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Medicinski pregled
2018, vol. 71, br. 9-10, str. 335-339
jezik rada: engleski
vrsta rada: istoriografski prilog
doi:10.2298/MPNS1810337D


Istorija istraživanja na mentalno obolelim licima - od eksploatacije preko zabrane do adekvatne inkluzije
Clinical Center of Montenegro,Psychiatric Clinic, Podgorica, Montenegro

e-adresa: teapg@t-com.me

Projekat

This research was partially supported by NIH Research Grant, funded by the Fogarty International Center.

Sažetak

Uvod. Nemogućnost da zaštite sopstvene interese čini mentalno obolela lica posebno vulnerabilnim. Oni su, stoga, podložni većem riziku da im se u kontekstu biomedicinskih istraživanja naškodi, zbog čega im se moraju osigurati dodatne mere zaštite. Istorija zloupotrebe mentalno obolelih pacijenata u istraživanjima. Dvadeseti vek obiluje primerima etički nedopustivih eksperimenata sprovedenih na osobama koje nisu bile u stanju da ispravno rasuđuju i donose odluke za sebe. Verovatno među ovim primerima najstrašnija su zlodela koja su sprovodili nacistički doktori, čiji su eksperimenti rezultirali smrću stotina hiljada nevoljnih i prisilno zatvorenih mentalno obolelih osoba. Dosadašnji i aktuelni propisi o istraživanjima na mentalno obolelim osobama. Preterana upotreba potencijalno vulnerabilnih mentalno obolelih osoba u istraživanjima dovela je do uspostavljanja zakonodavnih politika i praksi koje služe zaštiti ovih lica od eksploatacije i zloupotrebe u istraživanjima. Dok je zakonska regulativa inicijalno štitila ove vulnerabilne pacijente tako što je potpuno zabranjivala istraživanja na njima, aktuelne smernice se okreću ka uspostavljanju adekvatnih mera zaštite tako da se ova lica mogu uključiti u odgovarajuća istraživanja. Zaključak. Zaštita mentalno obolelih lica koja nisu sposobna da daju svoj pristanak za učešće u istraživanjima tako što će se zabraniti svako istraživanje na njima suviše je restriktivna i nepotrebna. Čak iako je dobronamerna, ovakva prezaštićujuća politika je diskriminatorna i onemogućava da se otkriju nove terapije za stanja koja direktno pogađaju ova lica. Pod uslovom da su valjano zaštićeni od nepotrebnih rizika, neophodno je omogućiti vulnerabilnim mentalno obolelim pacijenatima da učestvuju u biomedicinskim istaživanjima kako bi se na adekvatan način izašlo u susret njihovim zdravstvenim potrebama.

Ključne reči

istorija medicine; mentalno obolele osobe; etičkikodovi; eksperimenti na ljudima; prava pacijenata; informisanipristanak; bioetika; psihijatrija

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