Brandt A M
Int J Health Serv. 1978;8(2):257-70. doi: 10.2190/37T3-TDH8-GLRT-WU5W.
This paper is an historical account of the discovery, testing, and early distribution of the Salk polio vaccine. The discovery posed fundamental dilemmas of medical research, pharmaceutical production, and public health. This paper assesses the ethical problems which arose, and examines critically their resolution. The National Foundation for Infantile Paralysis (March of Dimes) financed and directed the discovery of the vaccine, subsequent field trials, and early distribution. The Foundation's role is analyzed with special attention to the conflicts between its philanthropic and scientific functions. The reat public demand which the discovery of the vaccine generated created a need for federal control which was only partly met. The federal government did not have sufficient institutional and legal mechanisms to assure the safety of the vaccine and protect the public. This discussion illustrates the failure of the government to keep pace with medical technology.
本文是关于索尔克脊髓灰质炎疫苗的发现、测试及早期推广的历史记述。这一发现引发了医学研究、药品生产及公共卫生等方面的基本困境。本文评估了由此产生的伦理问题，并对其解决方案进行批判性审视。国家婴儿麻痹症基金会（美国疾病控制与预防中心）资助并指导了疫苗的发现、后续的现场试验及早期推广。基金会的作用得到分析，特别关注其慈善功能与科学功能之间的冲突。疫苗的发现所引发的巨大公众需求催生了对联邦管控的需求，但这一需求仅得到部分满足。联邦政府没有足够的制度和法律机制来确保疫苗的安全性并保护公众。这一讨论说明了政府在跟上医疗技术发展步伐方面的失败。
