Ethical issues in perinatal mental health research

Ethical issues in perinatal mental health research
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DOI:
10.1097/yco.0b013e3283318e6f
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发表时间:
2009-11-01
影响因子:
6.9
通讯作者:
Sadler, John Z.
Sadler, John Z.
中科院分区:
医学2区
文献类型:
--
作者:
Brandon, Anna R.;Shivakumar, Geetha;Sadler, John Z.

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综述的目的回顾目前进行围产期心理健康研究的伦理标准的背景,并描述这一研究领域的伦理挑战。最近的发现当前的文献反映了科学界越来越多的一种观点,即没有关于精神治疗对母亲和发育中的胎儿/婴儿的影响的信息构成的危险可能超过研究所涉及的风险。然而,在科学界没有足够的共识的情况下,监管机构和围产期研究人员都发现自己没有一个决策框架来令人满意地限制孕妇和哺乳期妇女参与临床研究的风险并促进其受益。摘要围产期心理健康的精神病学研究至关重要,因为它使临床医生和患者能够参与有关精神疾病治疗的知情决策。具体的关注领域包括胎儿安全、产妇风险、治疗误解、商业利益、法医/法律问题、知情同意过程和研究设计。除了为这一群体提供以证据为基础的心理保健外,制定解决伦理挑战并包括多个利益相关者的观点和关切的指导方针可以改善围产期妇女获得参与心理健康研究的好处的机会。
Purpose of reviewTo review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain.Recent findingsCurrent literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research.SummaryPsychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.