摘要：Increasingly, researchers grapple with meaningful efforts to involve communities in research, recognizing that communities are distinct from individuals. We also struggle to ensure that individual participants in research are fully protected. Community advisory boards (CABs) offer an opportunity to adopt a relationships paradigm that enables researchers to anticipate and address the context in which communities understand risks and benefits, and individuals give consent. CABs provide a mechanism for community consultation that contributes to protecting communities and fostering meaningful research. Furthermore, CABs can help us to re-create informed consent as a process. It is critical that we conduct research to understand the role of CABs in the informed consent process. THE BELMONT REPORT: ETHICAL Guidelines for the Protection of Human Subjects 1 was born from the fire of controversy over egregious abuses of human subjects. Its principles provide the foundation for contemporary regulations designed for the protection of human subjects. Since the mid-1980s, there has been an increased focus on the participation of groups and communities in the research process, originating from the demand of activists to be heard in the context of AIDS research. New voices and scientific challenges today are increasing the pressure to supplement or reinterpret the principles of the Belmont Report. Gostin 2 expands the application of existing ethical principles of respect, beneficence, and justice to populations and communities, extending to groups the protections now reserved for individuals. Weijer 3 asserts that a fourth ethical principle, “respect for communities,” is necessary to address the increasing vulnerability of groups and to supplement the “atomistic” view of the person epitomized in the Belmont Report. Other scholars also agree that the Belmont framework focuses heavily on individuals. Today, research demands that we consider if not a new principle, a new interpretation of Belmont to account for the ways in which research affects communities. 4, 5 The challenge to expand or revise the human subject protections of the Belmont Report by including community protection and participation as a principle builds on the assumption that new principles or regulations are necessary to include communities in a meaningful partnership. However, to date, the existence of the Belmont principles and regulations governing human subjects research has not fully prevented research abuses nor has it contributed to positive partnerships with communities. Therefore, the solution is not to change principles or regulations alone when in fact a new approach that integrates the relationships paradigm that was advocated by King et al. 6 is necessary. Community advisory boards (CABs) become one meaningful and feasible way to operationalize new protections of communities.
