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Research involving prisoners: Consensus and controversies in international and European regulations

机译：涉及囚犯的研究：国际和欧洲法规中的共识和争议

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This article examines international and European regulations on research involving prisoners for consensus, differences, and their consequences, and offers a critical evaluation of the various approaches. Agreement exists that prisoners are at risk of coercion, which might interfere with their ability to provide voluntary informed consent to research. Controversy exists about the magnitude of this risk and the consequences that should follow from this risk. Two strategies are proposed for a method of protecting prisoners that does not lead to discrimination: first, more caution to assure non-coerced consent and second, restrictions on the type of research. Most regulations stress the importance of the principle of equivalence of healthcare in places of detention as part of an efficient protection against research risks and discrimination. All the presented approaches have shortcomings. While 'over-use' of prisoners for research as compared to the general population is ethically unjustified, not granting prisoners access to studies beneficial to their own health because of over-strict regulations is equally unjustified. A middle solution should be preferred, one that grants a minimum of protection together with the lowest possible barriers. Research that does not entail a direct benefit for the individual detainee should be restricted to types of research that have a benefit for detainees as a group and that are of low risk. What will ultimately protect prisoners best, while producing the greatest benefit for them, is access to the same healthcare available to members of the community including research as a true option.
机译：本文研究了有关囚犯达成共识，分歧及其后果的研究的国际和欧洲法规，并对各种方法进行了严格的评估。已经达成协议，囚犯有被胁迫的危险，这可能会干扰他们提供自愿知情同意进行研究的能力。关于这种风险的严重性以及由此带来的后果，存在争议。针对保护囚犯的方法，提出了两种策略，该方法不会导致歧视：第一，要更加谨慎，以确保获得非强制性的同意;第二，是对研究类型的限制。大多数法规都强调了拘留场所医疗保健等效原则的重要性，这是有效防范研究风险和歧视的一部分。所有提出的方法都有缺点。从道德上说，与一般人群相比，“过度使用”囚犯是没有道理的，但由于法规过于严格，不让囚犯获得对自身健康有益的研究机会也是没有道理的。应该选择一种中间解决方案，该解决方案应提供最少的保护以及最低的障碍。不能给单个被拘留者带来直接好处的研究应仅限于对整个被拘留者都有好处并且低风险的研究类型。最终能最大程度地保护囚犯，同时为他们带来最大的利益，是获得社区成员可用的相同医疗保健，包括将研究作为真正的选择。

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