J Med Ethics. 2018 Jan;44(1):9-10. doi: 10.1136/medethics-2016-103843. Epub 2016 Nov 21.
In his article 'The Ebola Clinical Trials: a precedent for research ethics in disasters', Philippe Calain constructs a compelling case as to why and how experiences from the recent Ebola epidemic should be used to develop a framework for disaster research ethics. In particular, Calain proposes a useful model for assessing whether or not an unproven intervention could be suitable for human use in a disaster context, and makes a powerful argument against the separation of patient care from research goals. In this commentary, I argue that the separation of patient care goals from research goals is also unhelpful in the context of other forms of participant disadvantage even when that disadvantage is less severe than an ongoing public health emergency. I contend that recognising that research in disadvantaged populations is an intervention that could and should aim to produce positive outcomes for participants, just as it should in disaster contexts, therefore seems a well-justified lesson that can be extrapolated from the experience of the Ebola epidemic.
在他的文章《埃博拉临床试验：灾难研究伦理学的先例》中，Philippe Calain 令人信服地阐述了为什么以及如何利用最近的埃博拉疫情经验来制定灾难研究伦理学框架。特别是，Calain 提出了一个有用的模型，用于评估未经证实的干预措施是否适合在灾难情况下用于人类，并且强烈反对将患者护理与研究目标分开。在这篇评论中，我认为即使在参与者处于其他形式的劣势情况下，将患者护理目标与研究目标分开也无济于事，即使这种劣势不如正在发生的公共卫生紧急情况那么严重。我认为，认识到在弱势群体中进行研究是一种干预措施，它可以而且应该旨在为参与者带来积极的结果，就像在灾难情况下一样，因此这似乎是一个可以从埃博拉疫情经验中推断出来的合理教训。
