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临床试验中的归纳总结——仿制药是有益还是有害?

Generalizations in Clinical Trials-Do Generics Help Or Harm?

作者信息

Chin-Yee Benjamin

出版信息

Kennedy Inst Ethics J. 2023;33(4):359-400. doi: 10.1353/ken.2023.a931051.

Abstract

Generalizations in medical research can be informative, but also misleading. Building on recent work in the philosophy of science and ethics of communication, I offer a novel analysis of common generalizations in clinical trials as generics in natural language. Generics, which express generalizations without terms of quantification, have attracted considerable attention from philosophers, psychologists, and linguists. My analysis draws on probabilistic and contextual features of generics to diagnose how these generalizations function and malfunction across communicative contexts in medicine. Given a high risk of misinterpretation ("slippage"), I recommend avoidance of generic claims about medical interventions in public contexts, exemplified by clinical trials and medical research more generally. Generics should only be used with vigilance in private contexts, exemplified by the physician-patient encounter. My analysis provides tools to support vigilance when communicating with generics, suggests new norms for public science communication, and raises deeper questions in the ethics of clinical communication.

摘要

医学研究中的概括可能具有启发性,但也可能产生误导。基于科学哲学和传播伦理学的最新研究成果,我对临床试验中常见的概括进行了新颖的分析,将其视为自然语言中的类属句。类属句在不使用量化词的情况下表达概括,已经引起了哲学家、心理学家和语言学家的广泛关注。我的分析借助类属句的概率和语境特征,来诊断这些概括在医学交流语境中的作用方式以及出现的问题。鉴于存在较高的误解风险(“偏差”),我建议在公共语境中避免使用关于医学干预的类属句表述,临床试验及更广泛的医学研究就是典型例子。类属句仅应在私人语境中谨慎使用,医患交流就是典型例子。我的分析提供了在使用类属句进行交流时保持警惕的工具,提出了公共科学传播的新规范,并引发了临床交流伦理学中更深层次的问题。

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