Shifting from Equality toward Equity: Addressing Disparities in Research Participation for Clinical Cancer Research.

Shifting from Equality toward Equity: Addressing Disparities in Research Participation for Clinical Cancer Research.
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从平等转向公平:解决临床癌症研究的研究参与差异。

DOI:
10.1086/728144
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发表时间:
2024
期刊:
The Journal of clinical ethics
影响因子:
--
通讯作者:
Hantel,Andrew
Hantel,Andrew
中科院分区:
--
文献类型:
--
作者:
Warner,Elizabeth;Marron,JonathanM;Peppercorn,JeffreyM;Abel,GregoryA;Hantel,Andrew

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有社会共识,癌症临床试验参与是不公平的,因为一些社会人口群体一直系统性地代表不足。尽管如此,在这种背景下,公平的正义规范的定义和伦理解释都没有明确阐述,导致其应用和目标的混乱。在这里,我们将公平定义为承认社会人口状况,分配资源和机会,以消除结果的差异,我们通过实际例子探讨这一规范产生的问题和紧张局势。我们评估了临床癌症研究中基于平等的招生结构如何延续历史差异,以及基于平等的替代方案对于实现临床癌症研究中的代表性和参与性正义的扩展概念是必要的。该框架通过定义公平的正义规范并将其转化为解决临床癌症研究中参与差异的实际策略,解决了从规范到应用的广度。
There is societal consensus that cancer clinical trial participation is unjust because some sociodemographic groups have been systematically underrepresented. Despite this, neither a definition nor an ethical explication for the justice norm of equity has been clearly articulated in this setting, leading to confusion over its application and goals. Herein we define equity as acknowledging sociodemographic circumstances and apportioning resource and opportunity allocation to eliminate disparities in outcomes, and we explore the issues and tensions this norm generates through practical examples. We assess how equality-based enrollment structures in clinical cancer research have perpetuated historical disparities and what equity-based alternatives are necessary to achieve representativeness and an expansive conception of participatory justice in clinical cancer research. This framework addresses the breadth from normative to applied by defining the justice norm of equity and translating it into practical strategies for addressing participation disparities in clinical cancer research.
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