Forty years ago, the Belmont Report counseled that a "systematic, nonarbitrary analysis of risks and benefits" is vital to ensuring the ethical appropriateness of research with human subjects. Since then, research ethics has devoted considerable attention to the first half of this advice, emphasizing the ethical importance of assessing and minimizing the risks of research with human subjects. Significantly less attention has been devoted to a systematic assessment of the potential benefits of research participation. To the extent that benefits for individual participants are considered at all, commentators tend to focus on their potential to undermine the goal of minimizing risks. A chance for clinical benefit may obscure the fact that research poses risks not present in clinical care, while an offer of financial compensation or ancillary care may induce individuals to accept risks that conflict with their long-term interests. This article argues that, while undoubtedly important, minimizing risks fails to offer sufficient protection for research participants, especially those who cannot consent, because it neither ensures that the risks of research are justified nor protects participants from exploitation. Belmont's advice to develop systematic and nonarbitrary ways to ensure that research participants receive appropriate benefits needs to be heeded as well.

中文翻译：

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将风险降至最低是不够的：收益与保护研究参与者的相关性

四十年前，贝尔蒙特报告建议，“对风险和收益进行系统的、非武断的分析”对于确保人类受试者研究的伦理适当性至关重要。从那时起，研究伦理就对这一建议的前半部分给予了相当大的关注，强调了评估和最小化人类受试者研究风险的伦理重要性。对参与研究的潜在利益进行系统评估的关注明显较少。就完全考虑个体参与者的利益而言，评论员倾向于关注他们破坏最小化风险目标的潜力。临床获益的机会可能会掩盖这样一个事实，即研究会带来临床护理中不存在的风险，而提供经济补偿或辅助护理可能会诱使个人接受与其长期利益相冲突的风险。本文认为，尽管毫无疑问很重要，但最小化风险并不能为研究参与者提供足够的保护，尤其是那些不能同意的人，因为它既不能确保研究风险是合理的，也不能保护参与者免受剥削。Belmont 关于开发系统的和非任意的方法以确保研究参与者获得适当利益的建议也需要引起注意。因为它既不能确保研究的风险是合理的，也不能保护参与者免受剥削。Belmont 关于开发系统的和非任意的方法以确保研究参与者获得适当利益的建议也需要引起注意。因为它既不能确保研究的风险是合理的，也不能保护参与者免受剥削。Belmont 关于开发系统的和非任意的方法以确保研究参与者获得适当利益的建议也需要引起注意。