Wendler David, Rid Annette
Bioethics. 2017 Feb;31(2):77-86. doi: 10.1111/bioe.12325.
Many guidelines and commentators endorse the view that clinical research is ethically acceptable only when it has social value, in the sense of collecting data which might be used to improve health. A version of this social value requirement is included in the Declaration of Helsinki and the Nuremberg Code, and is codified in many national research regulations. At the same time, there have been no systematic analyses of why social value is an ethical requirement for clinical research. Recognizing this gap in the literature, recent articles by Alan Wertheimer and David Resnik argue that the extant justifications for the social value requirement are unpersuasive. Both authors conclude, contrary to almost all current guidelines and regulations, that it can be acceptable across a broad range of cases to conduct clinical research which is known prospectively to have no social value. The present article assesses this conclusion by critically evaluating the ethical and policy considerations relevant to the claim that clinical research must have social value. This analysis supports the standard view that social value is an ethical requirement for the vast majority of clinical research studies and should be mandated by applicable guidelines and policies.
许多指导方针和评论家都赞同这样一种观点,即临床研究只有在具有社会价值时才在伦理上是可接受的,这里的社会价值是指收集可能用于改善健康的数据。《赫尔辛基宣言》和《纽伦堡法典》都包含了这种社会价值要求的一个版本,并且在许多国家的研究法规中都有明确规定。与此同时,对于为什么社会价值是临床研究的一项伦理要求,还没有系统的分析。认识到文献中的这一空白,艾伦·韦特海默和大卫·雷斯尼克最近的文章认为,目前对社会价值要求的正当理由缺乏说服力。两位作者都得出结论,与几乎所有现行的指导方针和法规相反,在广泛的案例中,开展前瞻性地已知没有社会价值的临床研究可能是可以接受的。本文通过批判性地评估与临床研究必须具有社会价值这一主张相关的伦理和政策考量来评估这一结论。这一分析支持了标准观点,即社会价值是绝大多数临床研究的一项伦理要求,并且应该由适用的指导方针和政策来规定。