Müller-Oerlinghausen B
Int J Clin Pharmacol Biopharm. 1978 Oct;16(10):443-50.
The present article originates from some intriguing problems which the author, working as a clinical pharmacologist and psychiatrist, was faced with during clinical investigations. Practical difficulties appearing at first glance as of a rather methodological nature often reveal themselves as ethical questions. Investigation of psychotropic drugs in normal volunteers as well as in psychiatric patients is taken as a model to exemplify certain fundamental ethical aspects of medical research. It is emphasized that the "solution" of ethical problems cannot be achieved by referring to a given code of norms which themselves depend on certain historical circumstances, but rather by recognizing and reasoning the conflicts which result from various moral maxims. Clinical psychopharmacology should not only be conscious of its methodological shortcomings and future goals but also accept the justification of discussions about the ethical and legal questions involved in its dealings and take an active part in these debates. With regard to the relationship between patient and investigator, "solidarity" [23] instead of ongoing paternalism or legal formalism, appears to be a realistic goal. This is also true in the area of psychopharmacological research.
本文源于作者作为临床药理学家和精神科医生在临床研究过程中所面临的一些有趣问题。乍一看似乎具有相当方法学性质的实际困难，往往会暴露出其伦理问题的本质。以在正常志愿者和精神科患者中对精神药物进行研究为例，阐述医学研究中某些基本的伦理问题。需要强调的是，伦理问题的“解决”不能通过参照本身依赖于特定历史背景的既定规范准则来实现，而应通过认识和思考由各种道德准则引发的冲突来达成。临床精神药理学不仅应意识到其方法学上的不足和未来目标，还应接受对其研究中涉及的伦理和法律问题进行讨论的合理性，并积极参与这些辩论。就患者与研究者之间的关系而言，“团结”[23]而非持续的家长式作风或法律形式主义，似乎是一个现实的目标。这在精神药理学研究领域也是如此。
