Evers David L, Fowler Carol B, Mason Jeffrey T, Mimnall Rebecca K
Veterans Affairs Maryland Health Care System, Research Service, 10 North Greene Street, Baltimore, MD, 21201, USA,
Sci Eng Ethics. 2015 Aug;21(4):1049-64. doi: 10.1007/s11948-014-9579-z. Epub 2014 Aug 24.
Here we identify approximately 40,000 healthy human volunteers who were intentionally exposed to infectious pathogens in clinical research studies dating from late World War II to the early 2000s. Microbial challenge experiments continue today under contemporary human subject research requirements. In fact, we estimated 4,000 additional volunteers who were experimentally infected between 2010 and the present day. We examine the risks and benefits of these experiments and present areas for improvement in protections of participants with respect to safety. These are the absence of maximum limits to risk and the potential for institutional review boards to include questionable benefits to subjects and society when weighing the risks and benefits of research protocols. The lack of a duty of medical care by physician-investigators to research subjects is likewise of concern. The transparency of microbial challenge experiments and the safety concerns raised in this work may stimulate further dialogue on the risks to participants of human experimentation.
在此,我们识别出约4万名健康人类志愿者,他们在从第二次世界大战后期到21世纪初的临床研究中被有意暴露于传染性病原体。如今,微生物挑战实验仍在当代人体研究要求下继续进行。事实上,我们估计在2010年至目前期间还有4000名志愿者被实验性感染。我们审视了这些实验的风险与益处,并提出了在参与者安全保护方面有待改进的领域。这些问题包括风险没有上限,以及机构审查委员会在权衡研究方案的风险和益处时,可能将对受试者和社会有问题的益处纳入考量。同样令人担忧的是,医师研究人员对研究对象缺乏医疗护理责任。微生物挑战实验的透明度以及本研究中提出的安全问题,可能会激发关于人体实验对参与者风险的进一步讨论。