisoners as research participants is controversial. Efforts to protect them in response to past exploitation and abuse have led to strict regulations and reluctance to involve them as participants. Hence, prisoners are routinely denied the opportunity to participate in research. In the absence of comprehensive information regarding prisoners' current involvement in research, we examined UK prisoners' involvement through review of research applications to the UK National Research Ethics Service. We found that prisoners have extremely limited access to research participation. This analysis was augmented by a survey of those involved in research and research governance (UK researchers and Research Ethics Committee members). Our results suggest that pragmatic concerns regarding the perceived burden of including prisoners are far more prominent in motivating their exclusion than ethical concerns or knowledge of regulations. While prisoners may remain a vulnerable research population due to constraints upon their liberty and autonomy and the coercive nature of the prison environment, routine exclusion from participation may be disadvantageous. Rigorous ethical oversight and the shift in the prevailing attitude towards the risks and benefits of participation suggest that it may be time for research to be more accessible to prisoners in line with the principle of equivalence in prison healthcare. We suggest the necessary first step in this process is a re-examination of current guidance in the UK and other countries with exclusions.
将囚犯用作研究参与者存在争议。为应对过去的剥削和虐待而采取的保护他们的措施导致了严格的规定，并且人们不愿让他们成为参与者。因此，囚犯通常被剥夺参与研究的机会。在缺乏有关囚犯当前参与研究的全面信息的情况下，我们通过审查向英国国家研究伦理服务局提交的研究申请，研究了英国囚犯的参与情况。我们发现，囚犯参与研究的机会极其有限。对参与研究和研究治理的人员（英国研究人员和研究伦理委员会成员）进行的一项调查进一步证实了这一分析结果。我们的研究结果表明，在促使将囚犯排除在外的因素中，对纳入囚犯所带来的负担的务实担忧远比伦理问题或对规定的了解更为突出。虽然由于囚犯的自由和自主权受到限制以及监狱环境的强制性，他们可能仍然是一个易受伤害的研究群体，但将他们常规性地排除在参与之外可能是不利的。严格的伦理监督以及对参与研究的风险和益处的主流态度的转变表明，根据监狱医疗保健平等原则，现在或许是让囚犯更容易参与研究的时候了。我们建议，这一过程中必要的第一步是重新审视英国和其他存在排除规定的国家的现行指导方针。
