Ethics

1. Ethics Ethics Applied to Research Back to Class 2

2. Ethics in Nursing Research • Scientific Misconduct – a fabrication, falsification, plagiarism or other practice that seriously deviates from those that are commonly accepted within the scientific community. It does not include honest error or honest differences in interpretation or judgments of data. It does include irresponsible authorship. (PHS, 1989)

3. Historical Events Which Affected Ethical Codes • The Nazi medical experiments from 1933-1945 – • The Nuremberg Code of 1949 • The Declaration of Helsinki of 1964 (rev. 1975) • The Tuskegee Syphilis Study – 1932-72 • The Jewish Chronic Disease Hospital – 1965 • Milledgeville, GA Drug Case – 1969 • San Antonio Contraceptive Study – 1969 • Willowbrook Hospital Admissions – 1972 • Classroom Schoolteachers – 1973 • Psychology Studies – 1973

4. Ethical Principles for Research • Identified by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research • Respect for Persons • Beneficence • Justice

5. Human Rights To be Protected Belmont Report - 1978 • The right to self-determination • Violations – coercion, covert collection, deception, diminished autonomy • The right to privacy and dignity • Violations – invasion of privacy – sharing information, collecting information • The right to anonymity and confidentiality • Violations, breech of confidentiality, lack of coding or grouping, reporting so individual can be ID’d.

6. Human Rights To be Protected • Right to fair treatment • Violations – unfair selection, unfair treatment during study • Right to protection from discomfort and harm • Violations – physical, psychological, social, or economic discomfort or harm • Right to full disclosure

7. Specific Things the Subject Should Know about a Project • Nature, duration and purposes • Processes by which data will be collected • Use to which findings will be put • Any and all inconveniences • Andy results or side effects • Alternatives to participating • Right to refuse • Identities of investigators – how to contact them

8. Reynold’s Five Categories of Discomfort or Harm • No anticipated effects • Temporary discomfort • Unusual levels of temporary discomfort • Risk of permanent damage – physically, emotionally, socially, personality, reputation • Certainty of permanent damage

9. Institutional Review Board (IRB) required by law - 1974 • Must have at least five members who reflect expertise and professional, gender, racial and cultural diversity. One must be primarily nonscientific and one must be from an outside agency. • Exempted reviews and expedited reviews • Satisfaction of the Code of Federal Regulations – p. 294 text

10. Assessments • Risks – type, degree and number, actual or potential, physical, emotional, social, economic – likelihood • Benefits – knowledge to be gained, improvement expected – physical or otherwise, rewards • Ratio – benefits and risks should balance or benefits should outweigh the risks

11. Informed Consent Essentials • Introduction of research activities • Statement of purpose • How or why subject was selected • Explanation of procedures • Description of risks or discomforts • Description of benefits • Alternatives • Confidentiality • Offer to answer questions • Claim of no coersion • Offer to withdraw

12. Documentation of Consent • Waived consent – instudies that have only minimal risk – questionnaires • Short form consent – “The elements of informed consent required by law have been presented orally to the subject or the subject’s legally authorized representative” Needs a witness. • Long form – signed by subject and witnessed • Children from 7 -18 years should be given the right to assent – they do not have to sign Back to Class 2