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国家卫生健康委起草管理条例 杜绝下一个“贺建奎”

2019-02-27 不详 网络

国家卫生健康委起草管理条例,规范临床研究的安全伦理问题

生物医学技术为诊断治疗疾病,增进人类健康提供新的手段,但如果临床研究和应用不当,也会带来隐私保护、生物安全、公共安全和社会伦理等问题。近期,"贺建奎基因编辑婴儿""疟原虫治疗癌症"等事件引起轩然大波,医学伦理成为社会关注焦点。

为进一步完善生物医学新技术临床研究与转化应用管理制度,推动生物医学新技术临床研究与转化应用规范有序进行,2月26日,国家卫生健康委所起草的《生物医学新技术临床应用管理条例(征求意见稿)》(下称《条例》)发布,并公开征求社会各界意见。其中明确,医务人员若违反规定开展临床研究和转化应用,情节严重者,吊销其执业证书,终生不得从事生物医学新技术临床研究。

哪些研究将被约束?

《条例》所称生物医学新技术是指完成临床前研究的,拟作用于细胞、分子水平的,以对疾病作出判断或预防疾病、消除疾病、缓解病情、减轻痛苦、改善功能、延长生命、帮助恢复健康等为目的的医学专业手段和措施。

生物医学新技术临床研究(以下简称临床研究),是指生物医学新技术临床应用转化前,在人体进行试验的活动。

《条例》明确,在人体进行试验包括但不限于以下情形:

(一)直接作用于人体的;

(二)作用于离体组织、器官、细胞等,后植入或输入人体的;

(三)作用于人的生殖细胞、合子、胚胎,后进行植入使其发育的。

此次《条例》中还涉及到高风险生物医学新技术,这包括但不限于以下情形:

(一)涉及遗传物质改变或调控遗传物质表达的,如基因转移技术、基因编辑技术、基因调控技术、干细胞技术、体细胞技术、线粒体置换技术等;

(二)涉及异种细胞、组织、器官的,包括使用异种生物材料的,或通过克隆技术在异种进行培养的;

(三)产生新的生物或生物制品应用于人体的,包括人工合成生物、基因工程修饰的菌群移植技术等;

(四)涉及辅助生殖技术的;

(五)技术风险高、难度大,可能造成重大影响的其他研究项目。

分级管理 各司其职

《条例》指出,生物医学新技术临床研究实行分级管理。中低风险生物医学新技术的临床研究由省级卫生主管部门管理;高风险生物医学新技术的临床研究由国务院卫生主管部门管理;生物医学新技术风险等级目录由国务院卫生主管部门制定;生物医学新技术的转化应用由国务院卫生主管部门管理;临床研究学术审查和伦理审查规范由国务院卫生主管部门制定并公布。

谁能负责临床研究活动?

在"贺建奎事件"中,其所供职的研究机构备受质疑。《条例》明确,医疗机构是开展生物医学新技术临床研究工作的责任主体,医疗机构主要负责人是第一责任人。多家医疗机构合作开展的生物医学新技术临床研究项目,项目负责人所在医疗机构作为该项目的牵头单位,并承担主要责任。

从事临床研究活动的机构,应当具备下列条件:

(一)三级甲等医院或三级甲等妇幼保健院;

(二)有与从事临床研究相适应的资质条件、研究场所、环境条件、设备设施及专业技术人员;

(三)有保证临床研究质量安全和伦理适应性及保障受试者健康权益的管理制度与能力条件。

《条例》要求,完成临床前研究拟进行临床研究的,应当在医疗机构内开展,在人体进行的操作应当由医务人员完成。教育机构、科研机构等非医疗机构提出的生物医学新技术临床研究项目,应当与符合条件的医疗机构合作。

这些技术 不得进入临床应用

《条例》要求,开展生物医学新技术临床研究应当通过学术审查和伦理审查,转化应用应当通过技术评估和伦理审查。

法律法规和国家有关规定明令禁止的,存在重大伦理问题的,未经临床前动物实验研究证明安全性、有效性的生物医学新技术;未经临床研究证明安全性、有效性的,或未经转化应用审查通过的生物医学新技术,不得进入临床应用。

研究结束 事情没完

《条例》对研究材料的保存作出了要求,即留存相关原始材料,保存至临床研究结束后30年;其中涉及子代的需永久保存。临床研究结束后,医疗机构应当对受试者进行随访监测,评价临床研究的长期安全性和有效性。

惩罚:情节严重者与研究无缘

《条例》明确了医疗机构及医务人员违反条例的惩罚措施。其中,医务人员违反规定开展临床研究和转化应用的,情节严重者,吊销其执业证书,终生不得从事生物医学新技术临床研究。

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