傳染病大流行時的公共衛生研究倫理：兼論特殊研究倫理審查機制之芻議

Public Health Research Ethics during Pandemics: With Reflections on the Specialized Ethics Committee Review Procedures

因應COVID-19大流行，公衛政策與研究遭遇急迫又時而尖銳的倫理挑戰，平時適用的研究倫理規範內容與權重，在傳染病大流行的非常時期，應予以重新考量。本文首先區別公共衛生「研究」（research）與「行動」（practice）之特殊連結，並釐清研究倫理與公衛行動所立基的民主政治倫理的關係。接著針對研究參與者自主同意、研究之利益風險分析、易受傷害群體保護及研究倫理審查機制等四個研究倫理議題進行探討，並逐一檢視一般研究與傳染病大流行時之特殊倫理考量。本文採取調和例外論的觀點，提出以四個標準來判斷一研究案是否適用於傳染病大流行時之「公衛緊急事件時期」特殊審查機制：（一）公部門屬性、（二）知識相關性、（三）知識必要性、（四）最小公衛行動阻礙。

During the COVID-19 pandemic, public health research and practices have encountered many ethical challenges. The principles and guidelines in ordinary times need to be reconsidered during pandemics. This article first distinguishes the unique connectedness between public health research and practices, clarifying the different grounds of research ethics and the ethics of democratic politics. The article then focuses on four issues, namely, participants’informed consent, analysis of research risks, protection of vulnerable populations, and ethical review mechanisms, all of which are salient in both general research ethics and public health research ethics, and merit special consideration during pandemics. Finally, adopting a harmonized exceptionalism perspective, the article proposes four criteria to determine whether a research proposal should be considered for special ethical review procedures during public health emergencies such as pandemics. These criteria include (1) a public authority mandate, (2) relevance of the knowledge sought by the proposed research, (3) necessity of that knowledge, and (4) minimal impediment to public health practices.