Department of Public Health, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Santa Catarina, Brazil.
Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Quebec, Canada.
Arch Med Res. 2020 Aug;51(6):572-573. doi: 10.1016/j.arcmed.2020.04.017. Epub 2020 Apr 29.
A TV debate in April 2020 between two French doctors regarding the benefits of testing a coronavirus vaccine in Africa where there are no masks or treatments available has led to international criticism. This case highlights a problematic ethical double standard in multinational clinical research: trials that would be considered unethical in high income countries (e.g., placebo-controlled where there is an existing treatment) are nonetheless justified in low-and-middle-income countries because the existing standards of care are less (i.e., no access to a treatment). Underlying this ethical double standard in some multinational clinical trials is a moral imperialism and persistent colonialist thinking that must be rejected.
2020 年 4 月,两位法国医生在电视辩论中讨论了在没有口罩和治疗方法的情况下在非洲测试冠状病毒疫苗的好处,这引发了国际批评。这一案例突显了跨国临床研究中存在的一个有问题的伦理双重标准:在高收入国家,某些临床试验被认为是不道德的(例如,在存在现有治疗方法的情况下进行安慰剂对照试验),但在中低收入国家却是合理的,因为这些国家的现有护理标准较低(即无法获得治疗)。在一些跨国临床试验中存在这种伦理双重标准的背后,是一种必须摒弃的道德帝国主义和持久的殖民主义思维。