[Ethical Considerations of Including Minors in Clinical Trials Using the Example of the Indicated Prevention of Psychotic Disorders].

IF 0.8 4区 医学 Q4 PSYCHIATRY Zeitschrift Fur Kinder-Und Jugendpsychiatrie Und Psychotherapie Pub Date : 2024-09-01 Epub Date: 2024-05-29 DOI:10.1024/1422-4917/a000981
Frauke Schultze-Lutter, Tobias Banaschewski, Gottfried M Barth, Andreas Bechdolf, Stephan Bender, Hans-Henning Flechtner, Sandra Hackler, Fabiola Heuer, Sarah Hohmann, Laura Holzner, Michael Huss, Nikolaos Koutsouleris, Michael Lipp, Selina Mandl, Eva Meisenzahl, Manuel Munz, Naweed Osman, Jens Peschl, Volker Reissner, Tobias Renner, Anett Riedel, Marcel Romanos, Georg Romer, Georg Schomerus, Ulf Thiemann, Peter J Uhlhaas, Christiane Woopen, Christoph U Correll, das Care-Konsortium
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Abstract

Ethical Considerations of Including Minors in Clinical Trials Using the Example of the Indicated Prevention of Psychotic Disorders Abstract: As a vulnerable group, minors require special protection in studies. For this reason, researchers are often reluctant to initiate studies, and ethics committees are reluctant to authorize such studies. This often excludes minors from participating in clinical studies. This exclusion can lead to researchers and clinicians receiving only incomplete data or having to rely on adult-based findings in the treatment of minors. Using the example of the study "Computer-Assisted Risk Evaluation in the Early Detection of Psychotic Disorders" (CARE), which was conducted as an 'other clinical investigation' according to the Medical Device Regulation, we present a line of argumentation for the inclusion of minors which weighs the ethical principles of nonmaleficence (especially regarding possible stigmatization), beneficence, autonomy, and fairness. We show the necessity of including minors based on the development-specific differences in diagnostics and early intervention. Further, we present specific protective measures. This argumentation can also be transferred to other disorders with the onset in childhood and adolescence and thus help to avoid excluding minors from appropriate evidence-based care because of insufficient studies.

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[将未成年人纳入临床试验的伦理考量--以《精神障碍的指定预防》为例]。
以指明预防精神障碍为例,将未成年人纳入临床试验的伦理考虑 摘要:作为弱势群体,未成年人在研究中需要特殊保护。因此,研究人员往往不愿启动研究,伦理委员会也不愿批准此类研究。这往往会将未成年人排除在临床研究之外。这种排斥可能导致研究人员和临床医生只能获得不完整的数据,或者在治疗未成年人时不得不依赖于成年人的研究结果。我们以 "计算机辅助风险评估在精神障碍早期检测中的应用"(CARE)研究(根据《医疗器械管理条例》,该研究属于 "其他临床研究")为例,提出了将未成年人纳入研究的论证思路,该思路权衡了非渎职(尤其是可能的污名化)、受益、自主和公平等伦理原则。根据诊断和早期干预方面的发育差异,我们说明了纳入未成年人的必要性。此外,我们还提出了具体的保护措施。这一论点也可应用于其他在儿童和青少年时期发病的疾病,从而有助于避免因研究不足而将未成年人排除在适当的循证治疗之外。
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来源期刊
CiteScore
1.90
自引率
16.70%
发文量
74
期刊介绍: Die Zeitschrift veröffentlicht Originalarbeiten, Übersichtsreferate, Fallberichte, aktuelle Mitteilungen und Buchbesprechungen und informiert laufend über die Arbeit anderer internationaler Fachzeitschriften. Sie ist offizielles Organ der Deutschen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie.
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