加拿大安大略公共卫生伦理框架及相关启示

Introduction and Reflections on Public Health Ontario Ethical Framework in Canada

2012年,加拿大安大略公共卫生机构发表《公共卫生项目伦理实施框架》工作报告,尝试建构一个综合性的公共卫生项目伦理监管框架。报告主张在公共卫生领域打破"研究"与"实践"的传统二分,这一理念的提出,一方面是想满足公共卫生领域不断发展的伦理监管需求;同时,也是对传统的研究伦理监管模式的改进。在介绍安大略公共卫生伦理框架的基础上进行反思,分析打破研究与实践二分的重要性,强调关注公共卫生项目在数据收集、保存、使用等方面所涉及的伦理问题的共性特征,拓展既有受试者保护概念,实现公共卫生项目全过程的人的保护的理念转变。

Public Health Ontario in Canada published a report named A Framework for the Ethical Conduct of Public Health Initiatives with aims to construct an integrated ethical review framework for evidence-generating public health initiatives in 2012. The report advocated breaking the traditional dichotomy between research and practice based on concerns about the urgent needs for ethical review of public health initiatives on one hand, and setting up strategies for updating the conventional ethical review mechanisms on the other hand. This paper firstly provided introductions and reflections on this framework. Then it analyzed the importance of breaking the dichotomy between research and practice in public health. Finally, it advocated that more considerations should be given to the similarities and ethical problems raised during data collection, storage and reuse in public health activities, which will significantly broaden the idea of human subject protection to protect human beings engaged in public health initiatives.