Societal and ethical issues in human biomonitoring--a view from science studies.
Societal and ethical issues in human biomonitoring--a view from science studies.
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DOI：
10.1186/1476-069x-7-s1-s10
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发表时间：
2008-06-05
期刊：
影响因子：
--
通讯作者：
Bauer S
中科院分区：
文献类型：
--
作者：
Bauer S
人体生物监测（HBM）的重要性迅速增加。在一些流行病学研究中，测量和使用暴露、易感性和疾病的生物标志物取代了传统的环境指标。虽然在HBM中，伦理问题主要是在知情同意和保密方面得到解决，但本文从认识论的角度绘制了一系列更大的社会问题，即关注环境健康科学中如何和什么是已知的。为了分析HBM的影响以及在更广泛的社会背景下环境污染评估中向生物标志物研究的转变，介绍了科学研究的选定分析框架。为了发展认识论的观点，从“生物医学平台社会学”的概念和“认知文化”和“思维风格”的概念被应用到HBM的研究基础设施。此外，“生物公民”和“公民认识论”的概念被作为分析工具来讨论HBM的愿景和承诺以及相关的伦理问题。在人类生物监测中，两种不同的认识论文化相遇;一方面是环境科学，例如污染调查和毒理学评估，另一方面是分析流行病学，调查概率风险估计中暴露与疾病之间的联系。HBM中设想的通过生物标志物监测暴露和剂量正在将暴露监测的地点转移到人体。建立HBM平台不仅需要考虑个人决策自主性作为一个伦理问题，而且还需要考虑更大的认识论和社会问题，例如科学，政策和法规所需的证据模式。接触监测向人口生物监测的转变涉及到环境、健康和疾病概念化方式的根本变化;这可能导致健康风险和预防行动责任的个体化。关注科学知识产生的条件及其更广泛的社会背景对于HBM为环境正义做出贡献至关重要。
Human biomonitoring (HBM) has rapidly gained importance. In some epidemiological studies, the measurement and use of biomarkers of exposure, susceptibility and disease have replaced traditional environmental indicators. While in HBM, ethical issues have mostly been addressed in terms of informed consent and confidentiality, this paper maps out a larger array of societal issues from an epistemological perspective, i.e. bringing into focus the conditions of how and what is known in environmental health science. In order to analyse the effects of HBM and the shift towards biomarker research in the assessment of environmental pollution in a broader societal context, selected analytical frameworks of science studies are introduced. To develop the epistemological perspective, concepts from "biomedical platform sociology" and the notion of "epistemic cultures" and "thought styles" are applied to the research infrastructures of HBM. Further, concepts of "biocitizenship" and "civic epistemologies" are drawn upon as analytical tools to discuss the visions and promises of HBM as well as related ethical problematisations. In human biomonitoring, two different epistemological cultures meet; these are environmental science with for instance pollution surveys and toxicological assessments on the one hand, and analytical epidemiology investigating the association between exposure and disease in probabilistic risk estimation on the other hand. The surveillance of exposure and dose via biomarkers as envisioned in HBM is shifting the site of exposure monitoring to the human body. Establishing an HBM platform faces not only the need to consider individual decision autonomy as an ethics issue, but also larger epistemological and societal questions, such as the mode of evidence demanded in science, policy and regulation. The shift of exposure monitoring towards the biosurveillance of human populations involves fundamental changes in the ways environment, health and disease are conceptualised; this may lead to an individualisation of responsibilities for health risks and preventive action. Attention to the conditions of scientific knowledge generation and to their broader societal context is critical in order to make HBM contribute to environmental justice.