转化医学研究中生命伦理学辩护的现况分析与前瞻思考

转化医学作为一门新兴学科,运用多学科交叉策略来推动医学发展,从临床实践中发现问题,将其凝练成科学问题进行基础医学研究,再将研究成果应用到疾病诊断、治疗和预防过程中,使其真正发挥作用,是一个从基础医学到临床应用的双向进程。转化医学已逐步融入各个学科,并在干细胞研究、生物标志物、细胞信号转导、药物及器具研发及个体化医学等各个领域发挥重要作用。随着转化医学研究深入,一些临床试验势必对人体存在一定伤害和潜在危险,存在各种伦理问题。虽说科学研究与伦理道德是一对相互冲击的矛盾,但两者在总体上又是一致的,共同决定着社会前进步伐。科研的重大进步必然会对伦理道德提出更高要求,而伦理道德的高标准又规范、引导、促进科学研究朝着正确方向迈进,两者相辅相成。鉴于伦理辩护对于转化医学研究强有力的支撑,建议在转化医学研究中能进一步完善伦理监管体系,发挥机构伦理委员会的功效,持续加大伦理培训的力度,强化研究人员的伦理道德修养,从而为转化医学的发展夯实人文基础。     

侵袭性念珠菌感染的转化医学研究

念珠菌是人类深部真菌病,尤其是侵袭性真菌病常见病原之一,危害甚大。由于其既可定植又可引发感染,因此要确定其是否致病,必须从实验室到临床进行分析,如判断错误,则可贻误生命。目前,侵袭性念珠菌感染相关死亡率仍较高,而有关念珠菌感染的诊断能力在各个国家及实验室之间仍差异较大,且都尚待提高。为此,欧洲临床微生物学与感染性疾病学会组织专家团队--欧洲真菌     

生物科技及医学的发展与生命伦理学——生命伦理学专刊序言

<正>自有人类以来,生物技术的发展就一直伴随着人类的进步。人类在不断适应或改变我们赖以生活的环境。人类运用自己创造的工具为居住、饮食、繁衍和生存改造我们的自然环境,这些均与对生命的认识和技术的运用相关。现代生物科技和医学的发展,在继续造福人类、增进人类的健康、延长人类寿命的同时,也提出了诸多棘手的两难问题,甚     

转化医学研究与循证决策

<正>20世纪90年代,国际上开始注重转化医学的理念,其典型含义是将基础研究的成果转化为有效的临床治疗手段,强调从实验室到病床旁的连接,通常称之为"从实验台到病床旁".随着转化医学在医学研究中的重要性不断提升,其定义和内涵也在不断变化和丰富.有学者指出,转化医学的概念还有新的内涵,即"将研究结果、结论应用到日常健康保健工     

生物技术应用的伦理学问题——克隆人研究的伦理问题

如果单纯从技术角度看,克隆人未来也许会满足某一部分人的需求。比如,有些女性没有结婚但是又希望有自己的后代,通过细胞核移植技术就可以满足这种愿望。克隆人最终可能会解决一个很小人群的特殊需求。但是克隆人技术一旦获得法律认可,必将带来一系列伦理和社会问题。其明显的负面影响主要表现在以下几个方面：     

干细胞与再生医学研究及其产业化前景

再生医学是在生命科学、材料科学、计算机技术等众多学科交融渗透的基础上发展起来的,这一新兴技术领域涵盖了干细胞与克隆技术、体细胞重编程技术、组织工程技术、组织器官代用品、异种器官移植等多项现代生物技术,其研究与应用将给因疾病、创伤、衰老或遗传因素所造成的组织器官缺损或功能障碍的修复及再生治疗带来希望。     

全球化背景下医学伦理学教学改革的探索

医学伦理学理论和实践根植于一定时期的社会经济、文化和教育,并随之发生改变和发展。随着全球经济一体化的进展完善,不同国家的文化和教育已在全球范围内互联互通并进而影响异乡本土医学文化。从目前我国医学伦理学教育和实践看,医学伦理学教学及评价体系已不能满足日新月异的全球化医学发展进程。本文从传统医学文化和医学伦理学的理论渊源入手,针对我国医学伦理学教学实践中存在的德性培育重视不足、临床决策能力培养缺失、标准化评价体系缺失等主要问题,探析教学改革的路径,以促进医学伦理学教学理论和实践的发展。     

干细胞研究的伦理学和社会学思考

每年都有千百万人罹患神经系统、心脏、肝脏和其他系统或器官的严重的和基本上无法治愈的变性疾病 ,例如神经系统的帕金森病或震颤麻痹、多发性硬化和中风 ,心脏的心肌梗死 ,肝脏的肝炎 ,胰脏的糖尿病等等 ,甚至最后死于这些疾病。干细胞疗法诚然有可能缓解甚或治愈某些上述疾病。然而 ,倘若这些干细胞来源于胚胎 ,那么对于这种干细胞疗法 ,在伦理学上又有什么看法呢 ?任何一种新的实验性医疗都可对医生和病人双方提出伦理学上的问题 ,但胚胎干细胞 (ＥＳ细胞 )研究则除此之外 ,还存在破坏性人类胚胎研究与可能的利益大小之间的伦理学矛盾。…     

什么是生命伦理学？——从历史发展的视角

生命伦理学是20世纪60年代兴起于美国的一门新兴学科,旨在应对生命科学和生物技术的发展或医疗保健的演变使人类面临的种种伦理难题。生命伦理学的兴起有着特殊的社会历史背景。它在发展过程中出现的一些里程碑式的案例,对生命伦理学的发展产生了深远的影响。从其发展特征上看,生命伦理学和医学伦理学紧密联系,有着更为广泛的研究内容和独特的专业特性。生命伦理学要有效回应现代医学和生命科学的发展给人类带来的伦理难题,既要准确地界定伦理问题,又要以适当的方式将伦理学基础理论应用到具体问题当中。对生命伦理学的基本理论进行概述。     

精子库的发展历史及伦理学思考

精子库的形成至今已有200多年历史,它的建立和辅助生殖技术的发展让庞大的不孕不育群体看到了希望。虽然随之而来的是对传统伦理观念的巨大挑战,但只要严格管理精子库系统,并采取相应的对策,精子库必能造福于人类。     

温度和光周期对水稻抽穗期调控的交互作用

光周期和温度是植物开花的2个关键的调控因素,植物成花转变决定于植物对光周期和温度变化的精确测量.作为短日照植物,水稻在长日低温条件下抽穗期推迟,为了阐明温度和光周期对水稻开花时间的调控效应,本文利用1个光周期不敏感的突变体及其野生型,系统地分析了不同温度和光周期处理条件下,调控水稻开花时间几个关键基因（Hd3a,RFT1,Ehd1,Ghd7,RID1/Ehd2/OsId1,Se5）的表达调控模式,结果表明Ehd1-Hd3a/RFT1通路在光周期和温度调控水稻开花途径中保守.Ehd1,Hd3a和RFT1的表达在低温（23℃）条件下急剧下降,表明Ehd1,Hd3a和RFT1表达阻抑是低温条件下水稻开花推迟的主要原因.另外,在长日照条件下,低温（23℃）处理促进了水稻开花抑制子Ghd7的表达,表明低温条件和长日照条件对Ghd7的表达具有协同作用.此外,本文还分析了Hd1与光周期开花调控途径中几个关键基因的调控关系,发现Hd1在长日照条件下负向调控Ehd1的表达而正向调控Ghd7的表达,表明在长日照条件下,Hd1-Ghd7-Ehd1-RFT1通路也是水稻抽穗期调控的一条重要途径.     

Strengthening medical ethics by strategic planning in the Islamic Republic of Iran

To bring attention to medical ethics and to enhance the quality of health care in Iran, the Ministry of Health and Medical Education has introduced a strategic plan for medical ethics at a national level. This plan was developed through the organization and running of workshops in which experts addressed important areas related to medical ethics. They analysed strengths and weaknesses, opportunities and threats, and outlined a vision, a mission and specific goals and essential activities surrounding medical ethics. The current strategic plan has six main goals that will be reviewed in this paper. Some major activities that were carried out in recent years, and some future plans, will be also reviewed.     

A moderate Buddhist animal research ethics

Though there is a burgeoning interest in applied Buddhist ethics, Buddhist animal research ethics remains an underdeveloped area. In this paper I will explore how some central Buddhist ethical considerations can usefully engage our use of other animals (henceforth, animals) in science. As the scientific use of animals is broad, I will narrow my focus to laboratory science. I will show that, though a Buddhist abolitionism would not be unmotivated, it is possible to reject it. While doing so, it will be important to resist emphasizing elements of Buddhist thought that merely provide reasons to adopt the dominant ethical framework governing laboratory animal research ethics, known as the 3Rs. Though I will suggest how a Buddhist animal research ethics can sometimes permit the use of animals in harmful research, it will also require ethical constraints that resonate with some of the more progressive elements in ‘Western’ bioethics.     

Enriching the concept of vulnerability in research ethics: An integrative and functional account

The concept of vulnerability is widely used in research ethics to signal attention to participants who require special protections in research. However, this concept is vague and under‐theorized. There is also growing concern that the dominant categorical approach to vulnerability (as exemplified by research ethics regulations and guidelines delineating vulnerable groups) is ethically problematic because of its assumptions about groups of people and is, in fact, not very guiding. An agreed‐upon strategy is to move from categorical towards analytical approaches (focused on analyzing types and sources of vulnerability) to vulnerability. Beyond this agreement, however, scholars have been advancing competing accounts of vulnerability without consensus about its appropriate operationalization in research ethics. Based on previous debates, we propose that a comprehensive account of vulnerability for research ethics must include four components: definition, normative justifications, application, and implications. Concluding that no existing accounts integrate these components in a functional (i.e., practically applicable) manner, we propose an integrative and functional account of vulnerability inspired by pragmatist theory and enriched by bioethics literature. Using an example of research on deep brain stimulation for treatment‐resistant depression, we illustrate how the integrative‐functional account can guide the analysis of vulnerability in research within a pragmatist, evidence‐based approach to research ethics. While ultimately there are concerns to be addressed in existing research ethics guidelines on vulnerability, the integrative‐functional account can serve as an analytic tool to help researchers, research ethics boards, and other relevant actors fill in the gaps in the current landscape of research ethics governance.     

Political legitimacy and research ethics

In democratic theory, “legitimacy” refers to the set of conditions that must be in place in order for the claims to authority of somebody to be deemed appropriate, and for their claims to compliance to be warranted. Though criteria of legitimacy have been elaborated in the context of democratic states, there is no reason for them not to be drawn up, with appropriate amendments, for other kinds of authority structures. This paper examines the claims to authority made over researchers by international bodies governing research ethics, who exercise their authority by the research ethics guidelines they produce (including recent revisions to the Declaration of Helsinki and CIOMS Guidelines). We argue that discussions of such bodies and sets of guidelines often elide questions of justification and questions of legitimacy, and that the grounds that might allow us to mount a strong case for the latter are at present sorely underdeveloped.     

The ubiquity of deception and the ethics of deceptive research

Does the fact that deception is widely practised – even though there is a general prohibition against deception – provide insight into the ethics of deceptive methods in research, especially for social‐behavioral research? I answer in the affirmative. The ubiquity of deception argument, as I will call it, points to the need for a concrete and nuanced understanding of the variety of deceptive practices, and thus promises an alternative route of analysis for why some deception may be permissible in social‐behavioral research. As an alternative argument it also promises to break the stalemate that emerges in debates on the ethics of deceptive methods in social‐behavioral research. In the current paper I (1) motivate and articulate the ubiquity argument in order to clarify the significance of ubiquity and discharge some initial objections. Then, on the recommendations of the ubiquity argument, I (2) highlight the importance of interpersonal relationships for understanding the ethics of deception. Following this insight I (3) provide an analysis of several features of the researcher‐participant relationship relevant to the understanding of the ethics of deception in research. I then (4) conclude the argument with some recommendations for the ethical use of deceptive methods in social‐behavioral research.     

转化医学：现代医学发展的动力

Translational medicine is a class of medicalresearch that proposes a two-way interaction betweenlaboratory and clinical research[1].Elias A.Zerhouni,the director of the National Institutes of Health(NIH),