Research using human tissues – a crisis of supply?
Research using human tissues – a crisis of supply?
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使用人体组织进行研究——供应危机？
作者：
P. Furness
这是一个悖论，追求道德实践有时会产生明显的不道德的结果。病理学家寻求研究患病的人体组织，以造福人类，但在英国，这一基本资源的可用性突然受到限制，据说是出于道德原因。这是由关于儿科尸检时不适当保留整个器官的负面宣传引发的，但反应已经蔓延到影响治疗性切除，诊断性活检甚至血液样本常规分析后剩余的“手术废物”的使用。将这些材料用于研究受到限制，将其用于教学和实验室质量控制也受到质疑。尽管公众舆论赞成使用这种“废物”材料进行研究;否则组织将被焚烧;直到最近，这些组织被认为是被病人“抛弃”的，但这种情况还是发生了。这篇评论试图描绘这种戏剧性的变化是如何发生的。然后，它考虑了一些伦理问题，在使用这种“多余”的组织，并提出了机制，这种宝贵的资源可以保持可用于大多数生物医学研究，同时保持或提高个体患者的自主权。这场危机表明，管理当局倾向于采用限制性很强、过于简单的规则，而不适当考虑每个项目的特点。其动机是避免媒体批评的可能性，尽管这些规则阻碍了对所有人都有价值的道德上合理的工作，包括理应寻求保护的个人。道德需要逻辑伦理的论点，而不是这样的“一刀切”的规定强调。版权所有© 2001约翰威利父子有限公司。
It is a paradox that the pursuit of ethical practice can sometimes produce distinctly unethical results. Pathologists seek to study diseased human tissues for the benefit of mankind, but in the UK there has been a sudden restriction in the availability of this basic resource, supposedly on ethical grounds. This was triggered by adverse publicity about the inappropriate retention of whole organs at paediatric post‐mortem, but the reaction has spread to influence the use of ‘surgical waste’ left over after routine analysis of therapeutic resections, diagnostic biopsies, and even blood samples. The use of such material for research is being restricted, and its use in teaching and laboratory quality control is being questioned. This has occurred despite the facts that public opinion favours using such ‘waste’ material for research; that the tissues would otherwise be incinerated; and that until very recently, such tissues were regarded as having been ‘abandoned’ by the patient. This review attempts to chart how this dramatic change has occurred. It then considers some of the ethical problems in using such ‘surplus’ tissues and proposes mechanisms by which this valuable resource can remain available for most biomedical research, while maintaining or enhancing the autonomy of individual patients. This crisis has shown a tendency for regulatory authorities to apply very restrictive, oversimplified rules, without due consideration of the character of each project. The motivation is to avoid the possibility of media criticism, even though such rules block ethically sound work which is of value to all, including the individuals whose protection is supposedly being sought. The moral need for logical ethical arguments instead of such ‘one size fits all’ regulations is emphasized. Copyright © 2001 John Wiley & Sons, Ltd.