Różyńska Joanna
Bioethics. 2015 Sep;29(7):451-61. doi: 10.1111/bioe.12146. Epub 2015 Feb 3.
Reigning regulatory frameworks for biomedical research impose on researchers and research ethics committees an obligation to protect research participants from risks that are unnecessary, disproportionate to potential research benefits, and non-minimized. Where the research has no potential to produce results of direct benefit to the subjects and the subjects are unable to give consent, these requirements are strengthened by an additional condition, that risks should not exceed a certain minimal threshold. In this article, I address the question of whether there should be limits of permissible risks in non-therapeutic research involving competent and healthy subjects. Some commentators argue that competent and informed individuals should have a right to participate even in extremely risky research and that research ethics committees should never reject studies because they are too dangerous. To use David Shaw's expression, competent volunteers should have 'a right to participate in high-risk research'. I argue that this idea is ill-founded, as it does not take into account the social mission and complex collaborative nature of research practice as well as the inequity of power between researchers and subjects. Imposition of limits on permissible risks for healthy volunteers is justified by the need to protect research enterprise and the need to protect the weaker party, namely the subjects. Also, I suggest that the best way to set boundaries on research risks is to leave the judgment of risk acceptability to research ethics committees.
现行的生物医学研究监管框架要求研究人员和研究伦理委员会有义务保护研究参与者免受不必要、与潜在研究益处不相称且未降至最低的风险。如果研究没有可能产生对受试者直接有益的结果,且受试者无法给出同意,这些要求会因一项附加条件而得到强化,即风险不应超过某个最低阈值。在本文中,我探讨了在涉及有行为能力且健康的受试者的非治疗性研究中是否应存在可允许风险限制这一问题。一些评论家认为,有行为能力且已充分知情的个人甚至应有权参与极具风险的研究,并且研究伦理委员会绝不应该因为研究过于危险而拒绝研究。用大卫·肖的话说,有行为能力的志愿者应有“参与高风险研究的权利”。我认为这种观点是没有根据的,因为它没有考虑到研究实践的社会使命和复杂的协作性质以及研究人员与受试者之间权力的不平等。对健康志愿者的可允许风险加以限制是合理的,这是出于保护研究事业以及保护较弱势一方即受试者的需要。此外,我建议为研究风险设定界限的最佳方式是将风险可接受性的判断留给研究伦理委员会。