Chapter 5
Ethical Concerns in
Research
Historical Perspective on Ethics
Nazi Experimentation in WWII
– “medical experiments”
– Nuremberg War Crime Trials
– Nuremberg Code – basic principles to govern
research involving human subjects
Tuskegee Syphilis Study
– PHS project related to untreated syphilis
– Highlights deception and informed consent
Human radiation experiments
Ethical Standards for the Protection of
Research Participants
Nuremberg Code (1947) – first set of guidelines
Helsinki Declaration (1964) – medical research
Belmont Report (1979) – fundamental document
for current federal regulations in US
Common Rule (1991) – 45 C.F.R. 46
– Federal rules that govern research involving human
participants in the US
Institutional Review Boards (IRB)
Basic Principles of Belmont Report
Respect for persons
– Proclaims individuals capable of selfdetermination;
thus voluntary consent is essential
Beneficence
– Obligates researchers to maximize potential benefits
and minimize possible harm
Justice
– Requires the benefits and burdens of research be
fairly distributed
Informed Consent
Arguably the most important ethical standard
Refers to telling research participants about all
aspects of the research that might reasonably
influence their decision to participate
Four important elements
1. Subjects are fully aware of nature and purpose of
research project
2. Consent is voluntarily given
3. Person has legal capacity to give consent
4. Responsibility for obtaining consent rests with
researcher
Protecting Vulnerable Subjects
Particular precautions must be taken to protect
the welfare of subjects that might be considered
especially vulnerable or at risk for some reason
The following types of subjects might be
considered to be vulnerable: children,
handicapped, cardiac rehab patients, welfare
recipients, prisoners, pregnant women, patients
in a mental hospital, etc.
Privacy & Confidentiality
Privacy – refers to the capacity of individuals to
control when and under what conditions others
have access to their behaviors, beliefs, and
values
Confidentiality – refers to treating subject
information or responses in a manner so that it is
not linked to any specific individual who
participated in a study
– singlesubject research requires particular caution
Normally addressed through informed consent
Institutional Review Boards
IRBs established by federal mandate to assure
compliance with governmental regulations
IRBs have authority to approve, require
modifications, or disapprove research
IRB approval required before any aspect of the
research involving human subjects may
commence
Categories of IRB Review
Exempt from review
Expedited review
Full review
Dependent upon amount of risk present
Criteria for IRB Approval
Risks to subjects are minimized
Risks to subjects are reasonable in relation to
anticipated benefits
Selection of subjects is equitable in relation to the
purpose of the research and its setting
Informed consent will be sought from each prospective
subject or their legal representative
Informed consent will be appropriately documented
Provisions for monitoring data collected to ensure
safety of subjects
Provisions to protect privacy of subjects and to
maintain confidentiality of data
Disclosure of Results
Research investigations normally result in some
disclosure of the results of the study (e.g.,
paper, published article, presentation)
The preeminent ethical obligation in this regard
is not to disclose inaccurate, deceptive, or
fraudulent research results
To do so undermines the very nature of the
scientific process!
Proper establishment of authorship.
Scientific Misconduct
According to the U.S. Public Health Service . . .
– “Misconduct” means fabrication, falsification,
plagiarism, or other practices that seriously deviate
from those that are commonly accepted within the
scientific community for proposing, conducting, or
reporting research
Ethical Obligations in Research
Researcher is responsible for his/her subjects
Researcher is responsible for his/her own actions and
those of any research aides
Subjects must provide informed consent
Researcher protects subjects from harm, danger, and
discomfort
Maintain anonymity and confidentiality
Subjects should not be coerced
Researcher has responsibility after the investigation is
complete to safeguard subject data
Honest disclosure of results