'He is now like a brother, I can even give him some blood' - Relational ethics and material exchanges in a malaria vaccine 'trial community' in The Gambia
'He is now like a brother, I can even give him some blood' - Relational ethics and material exchanges in a malaria vaccine 'trial community' in The Gambia
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DOI：
10.1016/j.socscimed.2008.02.004
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发表时间：
2008-09-01
影响因子：
5.4
通讯作者：
Pool, Robert
中科院分区：
文献类型：
--
作者：
Geissler, P. Wenzel;Kelly, Ann;Pool, Robert
本文探讨了冈比亚医学研究委员会 (MRC) 于 2001 年至 2004 年间实施的疟疾疫苗试验 (MVT) 的“试验社区”（工作人员和志愿者）内的社会关系。它将医学研究的伦理问题置于科学实地工作的日常生活中。基于与志愿者和工作人员的讨论，我们探索了科学项目和研究人群之间以及正式伦理、当地伦理辩论和日常实践之间的调解过程。我们观察到物质接触和实质性交易，特别是血液和药品，是 MVT 建设的核心。这些交易以具体和相关的道德形式为指导，这与科学研究协议所依据的抽象和垂直的正式道德原则形成鲜明对比。 MVT 的成功很大程度上归功于这些亲属般的道德规范。从这些观察中得出的一个可能的结论是，研究伦理不仅应该被理解为一种准法律框架，而且还应该被理解为一种开放的、探索性的运动，就像亲属关系不仅仅是一种司法制度和规定性规则框架一样。而是通过关系工作建立的网络。然而，这一结论提出了新的问题：通过将正式的、抽象的原则与亲密的、直接的关系以及经济正义与个人道德进行对比，我们承认医学研究的秩序进一步脱离了公共和政治，进入了准法律主张或私人道德的领域。尽管明确的规则和良好的面对面关系具有不可否认的重要性，但医学研究伦理的第三个重要基础是民主构成的公共领域，包括公平的卫生服务和促进公开辩论和规范特殊利益的透明机构。最终，全球科学伦理呼吁既不依赖原则也不依赖信任，而是需要公民身份和民主政府。 (C) 2008 Elsevier Ltd. 保留所有权利。
This paper explores social relations within the 'trial community' (staff and volunteers) of a Malaria Vaccine Trial (MVT), implemented by the Medical Research Council (MRC) in The Gambia between 2001 and 2004. It situates ethical concerns with medical research within the everyday life of scientific fieldwork. Based upon discussions with volunteers and staff, we explore processes of mediation between scientific project and study population, and between formal ethics, local ethical debates and everyday practice. We observe that material contact and substantial transactions, notably of blood and medicine, are central to the construction of the MVT. These transactions are guided by a concrete and relational form of ethics, which contrasts with the abstract and vertical formal ethical principles underwriting the scientific study protocol. The success of the MVT owed much to these kinshiplike ethics. One possible conclusion from these observations is that research ethics should be understood, not just as a quasi-legal frame but also as an open, searching movement, much in the same way that kinship is not merely a juridical institution and a prescriptive frame of rules. but a network made through relational work. However, this conclusion raises new problems: by contrasting formal, abstract principles to intimate, immediate relations, and economic justice to personal morality, we accept that the order of medical research is moved further out of the public and political, and into the domains of either quasi-legal claims or of private morality. Irrespective of the undeniable importance of clear-cut rules and of good face-to-face relations, a third essential foundation of medical research ethics is the democratically constituted public sphere, including equitable health services, and transparent institutions to facilitate open debate and regulate particular interests. Ultimately, the ethics of global science call rely neither on principles nor trust but requires citizenship and democratic government. (C) 2008 Elsevier Ltd. All rights reserved.