以种族为基础的医学?

帕洛阿尔托——种族无疑是一个棘手的问题,除了像肤色之外的表面特征,提起种族群体间的任何遗传差异都有可能唤起人们对19世纪优生运动及其最终在纳粹意识形态中所起作用的回忆。现在,随着制药公司越来越频繁地试图针对特定种族群体研发药物,一直为人们所避讳的种族遗传学问题再度被人们提起。

目前争论的核心问题是种族是否应当被纳入临床试验的标准——以及推而广之,药品标签是否应该特别提到种族问题。这一复杂问题的解决办法其实非常简单:那就是让数据说话。

事实上,临床试验的宗旨并不是显示某种治疗(包括药物、医疗设备或其他干预方法)对普通人群中完全随机抽取的样本是否有效,相反,科研人员以年龄或实验室检查结果等某些特点来“浓缩”被研究群体,并从中筛选出比未经过滤人员更容易显示疗效的那部分患者。近年来,特定DNA序列或带有某种药物受体的“生物指标”已经成为确定临床试验资格的重要标准。

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