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Beyond Regulations Ethics in Human Subject Research超越规范伦理在人类主体的研究
March 2009 HRPP 201 Beyond Regulations: Ethics in Human Subject Research Beyond Regulations: Ethical Considerations in Research Presented by: Marisue Cody, PhD Deputy Director, PRIDE Objectives Describe the ethical underpinnings of human subjects protection Discuss how regulations do not address all concerns regarding human subjects protection Nazi experiments Used unconsenting concentration camp victims as subjects and subjected them to great pain, suffering, disfigurement, and death These were not therapeutic trials. The Nuremberg Code Set of ethical principles developed by U.S. military tribunal post WWII (1949) Consent Right to withdraw Weighing of risks and benefits Thalidomide tragedy Use in pregnant women resulted in thousands of babies born with digits or limbs Lead to 1962 Drug Amendments Act – prove efficacy not just safety The Declaration of Helsinki Issued by the World Medical Association (1964, amended 5x, 2000 most recent) Well-being of the human subject should take precedence over the interests of science and society Physician’s responsibility is to safeguard the health of the people Medical research should be subject to review, approval, and oversight of an independent ethics committee Studies identified by Henry Beecher NEJM 1966 – review of 22 unethical published studies including: Jewish Chronic Disease Hospital case: injected live cancer cells into patients without informing them Willowbrook case: injected isolated strains of hepatitis into institutionalized mentally retarded children to understand the natural history of the disease and effects of gamma globulin U.S. PHS syphilis study at Tuskegee 40-year research study designed to gain an understanding of the natural history of untreated latent syphilis During course of study, penicillin was identified to be effective treatment but subjects denied access to treatment National Research Act Mandated regulations to protect human subjects Created National Commission to examine ethical
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