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超越伦理准则:在健康与医学研究中维护原住民及托雷斯海峡岛民的伦理治理。一项范围综述。

Beyond ethical guidelines: upholding Aboriginal and Torres Strait Islander ethical governance in health and medical research. A scoping review.

作者信息

Collis Felicity, Booth Kade, Bryant Jamie, Kennedy Michelle

机构信息

University of Newcastle, Newcastle, NSW.

出版信息

Med J Aust. 2025 Feb 3;222 Suppl 2:S42-S48. doi: 10.5694/mja2.52564.

Abstract

OBJECTIVES

To examine what ethics approvals are being sought for Aboriginal and Torres Strait Islander health and medical research, and to determine what proportion of this research upholds Aboriginal and Torres Strait Islander ethical governance via an Aboriginal and Torres Strait Islander community-controlled human research ethics committee (AHREC) by jurisdiction and funding body type.

STUDY DESIGN

Scoping review of all original, peer-reviewed health and medical literature published over a 5-year period (January 2018 to December 2022).

DATA SOURCES

Extending on a previous review, the search tool LIt.search was used to access all literature relating to Aboriginal and Torres Strait Islander health and medical research.

RESULTS

589 eligible publications were included from the parent review, and a further 1703 publications were identified from the updated search. A total of 945 publications were included. A substantial number of ethics approvals were obtained from government-based ethics committees (394, 41.7%). More than half of the publications reported obtaining institutional ethics approval (514, 54.4%). Less than half (400, 42.3%) reported obtaining AHREC approval. Almost one-third of publications were on research that was conducted in states or territories where there is no AHREC (334, 35.3%). Publications did not always report obtaining AHREC approvals, including in jurisdictions where one operates.

CONCLUSIONS

We found a concerning lack of Aboriginal and Torres Strait Islander ethical governance reported in health and medical research. Acknowledging that Aboriginal and Torres Strait Islander ethics guidelines and AHRECs were established due to harm caused to communities, these results suggest a high risk, with research not consistently being deemed safe, respectful and beneficial with appropriate AHREC ethics review and approval. We join calls for the establishment of AHRECs in all jurisdictions and nationally. Furthermore, we urge funding bodies and institutions to uphold requirements for Aboriginal and Torres Strait Islander ethical governance in research and funding agreements, as well as institutional policies and procedures.

摘要

目的

研究针对原住民和托雷斯海峡岛民健康与医学研究正在寻求哪些伦理批准,并按司法管辖区和资助机构类型确定通过原住民和托雷斯海峡岛民社区控制的人类研究伦理委员会(AHREC)进行的此类研究中,坚持原住民和托雷斯海峡岛民伦理治理的研究比例。

研究设计

对5年期间(2018年1月至2022年12月)发表的所有原创、同行评审的健康与医学文献进行范围综述。

数据来源

在前一项综述的基础上,使用搜索工具LIt.search获取所有与原住民和托雷斯海峡岛民健康与医学研究相关的文献。

结果

母综述纳入了589篇符合条件的出版物,更新搜索又识别出1703篇出版物。总共纳入了945篇出版物。大量伦理批准来自政府设立的伦理委员会(394项,41.7%)。超过一半的出版物报告获得了机构伦理批准(514项,54.4%)。不到一半(即400项,42.3%)报告获得了AHREC批准。近三分之一的出版物涉及在没有AHREC的州或领地开展的研究(334项,35.3%)。出版物并不总是报告获得了AHREC批准,包括在设有AHREC的司法管辖区也是如此。

结论

我们发现健康与医学研究中报告的原住民和托雷斯海峡岛民伦理治理存在令人担忧的缺失。鉴于原住民和托雷斯海峡岛民伦理准则及AHREC是因对社区造成的伤害而设立的,这些结果表明风险很高,因为研究在没有经过适当的AHREC伦理审查和批准的情况下,并不总是被视为安全、尊重和有益的。我们响应在所有司法管辖区和全国范围内设立AHREC的呼吁。此外,我们敦促资助机构和机构在研究与资助协议以及机构政策和程序中坚持对原住民和托雷斯海峡岛民伦理治理的要求。

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