Departments of Bioethics.
Biostatistics and Clinical Epidemiology Service, National Institutes of Health Clinical Center, Bethesda, Maryland.
Pediatrics. 2022 Jan 1;149(1). doi: 10.1542/peds.2021-052687.
Critics argue that it is unethical to expose children to research risks for the benefit of others, whereas many regulations permit "net-risk" pediatric research but only when the risks are minimal. In the present survey, we assessed whether the US public agrees with these views and whether the US public's views regarding the acceptability of net-risk pediatric research are influenced by its social value.
A 15-minute survey of a nationally representative sample of US adults. Participants were randomly assigned to 1 of 4 hypothetical scenarios involving procedures that pose increasing levels of risk. To assess whether respondents' views on the acceptability of the risks is influenced by the social value of the research, in each of the 4 scenarios we described the respective procedure being used in 3 studies with increasing levels of social value.
A total 1658 of the 2508 individuals who were sent the survey link participated (response rate = 66.1%). Approximately 91% approved of a research blood draw in minors, and ∼69% approved of a research bone marrow biopsy. The proportion who indicated that the respective procedure was acceptable increased as the study's social value increased. This effect was significantly stronger for studies which pose greater risks compared with studies with lower risks (P < .001).
The vast majority of the US public supports net-risk pediatric research that poses minimal risk, and a majority supports net-risk pediatric research that poses somewhat greater risks, provided it has high social value. These findings offer important information for assessing when it is acceptable to conduct net-risk pediatric research.
批评者认为,让儿童为了他人的利益而承受研究风险是不道德的,而许多法规允许进行“净风险”儿科研究,但前提是风险极小。在本研究中,我们评估了美国公众是否同意这些观点,以及美国公众对净风险儿科研究可接受性的看法是否受到其社会价值的影响。
对美国成年人进行了一项全国代表性样本的 15 分钟调查。参与者被随机分配到 4 个假设情景中的 1 个,这些情景涉及风险逐渐增加的程序。为了评估受访者对风险可接受性的看法是否受到研究社会价值的影响,在 4 个情景中的每一个中,我们描述了各自的程序正在用于社会价值逐渐增加的 3 项研究中。
在收到调查链接的 2508 人中,共有 1658 人参与了调查(回应率=66.1%)。大约 91%的人赞成在未成年人中进行研究性采血,约 69%的人赞成进行研究性骨髓活检。随着研究的社会价值增加,表明该程序可以接受的比例增加。与风险较低的研究相比,这种效果在风险较高的研究中更为明显(P<.001)。
绝大多数美国公众支持风险极小的净风险儿科研究,大多数人支持风险略高的净风险儿科研究,前提是其具有较高的社会价值。这些发现为评估何时进行净风险儿科研究是可接受的提供了重要信息。