Buchak Lara
J Med Ethics. 2017 Feb;43(2):90-95. doi: 10.1136/medethics-2015-103118. Epub 2016 Jun 30.
Some early phase clinical studies of candidate HIV cure and remission interventions appear to have adverse medical risk-benefit ratios for participants. Why, then, do people participate? And is it ethically permissible to allow them to participate? Recent work in decision theory sheds light on both of these questions, by casting doubt on the idea that rational individuals prefer choices that maximise expected utility, and therefore by casting doubt on the idea that researchers have an ethical obligation not to enrol participants in studies with high risk-benefit ratios. This work supports the view that researchers should instead defer to the considered preferences of the participants themselves. This essay briefly explains this recent work, and then explores its application to these two questions in more detail.
一些针对潜在的HIV治愈和缓解干预措施的早期临床研究，对参与者而言似乎具有不利的医学风险效益比。那么，为什么人们还要参与呢？允许他们参与在伦理上是否可行？决策理论的最新研究为这两个问题提供了启示，它对理性个体更倾向于选择能使预期效用最大化的观点提出了质疑，进而也对研究人员有道德义务不让参与者参加风险效益比高的研究这一观点提出了质疑。这项研究支持了这样一种观点，即研究人员应该转而尊重参与者自身经过深思熟虑的偏好。本文简要解释了这项最新研究，然后更详细地探讨了其在这两个问题上的应用。
