Tagin Mohamed, Zhu Changlian, Gunn Alistair J
Winnipeg Regional Health Authority, WS012 Women's Hospital, Winnipeg, Man., Canada.
Dev Neurosci. 2015;37(4-5):305-10. doi: 10.1159/000371722. Epub 2015 Feb 25.
The successful clinical translation of therapeutic hypothermia offers the tantalizing possibility that further improvements in outcomes may be possible by combining cooling with other neuroprotective drugs. The challenge now is to select from a daunting range of potential treatments. The patient's best interest must be central to ethical decision making at all times. However, the beneficence or nonmaleficence of potential therapies is seldom clear for any individual patient at the time of testing new therapies. Clinical randomized controlled trials are generally acknowledged by the scientific community as the 'gold standard' for evaluating interventions in health care. Therefore, ethical trial design is of the utmost importance. This paper explores contrasting ethical perspectives on how to select new interventions to treat neonatal encephalopathy after perinatal hypoxia-ischemia.
治疗性低温的成功临床转化带来了一种诱人的可能性，即通过将降温与其他神经保护药物相结合，可能进一步改善治疗效果。现在的挑战是从一系列令人望而生畏的潜在治疗方法中进行选择。患者的最大利益在任何时候都必须是伦理决策的核心。然而，在测试新疗法时，对于任何个体患者而言，潜在疗法的益处或无害性很少是明确的。临床随机对照试验通常被科学界公认为评估医疗保健干预措施的“金标准”。因此，符合伦理的试验设计至关重要。本文探讨了关于如何选择新的干预措施来治疗围产期缺氧缺血后新生儿脑病的不同伦理观点。
