Section of Legal Medicine, Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, 56124 Pisa, Italy.
Int J Mol Sci. 2019 Oct 18;20(20):5170. doi: 10.3390/ijms20205170.
Neurodegenerative diseases (NDs) represent one of the most important public health problems and concerns, as they are a growing cause of mortality and morbidity worldwide, particularly in the elderly. Despite remarkable breakthroughs in our understanding of NDs, there has been little success in developing effective therapies. The use of natural products may offer great potential opportunities in the prevention and therapy of NDs; however, many clinical concerns have arisen regarding their use, mainly focusing on the lack of scientific support or evidence for their efficacy and patient safety. These clinical uncertainties raise critical questions from a bioethical and legal point of view, as considerations relating to patient decisional autonomy, patient safety, and beneficial or non-beneficial care may need to be addressed. This paper does not intend to advocate for or against the use of natural products, but to analyze the ethical framework of their use, with particular attention paid to the principles of biomedical ethics. In conclusion, the notable message that emerges is that natural products may represent a great promise for the treatment of many NDs, even if many unknown issues regarding the efficacy and safety of many natural products still remain.
神经退行性疾病（NDs）是最重要的公共卫生问题之一，也是全世界，尤其是老年人死亡率和发病率上升的主要原因。尽管我们对 NDs 的认识有了显著的突破，但在开发有效的治疗方法方面却收效甚微。天然产物的使用可能为 NDs 的预防和治疗提供巨大的潜力机会；然而，其使用引发了许多临床关注，主要集中在缺乏科学支持或证据来证明其疗效和患者安全性。这些临床上的不确定性从生物伦理和法律的角度提出了关键问题，因为需要考虑与患者决策自主性、患者安全以及有益或无益护理相关的问题。本文并非旨在提倡或反对使用天然产物，而是分析其使用的伦理框架，特别关注生物医学伦理的原则。总之，一个显著的信息是，天然产物可能为许多 NDs 的治疗带来巨大的希望，尽管许多关于许多天然产物的疗效和安全性的未知问题仍然存在。
