Ethicshas become an important consideration, when doing research, and hasgained acceptance in the world of research. The application of ethicsin research has made researchers to follow moral obligations whenusing human subjects, as well as follow professional standards. Theconcept of ethical research has attracted different studies in anattempt to make different issues clear concerning the idea. Thepurpose of this report is to present a literature review on the topicof ethical research.
Nursingand Research Ethics
Ethicsis rooted in the philosophical inquiry of moral life. It can beperceived as a system of principles that can critically changeconsiderations about actions and choices. According to Mantzorou &Fouka (2011), ethics is the division of philosophy that deals withthe dynamics of making decisions on what is right or wrong. There aredifferent major ethical issues while conducting research, whichinclude informed consent, beneficence, respect for anonymity andconfidentiality, respect for privacy, vulnerable groups of people,and skills of the researcher. Mantzorou & Fouka (2011) arguesthat conflicts in the nursing profession, as a researcher and in theprovision of care, can be based on the principle of non-maleficence. The ANA Code of conduct claims that a nurse has the role ofprotecting the public from unethical practices of any individual.This provision raises a concern of advocacy when nurses have to guardpatients from the incompetence or unethical conduct of theresearcher. The issue of confidentiality entails another source ofconflict since there is the need to safeguard the confidentiality ofclients’ information. Researchers must ensure that they do notreveal any information concerning human subjects, even to the fellowteam members.
Accordingto Stang (2015), research that involves the participation of humanbeings, as subjects, requires to have an oversight by theInstitutional Review Boards (IRBs). Stang (2015) argues that theinvolvement of IRBs in research ensures safety, as well as privacy,of the subjects. From the author’s point of view, the nationalinstitutes of health outline seven tenets of ethics that allresearchers need to follow when dealing with human subjects. Theprinciples include social value, fair subject selection, scientificvalidity, informed consent, favorable risk-benefit ratio, independentreview, and respect for subjects. The social value principle claimsthat research that engages humans should result in improvements inthe health or well-being of individuals and society. According tothis principle, it is considered unethical to place individuals atperil without societal benefit. The principle of scientific validityargues that an ethical research needs to employ appropriate, rigorousscientific approaches that lead to the body of evidence for aparticular field (Stang, 2015). The tenet of fair selection ofsubjects posits that an ethical study should have a wide range forthe inclusion of individuals, and reasons need to be provided for theexclusion of a certain group in research. Alternatively, thefavorable risk-benefit ratio claims that a research needs to begeared towards providing a solution to the issues that it covers. Therespect for subjects tenet provides that an ethical study requiresthat the privacy, as well as the well-being of participants beguarded at all times. On the other hand, independent review principleclaims that research studies, as well as interventions that areemployed, should be reviewed by experts in the field. Furthermore,the principle of informed consent holds that, in an ethical research,participants need to offer informed consent before participating in astudy (Stang, 2015).
Astudy carried out by Salloch et al. (2015) showed that the entiredesign of an empirical-ethical research is a multi-faceted endeavorthat needs to balance amid pragmatic and theoretical considerations.According to Salloch et al. (2015), empirical-ethical study comprisesa slightly new area of enquiry that is characterized by thecircumstance that socio-empirical research and ethical analysis arecombined for the treatment of concrete moral queries in contemporarymedicine. The authors distinguish between an ethical theory andphilosophical-ethical theories where they indicate that an ethicaltheory that underlies an empirical-ethical research has to fit thethematic subject of the study. Alternatively, philosophical-ethicaltheories are supposed to offer guidance to human action generally andare not restricted to a given field of practice. Furthermore,according to the authors, specific set-up of empirical-ethical studynecessitates a detailed reflection with regard to choosing an ethicalbackground theory (Salloch et al., 2015).
EthicalResearch and IRBs
Inan ethical research, an institutional review board (IRB) isconsidered vital. McEvenue et al. (2016) provide differentinformation concerning IRB. According to the authors, an IRB is acommittee that is charged with the responsibility of approving,monitoring, as well as reviewing biomedical research that involveshuman subjects. The primary goal of IRB is protecting the rights andwell-being of research subjects. Researchers need to submit theirstudy protocol and consent forms for the review by IRB. McEvenue etal. (2016) argue that IRBs were traditionally based in academicinstitutions so as to facilitate the monitoring of internal researchstudies and prevent ethical problems. The modern ethical standardsemerged as a response to historical abuses of vulnerable populationsin the course of conducting research. The modern IRBs usually basetheir decisions on the core principles of the Nuremberg Code. TheNuremberg Code came up as a response to the atrocities committed inmedical research during the WWII. The authors posit that local IRBsneed to offer assurances that they are protecting the safety, rights,as well as the well-being of human participants. Thus, modern IRBsbecame established as a response to historical occurrences to guardresearch subjects from unethical study. The question that has beenasked by researchers is whether they need an approval from IRB. Thisquestion has been answered by the authors, where they indicate thatthe review by IRB, as well as approval, is necessary for all studiesthat involve human participants. In addition, most scientificjournals have embraced the principles of the Declaration of Helsinki(DOH), which requires authors to indicate that their study has beenaccepted by an IRB for its publication (McEvenue et al., 2016).Furthermore, the authors have the opinion that there are threeoptions that can be used to obtain an IRB approval, which include theuse of an external IRB, partnering with an institution having an IRB,or starting an IRB for a private practice (McEvenue et al., 2016).
Applicationsof Ethical Research
Studiesinvolving humans that have been adversely affected by an occurrencemay be difficult to carry out. However, through the application ofethical considerations, it is feasible to conduct such researches.This was proved through a study that was conducted by Omerov et al.(2013). The research involved investigating whether it is possible touse suicide-bereaved patients in research, despite their experience.According to the authors, IRBs may hesitate to accept trauma-relatedprojects since they may argue that the contact might be hurtful oreven re-traumatizing for some people. However, the risks of questingparticipants about traumatic events may be overestimated and thebenefits not considered. Thus, in some instances, valuable researchmay be hindered. Omerov et al. (2013) engaged in a study thatinvolved parents who had lost a son or a daughter that was 15-30years old through suicide. In their research, the authors applieddifferent research ethics. Apart from the suicide-bereaved parents,non-bereaved parents were also included in the study. From theresearch findings, a minority of the subjects indicated that theywere adversely affected by the participation, and out of the totalnumber (1043), only two thought that the adverse impacts might lastone of subjects was bereaved while the other was not. The findings ofthe authors indicated that provided the study design of the researchis ethically sound, it is possible to use suicide-bereavedindividuals as participants because the benefits outnumber the risks.It was clear that almost all parents found the research to bevaluable. Therefore, integration of ethics in research is depicted ascrucial by the authors.
Inanother research, Sheelan & McGee (2013) conducted a study thatwas intended to indicate the ethical challenges, as well asrecommendations, for screening for depression in medical research.According to the authors, depression has been considered to play asignificant role in various major diseases. For example, depressionhas been associated with patients having diabetes, Parkinson’sdisease, and cancer among others. Also, it is associated withdecreased adherence to medical treatment or conduct changerecommendations. Because of the increasing evidence on the role thatdepression plays across diseases, researchers have seen the need tomeasure depression in studies. However, questionnaires that arestandardized and self-rating screening are commonly used. Accordingto Sheelan & McGee (2013), when carrying out a research thatinvolves screening participants for depression, the issues ofconfidentiality and informed consent need to be put intoconsideration. In case positive screens are to be referred to medicalpractitioners, subjects need to have such information and accept thereferral process, which is in line with the ethical principles. Thereshould be a leaflet showing participant’s information concerninghis/her consent to the process. Besides, the results need to beconfidential, but there is the need to reveal to them that theresults would be disclosed to the medical team in case there is apositive outcome. Sheelan & McGee (2013) posit that there aredifferent alternatives that should be considered when conducting aresearch that involves screening for depression, which includesreferring participants having positive outcomes to a morecomprehensive evaluation, referring subjects to primary care wherethe condition is most commonly managed, or reporting of positiveoutcomes in the context of collaborative. The latter option would bethe best alternative for optimal disease management.
Theissue of ethical research has become a consideration when dealingwith research involving individuals with disability. The manner inwhich these participants should be handled is of chief importancebecause there is the need to follow research ethics. In a researchconducted by Nuwagaba & Rule (2015), there is unease in carryingout research involving people with disabilities emanating fromethical processes and practices that have to be followed. In theirstudy, they indicated that there are five ethical contestations thatemerge from research involving disabled participants, which includevulnerability, positionality, anonymity, signed consent, and researchcommittee composition. The authors argue that the position of theresearcher in a study involving disabled subjects has implicationsfor the association amid the researcher and the participants, andtherefore, for the ethics of the research. The ethical tenet ofnon-maleficence is of essence in the relationship and may becomecompromised through the disparities of power. The researcher’sposition determines the ethical decisions that he/she would make.Alternatively, vulnerability differs from either side because theresearcher may deem subjects as vulnerable, but they see themselvesdifferently (Nuwagaba & Rule, 2015). Although it is not alwaysthe case, the authors indicated that dealing with the disabledbrought the issue of whether or not to sign the informed consentforms. Alternatively, despite anonymity being advocated for inresearch, the authors pointed out that there was a contestation ofwhether to include the names of the subjects in research because theparticipants desired to share their names since they felt that thenames could have an impact in case they were shared. In addition, theconstitution of the research committees may have played a role in theorientation of the disability research. From the authors’viewpoint, research involving disabled should be handled with a lotof care, and ethical principles need to be applied in entirety(Nuwagaba & Rule, 2015).
Furthermore,ethical research is exceedingly critical when carrying out researchinvolving indigenous people. According to Drugge (2016), studiesinvolving indigenous individuals are usually marked by discriminatorypractice as well as unequal research processes. In every culture,there are guidelines as to how members are expected to behavehowever, when dealing with indigenous subjects, researchers have theproblem of developing the best ethical strategies that need to beused for the indigenous participants. Drugge (2016) carried out astudy involving the Sami of Sweden to show that a study involvingindigenous participants is marked by discriminatory practice as wellas unequal research processes. According to Drugge (2016), althoughresearch ethics debates constantly take place in different nationalorganizations, there exists no global ethics system that has wontransnational approval. Rather, ethical guidelines and policies forresearch has become adjusted at varied times, and continue to changeamid different countries. In the research, the author indicated thatSweden has been left behind, in relation to other countries, indebating and developing, as well as implementing, ethical strategiesthat are best suited for indigenous research. The subject is still ininfant stage, which gives uncertainties on how indigenous researchneeds to be carried out. Therefore, in most countries, failure tohave ethical strategies that should be used while dealing with theindigenous people has made conducting of indigenous researchproblematic.
Researchinvolving children is an area that has not been offered greatsignificance by researchers. Since children are humans, it isimportant to integrate ethics in researches where kids act assubjects. According to Phelan & Kinsella (2013), conducting aresearch with children that is ethically sound is usually achallenge. There are various ethical considerations while carryingout research with kids. The authors propose that procedural ethics aswell as ethics in practice are two broad categories of ethics thatneed to be considered while doing research with children. Proceduralethics entails seeking approval from the ethics committees andreviewing boards. Alternatively, ethics in practice entails the dailyethical issues that emerge while carrying out research these issuesare usually unpredictable. Phelan & Kinsella (2013) argue thatwhile conducting research with children, it is ethical to seekinformed consent from kids that are to engage as participants. Thisshows respect and dignity for the subjects. It is important for theresearcher to find out whether a kid has fully understood what toascent to. The authors also claim that, when utilizing visual methodswith children, an additional level of informed consent is required. Since children may not have the ability to anticipate the informationthat they may be asked to provide, kids may not fathom the potentialrisks and benefits of engaging in research. Thus, it is critical fora researcher to try and anticipate the potential risks that may bepresent and explain them to the children involved in research. Inaddition, the manner in which the researcher presents himself/herselfto the kids is exceedingly vital. For instance, the language used,clothes worn, and the interaction with kids (Phelan & Kinsella,2013). Therefore, in order to have an ethical research with children,it is crucial for the researcher to understand how to deal with theconcerns of the kids as subjects.
Inanother research by Nuffield Council (2015), the issue of challengesinvolved while dealing with children, especially in health research.The study involved how researchers can ethically undertake the studyneeded in ensuring their health services are safe and effective.According to Nuffield Council (2015), there are various aspects thatmake children to be ethically different when conducting researchsuch aspects include children not being in a position to make theirown decision on whether to engage in a research or not and beingincapacitated to develop their own views. According to NuffieldCouncil (2015), parents have a responsibility in ensuring that theymake the best decisions on behalf of their kids. First, parents needto respect their children irrespective of their age or capacity.Also, they should help in the recognition of kid’s developingability for autonomous agency. Furthermore, they are supposed tothink about children’s immediate as well as long-term welfare.
Inconclusion, it can be indicated that research that involves theparticipation of human beings, as subjects, requires having anoversight by the Institutional Review Boards (IRBs). The IRBs play acritical role in safeguarding the privacy and safety of humansubjects involved in research. The national institutes of healthoutline seven tenets of ethics that all researchers need to followwhen dealing with human subjects. The principles include socialvalue, fair subject selection, scientific validity, informed consent,favorable risk-benefit ratio, independent review, and respect forsubjects. These tenets are considered significant to researchersbecause they help them to follow research standards. While dealingwith children as subjects, it is important for researchers toconsider applying additional principles of research ethics becausekids do not have the ability to make decisions on their own.
Drugge,A. (2016). How Can We Do it Right? Ethical Uncertainty in SwedishSami Research. Journalof Academic Ethics,14: 263-279.
Mantzorou,M. & Fouka, G. (2011). What are the Major Ethical Issues inConducting Research? Is there a Conflict between the Research Ethicsand the Nature of Nursing? HealthScience Journal,Vol. 5 (1).
McEvenue,G., Hofer, S., Lista, F. & Ahmad, J. (2016). Performing EthicalResearch as a Plastic Surgeon in Private Practice: The InstitutionalReview Board. AestheticSurgical Journal,Vol. 36 (4) 508-514.
NuffieldCouncil (2015). Childrenand Clinical Research: ethical issues.Nuffield Council of Bioethics.
Nuwagaba,E. & Rule, P. (2015). Navigating the Ethical Maze in DisabilityResearch: Ethical Contestations in an African Context.Disability & Society,30:2, 255-269, DOI: 10.1080/09687599.2014.998333.
Omerov,P., Steineck, G. Dyregrov, K. Runeson, B. & Nyberg, U. (2013).The Ethics of Doing Nothing. Suicide-Bereavement and Research:Ethical and Methodological Considerations. PsychologicalMedicine,44 3409-3420.
Phelan,K.S. & Kinsella, A.E. (2013). Picture This….Safety, Dignity,and Voice-Ethical Research with Children: Practical Considerationsfor the Reflexive Researcher. QualitativeInquiry,19 (2) 81-90.
Salloch,S., Wascher, S., Vollmann, J. & Schildmann, J. (2015). TheNormative Background of Empirical-Ethical Research: First Stepstowards a Transparent and Reasoned Approach in the Selection of anEthical Theory. BMCMedical Ethics,16: 20.
Sheehan,M.A. & McGee, H. (2013). Screening for Depression in MedicalResearch: Ethical Challenges and Recommendations. BMCMedical Ethics.
Stang,J. (2015). Ethics in Action: Conducting Ethical Research InvolvingHuman Subjects. Journalof the Academy of Nutrition and Dietetics.