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德国、波兰和俄罗斯临床研究中知情同意的规范框架。

Normative framework of informed consent in clinical research in Germany, Poland, and Russia.

作者信息

Orzechowski Marcin, Woniak Katarzyna, Timmermann Cristian, Steger Florian

机构信息

Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany.

出版信息

BMC Med Ethics. 2021 May 1;22(1):53. doi: 10.1186/s12910-021-00622-6.

Abstract

BACKGROUND

Biomedical research nowadays is increasingly carried out in multinational and multicenter settings. Due to disparate national regulations on various ethical aspects, such as informed consent, there is the risk of ethical compromises when involving human subjects in research. Although the Declaration of Helsinki is the point of reference for ethical conduct of research on humans, national normative requirements may diverge from its provisions. The aim of this research is to examine requirements on informed consent in biomedical research in Germany, Poland, and Russia to determine how each national regulatory framework relates to the provisions of the Declaration of Helsinki.

METHODS

For this analysis, we conducted a search of the legal databases "Gesetze im Internet" for Germany, "Internetowy System Aktow Prawnych" for Poland, and "ГAPAHT - Garant" for Russia. The search was complemented by a review of secondary literature contained in the databases Google Scholar, PubMed, Polish National Library, and eLibrary.ru. We have identified 21 normative regulations containing provisions on informed consent in clinical research in all three countries. The content of these documents was systematically categorized and analyzed.

RESULTS

The normative framework in all three countries shows a strong commitment towards the core ethical principles of research envisaged in the Declaration of Helsinki. Nevertheless, provisions on informed consent vary between these three countries. The differences range from the method and language in which information should be provided, through the amount of information required to be disclosed, to the form of documenting consent or withdrawal. In the case of research on vulnerable groups, these differences are particularly visible.

CONCLUSIONS

The identified differences can negatively impact the ethical conduct of international clinical studies. Attention needs to be paid that flexibilities within national regulations are not misused to undermine the protection of research subjects. Achieving global or regional legislative harmonization might prove impossible. Such lack of legal consensus reinforces the significance of the international ethical agreements.

TRIAL REGISTRATION

Not applicable.

摘要

背景

如今,生物医学研究越来越多地在跨国和多中心环境中开展。由于各国在诸如知情同意等各种伦理方面的法规存在差异,在研究中涉及人类受试者时存在伦理妥协的风险。尽管《赫尔辛基宣言》是人类研究伦理行为的参考依据,但各国的规范性要求可能与其中的规定有所不同。本研究的目的是考察德国、波兰和俄罗斯生物医学研究中对知情同意的要求,以确定每个国家的监管框架与《赫尔辛基宣言》的规定之间的关系。

方法

为进行此项分析,我们搜索了德国的法律数据库“互联网法律”、波兰的“互联网法律文件系统”以及俄罗斯的“ГAPAHT - 担保”。通过对谷歌学术、PubMed、波兰国家图书馆和俄罗斯电子图书馆数据库中二次文献的综述对搜索进行补充。我们在所有三个国家中确定了21项包含临床研究知情同意规定的规范性法规。对这些文件的内容进行了系统分类和分析。

结果

所有三个国家的规范性框架都对《赫尔辛基宣言》所设想的研究核心伦理原则表现出坚定承诺。然而,这三个国家在知情同意的规定方面存在差异。这些差异涵盖了信息提供的方式和语言、所需披露信息的数量,以及同意或撤回同意的记录形式。在对弱势群体的研究中,这些差异尤为明显。

结论

所发现的差异可能会对国际临床研究的伦理行为产生负面影响。需要注意的是,国家法规中的灵活性不能被滥用,以免损害对研究受试者的保护。实现全球或区域立法协调可能是不可能的。这种法律共识的缺乏强化了国际伦理协议的重要性。

试验注册

不适用。

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