Henden Edmund
Bioethics. 2016 May;30(4):293-8. doi: 10.1111/bioe.12208. Epub 2015 Sep 30.
In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not - in contrast with a common assumption in the bioethics literature - depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person makes even if they do possess a capacity for self-control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position.
在本期刊之前的一篇文章中，我认为，与生物伦理学文献中的一个常见假设相反，海洛因成瘾者是否能够自愿同意参与一项研究（该研究涉及让他们选择免费获取海洛因），并不完全取决于他们是否有能力抵制对海洛因的欲望。在某些情况下，即使一个人确实具备自我控制能力，环境和信念也可能会削弱其选择的自愿性。基于我认为合理的自愿性定义，我认为许多易受伤害的海洛因成瘾者的典型环境和信念使我们有充分理由怀疑，即使假定他们对海洛因的欲望并非不可抗拒，他们也无法自愿同意参与此类研究。在本期刊最近的一篇文章中，乌西塔洛和布罗斯对此提出反对，理由是我错误地描述了海洛因成瘾者的选项集，我所依赖的自愿性定义不现实且要求过高，更普遍地说，我对海洛因成瘾的看法存在缺陷。我认为他们的论点源于对我在文章中表达的观点的误解。因此，在接下来的内容中，我希望能阐明我的立场。
