Hastings Cent Rep. 2022 May;52(3):31-33. doi: 10.1002/hast.1394.
In "Compulsory Research in Learning Health Care: Against a Minimal Risk Limit," Robert Steel offers an argument in favor of compelling individuals to participate in some research that poses more than minimal risk. In his view, the ethics of compulsory research turns on questions of fair distribution of benefits and burdens, within a paradigm analogous to health care resource rationing. We do not dispute that it may theoretically be permissible to compel participation in certain circumstances, including those that rise above minimal risk. Nevertheless, Steel's argument for this conclusion faces several challenges that ultimately render it unconvincing in its present form. First, compulsion should be subject to a "necessity" criterion, which substantially limits its applicable scope. Second, compulsion is a prima facie rights violation that requires stronger ethical justification than Steel offers. And third, substantial structural and motivational differences between rationing and compulsion render the analogy inapt.
在《学习医疗保健中的强制研究：反对最小风险限制》一文中，罗伯特·斯蒂尔（Robert Steel）提出了一个论点，即赞成强制个人参与某些风险大于最小风险的研究。在他看来，强制研究的伦理学取决于在类似于医疗保健资源配给的范例内，利益和负担的公平分配问题。我们并不否认，在某些情况下，包括风险超过最小风险的情况下，理论上可能允许强制参与。然而，斯蒂尔提出这一结论的论点面临着几个挑战，这些挑战最终使其在目前的形式下缺乏说服力。首先，强制应该受到“必要性”标准的限制，这大大限制了其适用范围。其次，强制是一种表面上的权利侵犯，需要比斯蒂尔提供的更有力的伦理理由。第三，配给和强制之间存在实质性的结构和动机差异，使得这种类比不恰当。
