Winkler Eva C, Jungkunz Martin, Thorogood Adrian, Lotz Vincent, Schickhardt Christoph
Section for Translational Medical Ethics, Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
Section for Translational Medical Ethics, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.
J Med Ethics. 2025 Apr 24;51(5):jme-2022-108781. doi: 10.1136/jme-2022-108781.
Research using data from medical care promises to advance medical science and improve healthcare. Academia is not the only sector that expects such research to be of great benefit. The research-based health industry is also interested in so-called 'real-world' health data to develop new drugs, medical technologies or data-based health applications. While access to medical data is handled very differently in different countries, and some empirical data suggest people are uncomfortable with the idea of companies accessing health information, this paper aims to advance the ethical debate about secondary use of medical data generated in the public healthcare sector by for-profit companies for medical research (ReuseForPro).
We first clarify some basic concepts and our ethical-normative approach, then discuss and ethically evaluate potential claims and interests of relevant stakeholders: patients as data subjects in the public healthcare system, for-profit companies, the public, and physicians and their healthcare institutions. Finally, we address the tensions between legitimate claims of different stakeholders in order to suggest conditions that might ensure ethically sound ReuseForPro.
We conclude that there are good reasons to grant for-profit companies access to medical data if they meet certain conditions: among others they need to respect patients' informational rights and their actions need to be compatible with the public's interest in health benefit from ReuseForPro.
利用医疗保健数据进行的研究有望推动医学科学发展并改善医疗保健。学术界并非唯一期望此类研究能带来巨大益处的领域。以研究为基础的健康产业也对所谓的“真实世界”健康数据感兴趣,以开发新药、医疗技术或基于数据的健康应用程序。虽然不同国家在获取医疗数据方面的处理方式差异很大,并且一些实证数据表明人们对公司获取健康信息的想法感到不安,但本文旨在推进关于营利性公司将公共医疗保健部门生成的医疗数据用于医学研究(再利用用于营利)的二次使用的伦理辩论。
我们首先阐明一些基本概念和我们的伦理规范方法,然后讨论并从伦理角度评估相关利益相关者的潜在主张和利益:作为公共医疗保健系统中数据主体的患者、营利性公司、公众以及医生及其医疗机构。最后,我们解决不同利益相关者合法主张之间的紧张关系,以提出可能确保再利用用于营利符合伦理道德的条件。
我们得出结论,如果营利性公司满足某些条件,就有充分理由允许它们获取医疗数据:其中包括它们需要尊重患者的信息权利,并且其行为需要与公众从再利用用于营利中获得健康益处的利益相一致。