Ethical challenges in international HIV prevention research

Members of an HIV-prevention research network were asked to describe ethical challenges faced in their work. Major themes included acceptable standards of care for participants, defining research of relevance to host countries, reducing risks related to stigma, designing research that meets local needs without contributing to an inadequate status quo, and ensuring informed consent for complex research with potentially vulnerable participants. The challenges are interrelated and highlight the need for innovative, practical strategies to be incorporated into the planning, design, and conduct of HIV prevention trials. Research in applied ethics to support decision-making about HIV prevention research is needed, along with ethics training, mechanisms to support community-wide benefit from research, and expanded dialog on ethics surrounding HIV prevention and public health research.     

The Ethical Challenges of Socially Responsible Science

Social responsibility is an essential part of the responsible conduct of research that presents difficult ethical questions for scientists. Recognizing one’s social responsibilities as a scientist is an important first step toward exercising social responsibility, but it is only the beginning, since scientists may confront difficult value questions when deciding how to act responsibly. Ethical dilemmas related to socially responsible science fall into at least three basic categories: 1) dilemmas related to problem selection, 2) dilemmas related to publication and data sharing, and 3) dilemmas related to engaging society. In responding to these dilemmas, scientists must decide how to balance their social responsibilities against other professional commitments and how to avoid compromising their objectivity. In this article, we will examine the philosophical and ethical basis of social responsibility in science, discuss some of the ethical dilemmas related to exercising social responsibility, and make five recommendations to help scientists deal with these issues.     

Ethical Challenges to the Integrity of Physicans: Financial Conflicts of Interest in Clinical Research

Financial conflicts of interest arise when physicians' judgment and decision making become compromised by financial gains or interests, and thus create risk of undo harm to research participants, to the integrity of research projects, and, ultimately, to society at large. Such conflicts also violate the moral maxims of medicine, and thus damage the integrity of physicians and the medical profession. I submit that key remedies for this problem are the integrity (self-respect) of physicians and the respectful engagement of research participants (whether patients or nonpatient volunteers) as partners in research projects. Accordingly, I consider physicians the primary moral agents, research participants the secondary moral agents, and society the tertiary moral agent with responsibilities for protection against whatever undue harm in clinical research. The latter needs to address the powerful cultural, commercial, political, and social factors that contribute to physicians' financial conflicts of interest.     

AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research

The current analysis considers the  human immunodeficiency virus (HIV)  prevention research record in the social sciences. We do so with special reference to what has been termed "AIDS Exceptionalism"—departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for "Prevention for Positives," supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to address effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior.     

Ethical and Regulatory Challenges in Psychophysiology and Neuroscience-Based Technology for Determining Behavior

In the past three decades, there has been an explosion in research to understand the mechanisms of brain function. Recent advances in psychophysiology and neuroscience, while still limited, have sparked great interest in developing technologies that could peer into the brain and be used to identify or indicate certain behaviors. The polygraph (lie detector) represents an old technology used for discerning clues to the human brain; functional magnetic resonance imaging (fMRI) represents one of the newest efforts. The use of these technologies in intelligence and counterintelligence in the field without validation represents a major concern about its usefulness. Both research on this new technology and subsequent use on public raise ethical challenges. This article will address the overall ethical issues associated with these new technologies. The report identifies the ethical and cultural challenges in conducting research on these new tools, explores the possibility of using current U.S. regulatory requirements regarding drugs and devices as a model for regulating these new technologies, and suggests approaches for the future.     

Ethical Virtues in Scientific Research

Most approaches to promoting integrity in research are principle-based in that they portray ethical conduct as consisting of adherence to ethical rules, duties, or responsibilities. Bruce MacFarlane has recently criticized the principle-based approach to promoting integrity in research and offered a virtue-based alternative. MacFarlane argues that principle-based approaches do not provide adequate guidance for ethical decision-making and are not very useful in moral education. In this article, I examine and critique MacFarlane's defense of the virtue-based approach. I argue that virtue-based and principle-based approaches to ethics are complementary and that they both can help promote research integrity.     

Central Ethical Dilemmas in Research Involving Children

We are obligated to protect individual child subjects of research, yet it is also necessary to investigate the safety and efficacy of medical treatments that benefit children as a class. The federal regulations on research with children have provided ethical guidance since 1983, but divergent interpretations persist. Since varying interpretations can lead to confusion and abuses, efforts are underway to clarify the criteria. Clarity is needed to protect individual child subjects from harm while enabling ethical research to proceed. The "pediatric rule" and the "pediatric exclusivity" incentive are important policy initiatives for promoting sound research on the medical treatment of children.     

公平之伦理真义的掘发与拓展

公平与公正、正义、正当等概念相近似,本质上是一个利益分配和关系对待的范畴,它要求立意公的角度坚持平的标准去分配物质财富、社会好处,做到标准同一、一视同仁.因此,公平是公正与平等的有机统一.公平的伦理真义从主体和人格上讲就是推崇平等,从活动和交换上讲就是注重公正,从其交往和交换的原则上讲则是讲求互惠互利.社会主义公平是人类历史上最先进最具有道义性的公平.这不仅因为它是建立在正义的社会制度之上,而且因为它是以正义和平等作为其基本原则的.     

现代国际城市研究述评

随着城市化和经济全球化进程的深入推进,现代国际城市作为世界城市体系的高级阶层,日益受到学术界的重视。本文从国际国内两方面分别总结了理论界对现代国际城市研究的发展脉络和最新成果,特别是对现代国际城市评估指标体系的建立,本文总结了目前学术界特别是国内学者对这一问题研究中存在的问题,目的是为北京市建设现代国际城市提供借鉴。     

Research on Environmental Health Interventions: Ethical Problems and Solutions

This article reviews a variety of ethical issues one must consider when conducting research on environmental health interventions on human subjects. The paper uses the Kennedy Krieger Institute lead abatement study as well as a hypothetical asthma study to discuss questions concerning benefits and risks, risk minimization, safety monitoring, the duty to warn, the duty to report, the use of control groups, informed consent, equitable subject selection, privacy, conflicts of interest, and community consultation. Research on environmental health interventions can make an important contribution to our understanding of human health and disease prevention, provided it is conducted in a manner that meets prevailing scientific, ethical, and legal standards for research on human subjects.     

Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges

ABSTRACT

The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person’s ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults’ abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.     

国际关系研究的一件“利器”——评《国际关系研究实用方法》

当前专业人士普遍认为 ,我国国际关系 (国际政治 )研究领域现存的主要问题是 :评论多于创新 ;热衷讨论时事而轻视研究理论 ;低水平重复现象严重等。不少学者指出 ,对研究方法的忽视和研究方法的单一 ,是造成这些问题的一个重要原因 ;在一定程度上 ,研究方法的不科学和缺乏规范 ,也阻碍着中国国际关系学的专业化发展。“工欲善其事 ,必先利其器” ,一项工作的进展往往依赖工具的改进和方法的革新。对我国国际关系研究来说 ,阎学通教授的新著《国际关系研究实用方法》 ,可算是“利其器”的一本方法论工具书了。《方法》一书首先“利”在其“准…     

HIV Infections as Unanticipated Problems During Medical Research in Africa

Regulations and guidelines in the United States, Canada, and the United Kingdom require institutions that manage medical research on humans anywhere in the world to protect research participants. Analyses of published data from six medical research projects in Africa funded by governments and other organizations in the above countries reveal HIV infections statistically linked to participation in research. Given this evidence, regulations and guidelines obligate institutions that fund, manage, or regulate these projects to investigate to determine if invasive procedures in research clinics infected participants. Findings from such investigations could have a broad and beneficial impact on health care safety in Africa.     

Research Subjects with Limited English Proficiency: Ethical and Legal Issues

In this article, we examine Institutional Review Board (IRB) policies, international guidelines, and federal regulations and guidance for dealing with Limited English Proficiency (LEP) research subjects. We show that federal and international guidance concerning this topic is insufficient, and there is considerable variation in IRB policies. While some IRBs have thorough and useful policies, others do not. Many IRBs do not provide researchers and IRB members with answers to several important questions relating to language barriers in research. We recommend that federal agencies, international organizations, IRBs, and researchers take steps to fill in the gaps in guidance and policy to help insure that LEP populations will receive equitable and ethical treatment in research.     

From Assistance to Prevention: Categorizing Young Carer Support Services in Australia,and International Implications

Young people who provide unpaid care for a relative with chronic illness or disability are a growing focus of public policy and research in Australia and internationally. Support services for these young carers have emerged, but not enough is known about their effectiveness. This article develops an analytical framework that categorizes young carer support services according to their goals and the types of intervention provided. The analytical framework is based on Australian data. It is applied to young carer support services available in Australia but may be applicable to other countries. The aim of the framework is to provide a structure for assessing the effectiveness of current services in supporting young carers by clarifying service goals and identifying gaps in existing service provision. The framework contributes to conceptual discussions about young carer supports, and it can be used to guide future policy development. The article draws on Australian and international literature as well as findings from a recent Australian study on young carers. The proposed framework groups young carer support services according to three overarching goals: assisting young people who provide care; mitigating the care‐giving responsibility; and preventing the entrenchment of a young person's caring role. The framework is applied to an audit of Australian support services for young carers, illustrating how it can be used to assess existing supports for young carers and inform future policy development. The findings suggest that most services in Australia fall into the categories of assistance and mitigation, while few contain preventative elements.     

Challenges of Depression and Suicidal Ideation Associated With Aging With HIV/AIDS: Implications for Social Work

As the number of older adults with HIV/AIDS increases, new challenges are emerging that threaten their ability to age with this disease. Threats of particular concern are depression and suicidal ideation. Studies show that those aging with HIV/AIDS have a number of stressors that tax their coping mechanisms, increasing vulnerability to depression and suicidal ideation. These stressors can be categorized into three areas. First, there are psychosocial stressors that can contribute to depression. Second, there are health and biochemical stressors that can contribute to depression, as well as compromise cognitive abilities needed to adapt to such stressors. Third, cognitive stressors may create predispositions to depression. In particular, certain cognitive abilities needed to cope with depression and suicidal ideation may be compromised by aging with HIV/AIDS. A model of these stressors is provided for didactic purposes, as well as to suggest implications for social work practice and research.     

"一带一路"沿线国家来华留学生语言教学困境与对策研究

随着"一带一路"沿线来华留学生规模的不断扩大,这一群体的语言教育问题日益突出,如何提高来华留学生语言教育质量是教育工作者亟待解决的课题.沿线来华留学生官方语言众多,文化风俗多样,语言水平不均,教育背景不同,师生互动方式不一致,知识点理解与掌握存在差异,为来华留学生语言教学工作带来挑战.该文将针对上述问题进行探讨,结合教学实际,探索解决措施.