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引用次数: 0
摘要
2018年夏天,《明尼阿波利斯明星论坛报》(Minneapolis Star Tribune)报道了亨内平县医疗中心(Hennepin County Medical Center)的临床试验,在试验中,急救医务人员经常在警方的敦促下,给情绪激动的人注射氯胺酮。这些人在不知情或不同意的情况下参加了试验。在其中一项研究中,近40%服用氯胺酮的受试者出现了严重的呼吸问题,以至于不得不插管。许多受试者是弱势、边缘群体的成员。在本文中,我们描述了Hennepin医疗氯胺酮研究违反联邦研究指南的方式。我们考虑Hennepin医疗保健和执法部门之间令人不安的关系,以及兴奋性谵妄的概念。最后,我们考虑了一些概念化临床试验的替代方法,其中干预可能不会使受试者受益。我们将氯胺酮试验与疗养院和其他医疗机构的化学约束的临床试验以及“非致命”武器的研究进行了比较。
The Hennepin Healthcare Forced Ketamine Studies, Excited Delirium, and Police Violence
In the summer of 2018, the Minneapolis Star Tribune reported clinical trials at Hennepin County Medical Center in which emergency medical personnel were injecting agitated individuals with ketamine, often at the urging of police. These individuals were enrolled in the trials without their knowledge or consent. In one of the studies, nearly 40 percent of subjects given ketamine experienced breathing issues so serious that they had to be intubated. Many subjects were members of vulnerable, marginalized groups. In this paper, we describe the ways in which the Hennepin Healthcare ketamine studies violated federal research guidelines. We consider the troubling relationship between Hennepin Healthcare and law enforcement, as well as the concept of excited delirium. Finally, we consider some alternative ways of conceptualizing clinical trials in which the intervention may not benefit subjects. We compare the ketamine trials to clinical trials of chemical restraints in nursing homes and other health care institutions and also to studies of “nonlethal” weapons.
期刊介绍:
The Hastings Center Report explores ethical, legal, and social issues in medicine, health care, public health, and the life sciences. Six issues per year offer articles, essays, case studies of bioethical problems, columns on law and policy, caregivers’ stories, peer-reviewed scholarly articles, and book reviews. Authors come from an assortment of professions and academic disciplines and express a range of perspectives and political opinions. The Report’s readership includes physicians, nurses, scholars, administrators, social workers, health lawyers, and others.