The Role of Ethics in Nursing Research
The focus of subject protection in human research came to light in the U.S. and globally during the Nazi regime when human subjects were used in research during World War II. Eventually, this led to the Nuremberg Code in 1947, which emphasizes voluntary informed consent, independence of departure from a study, and defense against physical and mental damage, as well as death. Besides, it focuses on risk-benefit balance. In 1964, the World Medical Association established the Declaration of Helsinki, which has been revised periodically, with the up-to-date version being in 2008 (Ketefian, 2015). The Helsinki code emphasized the protection of human research subjects and proclaimed that their wellbeing is critical than social or scientific interests (Fouka & Mantzorou, 2011).
Similarly, several types of research came to light when human rights were violated in the United States, and ironically, these projects were facilitated by government and Public Health Services agencies. For instance, a study that began in the 1930s referred to as Tuskegee syphilis studies continued for over forty years, even when penicillin was already known to be an effective drug for the disease during the war (Fouka & Mantzorou, 2011). The researchers did so to study the progression of syphilis and concealed the truth from research subjects, and tis led to the death of patients. Therefore, the protection of human subjects is paramount in research.
The major ethical issues surrounding research using human subjects include voluntary informed consent, respect for human dignity and autonomy, beneficence, and justice (Ketefian, 2015). Informed consent means that a person voluntarily, aware, and intelligently permits to participate in a study. Informed consent can only be possible if the participant is made aware of the purpose, possible risks and benefits, and invasion of privacy if possible by the research. Informed consent incorporates the right to autonomy through self-determination. Besides, it protects the individual from assaults on their integrity and safeguards the subject’s veracity and freedom.
Beneficence is a Hippocratic word for “be of benefit, do no harm.” Ketefian (2015) cites that the ethical principle of beneficence involves the decree to significant research that serves better and enhances the wellbeing of participants. Thus, this principle requires researchers to assess potential risks against benefits, while averting intentional harm and reducing probable harm (National Institutes of Health, 2013). Respect for individual subjects is another ethical consideration in research which involves the respect for autonomy and privacy of research subjects. To ensure autonomy, informed consent should be sought, and the individual is given enough time to decide whether to participate in the study or not. For subjects who are unable to make informed choices, including minors and cognitively challenged, additional protections should be instituted. Justice requires fair treatment and equitability in bearing problems and getting benefits from research. For instance, justice should be demonstrated during the selection of participants through scrutiny of classes for a specific research problem rather than participants’ availability, manipulability, or compromised states.
References
Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing?. Health science journal, 5(1), 3.
Ketefian, S. (2015). Ethical considerations in research. Focus on vulnerable groups. Investigación y Educación en Enfermería, 33(1), 164-172. https:// doi: 10.17533/udea.iee.v33n1a19
National Institutes of Health. (2013). Protecting Human research participants. NIH Office of extramural research