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数据密集型健康研究的社会许可:走向共同创造、公共价值和信任。

The social licence for data-intensive health research: towards co-creation, public value and trust.

机构信息

Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands.

出版信息

BMC Med Ethics. 2021 Aug 10;22(1):110. doi: 10.1186/s12910-021-00677-5.

Abstract

BACKGROUND

The rise of Big Data-driven health research challenges the assumed contribution of medical research to the public good, raising questions about whether the status of such research as a common good should be taken for granted, and how public trust can be preserved. Scandals arising out of sharing data during medical research have pointed out that going beyond the requirements of law may be necessary for sustaining trust in data-intensive health research. We propose building upon the use of a social licence for achieving such ethical governance.

MAIN TEXT

We performed a narrative review of the social licence as presented in the biomedical literature. We used a systematic search and selection process, followed by a critical conceptual analysis. The systematic search resulted in nine publications. Our conceptual analysis aims to clarify how societal permission can be granted to health research projects which rely upon the reuse and/or linkage of health data. These activities may be morally demanding. For these types of activities, a moral legitimation, beyond the limits of law, may need to be sought in order to preserve trust. Our analysis indicates that a social licence encourages us to recognise a broad range of stakeholder interests and perspectives in data-intensive health research. This is especially true for patients contributing data. Incorporating such a practice paves the way towards an ethical governance, based upon trust. Public engagement that involves patients from the start is called for to strengthen this social licence.

CONCLUSIONS

There are several merits to using the concept of social licence as a guideline for ethical governance. Firstly, it fits the novel scale of data-related risks; secondly, it focuses attention on trustworthiness; and finally, it offers co-creation as a way forward. Greater trust can be achieved in the governance of data-intensive health research by highlighting strategic dialogue with both patients contributing the data, and the public in general. This should ultimately contribute to a more ethical practice of governance.

摘要

背景

大数据驱动的健康研究的兴起挑战了医学研究对公共利益的假定贡献,这引发了一些问题,例如,此类研究作为公共利益的地位是否应该被视为理所当然,以及如何维护公众信任。在医学研究中数据共享引发的丑闻表明,为了维持对数据密集型健康研究的信任,超越法律要求可能是必要的。我们建议在此基础上建立社会许可,以实现这种道德治理。

主要文本

我们对生物医学文献中提出的社会许可进行了叙述性综述。我们使用了系统的搜索和选择过程,然后进行了批判性的概念分析。系统搜索产生了九篇出版物。我们的概念分析旨在阐明如何授予依赖于健康数据的再利用和/或链接的健康研究项目社会许可。这些活动可能在道德上有要求。对于这些类型的活动,可能需要在法律之外寻求道德合法化,以维护信任。我们的分析表明,社会许可鼓励我们在数据密集型健康研究中承认广泛的利益相关者利益和观点。对于贡献数据的患者来说尤其如此。这种做法为基于信任的伦理治理铺平了道路。需要从一开始就让患者参与公众参与,以加强这种社会许可。

结论

使用社会许可概念作为伦理治理指南有几个优点。首先,它适用于与数据相关的风险的新型规模;其次,它关注可信度;最后,它提供了共创的前进道路。通过突出与数据贡献者患者和公众的战略对话,可以在数据密集型健康研究的治理中实现更大的信任。这最终应该有助于更符合伦理的治理实践。

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