Pratt Bridget, Hyder Adnan A
Bioethics. 2017 Jul;31(6):454-466. doi: 10.1111/bioe.12350. Epub 2017 Apr 3.
This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics - namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders' decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny.
本文提请注意,关于单个资助者在卫生研究资源分配中何为公平与公正的学术研究数量有限。它确定了研究资助者在资源分配方面经常做出的三个具有伦理意义的关键决策,并呼吁优先开展关于这些主题的学术研究——即,卫生资源应如何在公共卫生、医疗服务与卫生研究之间公平分配,卫生研究资源应如何在本国所面临的健康问题与资助者国家以外弱势群体通常面临的其他健康问题之间公平分配,以及国内和非国内卫生研究资金应如何进一步分配到不同领域,如研究类型和受助者。这三个主题应成为生物伦理学研究的重点,因为其结果对实现卫生公平有着重大影响。拟议的议程旨在推动关于卫生研究资助伦理的讨论,使其超越目前对全球基础研究和临床研究投资与全球疾病负担之间不匹配问题的关注。单个资助者关于是否以及在何种程度上向非国内卫生研究、卫生系统研究、健康社会决定因素研究、能力发展以及某些国家的受助者分配资源的决策,也应成为伦理审查的重点。