Scientific research is a moral duty
Scientific research is a moral duty
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DOI：
10.1136/jme.2005.011973
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发表时间：
2005-04-01
影响因子：
4.1
通讯作者：
Harris, J
中科院分区：
文献类型：
--
作者：
Harris, J
科学正受到攻击。特别是在欧洲、美洲和澳大拉西亚，科学家是怀疑的对象，处于守势。I‘’科学怪人‘’5-8是那些对科学的某些方面或科学家所说的某些滥用行为持反对意见的人的口头禅。然而，我们不应该忘记承担、支持和参与科学研究，特别是生物医学研究的强大义务，以及支撑这些义务的强大道德义务。现在比以往任何时候都更有必要阐明和解释这些义务，而这样做是本文件的主旨和客体。让我以最严厉的形式提出这个问题：在道义上，是否有义务从事、支持、甚至参与严肃的科学研究？如果有，这项义务是否不仅要求进行有益的研究，而且还要求“我们”、作为个人和作为社会的“我们”愿意在必要时支持甚至参与研究？到目前为止，这个问题给出的压倒性答案是‘不’，研究几乎普遍受到所有关心研究伦理和监管的人的怀疑，甚至是敌视。所谓的“预防方法”9概括了这种态度，要求认为危险比益处更有可能、更严重，并假定任何理智的人都不会或不应该参与研究，除非他们有紧迫的个人理由这样做，或者除非他们是完全出于客观的利他主义。国际协定和议定书--例如《赫尔辛基宣言》10和《国际IOMS指南》11--的主要目的是保护个人免受参与研究的危险，并确保他们在参与研究时得到充分知情同意。压倒性的假设一直是，而且仍然是，参与研究是一种过度夸张的行为，可能是鲁莽的行为，而不是义务。对医生和医学研究的怀疑是有充分依据的。在现代，它源于纳粹暴行的后果和最初的赫尔辛基宣言，尽管有点晚，但这是由纳粹医生在纽伦堡的审判引发的。12 13最近，又有更多的极端医学傲慢和家长作风的例子助长了这一现象。Tuskegee对未经治疗的梅毒的研究14--例如，在1932-1972年间，412名贫穷的非洲/美国男子故意不接受治疗，以便确定梅毒的自然历史。15即使当人们知道青霉素对梅毒有效时，他们也没有得到治疗。最近在英国发生了一起重大丑闻，引发了公众的想象力，反映了严重的医疗事故，涉及未经授权和欺骗性的尸检，并保留了儿童的器官和组织。16)有关此案的一些主要问题的评论，见我的论文《保留器官的法律和条例：伦理问题》。17)
Science is under attack. In Europe, America, and Australasia in particular, scientists are objects of suspicion and are on the defensive. i ‘‘Frankenstein science’’5–8 is a phrase never far from the lips of those who take exception to some aspect of science or indeed some supposed abuse by scientists. We should not, however, forget the powerful obligation there is to undertake, support, and participate in scientific research, particularly biomedical research, and the powerful moral imperative that underpins these obligations. Now it is more imperative than ever to articulate and explain these obligations and to do so is the subject and the object of this paper. Let me present the question in its starkest form: is there a moral obligation to undertake, support and even to participate in serious scientific research? If there is, does that obligation require not only that beneficial research be undertaken but also that ‘‘we’’, as individuals and ‘‘we’’as societies be willing to support and even participate in research where necessary? Thus far the overwhelming answer given to this question has been ‘‘no’’, and research has almost universally been treated with suspicion and even hostility by the vast majority of all those concerned with the ethics and regulation of research. The so called ‘‘precautionary approach’’9 sums up this attitude, requiring dangers to be considered more likely and more serious than benefits, and assuming that no sane person would or should participate in research unless they had a pressing personal reason for so doing, or unless they were motivated by a totally impersonal altruism. International agreements and protocols—for example, the Declaration of Helsinki10 and the CIOMS Guidelines11—have been directed principally at protecting individuals from the dangers of participation in research and ensuring that, where they participate, their full informed consent is assured. The overwhelming presumption has been and remains that participation in research is a supererogatory, and probably a reckless, act not an obligation.Suspicion of doctors and of medical research is well founded. In the modern era it stems from the aftermath of the Nazi atrocities and from the original Helsinki declaration prompted, although rather belatedly, by the Nazi doctors’ trial at Nuremberg. 12 13 More recently it has been fuelled by further examples of extreme medical arrogance and paternalism. The Tuskegee Study of Untreated Syphilis14—for example, in which 412 poor African/American men were deliberately left untreated from 1932–1972 so that the natural history of syphilis could be determined. 15 Even when it became known that penicillin was effective against syphilis they were left untreated. More recently in the UK a major scandal caught the public imagination and reflected serious medical malpractice, it involved the unauthorised and deceitful post-mortem removal and retention of organs and tissue from children. 16 (For a commentary on some of the major issues concerning this case see my paper, Law and regulation of retained organs: the ethical issues. 17)