Department of Cardiology, Bern University Hospital, Bern, Switzerland.
Eur J Clin Invest. 2018 Apr;48(4). doi: 10.1111/eci.12896. Epub 2018 Feb 17.
In clinical medicine, the moral obligation to care for the individual patient is absolute. Patient care means at least and by negative terms to minimize any risk of treatment. In this context, the question arises about the compatibility of clinical ethics and human biomedical research ethics. Or conversely, is there a common ground between the two? At the opposite end of the field between clinical ethics and biomedical research ethics is the proposal of an obligation to participate in biomedical research, which is argued for on the basis of biomedical knowledge being a public good available to the community as a whole. While patient accrual during a clinical investigation would certainly be facilitated by obligatory research participation, and the data obtained would be-at first sight-more representative for the population studied, the still feasible refusal to participate would be stigmatizing and as such detrimental for the patient-physician relation. This essay seeks to provide a reply to the titled question by focusing on aspects such as individual vs common medical claims, shared grounds between the two and an important document of medical research ethics, that is the Nuremberg code.
在临床医学中，照顾个体患者的道德义务是绝对的。患者护理至少意味着，从消极意义上讲，要将任何治疗风险最小化。在这种情况下，就会出现临床伦理学与人类生物医学研究伦理学之间的兼容性问题。或者相反，两者之间是否有共同点？在临床伦理学和生物医学研究伦理学的领域的另一端，提出了参与生物医学研究的义务，这是基于生物医学知识作为一种公共利益，可供整个社区使用的论点。虽然在临床研究中通过强制参与研究肯定会更方便患者的入组，并且获得的数据对于所研究的人群来说在最初看来更具有代表性，但仍然可行的拒绝参与将是污名化的，并且因此对医患关系不利。本文试图通过关注个体与共同医疗诉求、两者之间的共同基础以及医学研究伦理学的一个重要文件，即纽伦堡法典等方面来回答这个问题。
