Hastings Cent Rep. 2021 Mar;51(2):10-16. doi: 10.1002/hast.1235. Epub 2021 Mar 23.
Covid-19 has infected thousands and killed hundreds in prisons, jails, and immigration detention facilities across the United States. Responding to this crisis, leading medical researchers have called for expanding opportunities for people in prison to participate in vaccine trials. These calls, like current regulations, focus on individualized risk assessments around consent, coercion, and harm, while ignoring the unnaturalness of deprivation conditions in U.S. prisons. We need new frameworks of analysis that refocus on structural, rather than individual, risk assessments. Integrating structural perspectives-including skepticism of claims of scarcity, avoidance of representational distortions, and attention to institutional agency-into our existing, overly individualistic frameworks might permit the design of more ethical research projects involving people who are incarcerated. Still, the unnatural deprivations of incarceration might be so great that research subjects might need to be removed from prison entirely in order to ethically participate in research.
新冠病毒已感染了美国数千人,并导致数百人在监狱、拘留所和移民拘留所死亡。为应对这一危机,领先的医学研究人员呼吁扩大在押人员参与疫苗试验的机会。这些呼吁与当前的规定一样,侧重于围绕同意、强制和伤害的个体风险评估,而忽略了美国监狱剥夺条件的不自然性。我们需要新的分析框架,重新关注结构性,而不是个体性,风险评估。将结构视角——包括对稀缺性主张的怀疑、避免代表性扭曲,以及对机构代理的关注——纳入我们现有的、过于个人主义的框架中,可能会允许设计出更符合伦理的涉及被监禁者的研究项目。尽管如此,监禁的不自然剥夺可能是如此之大,以至于研究对象可能需要完全从监狱中移除,以便在道德上参与研究。