Nursing Research and Health Care Ethics
Ethics of Research
The ethics of research-defined as what one morally ought to do in conducting, disseminating, and implementing results from systematic investigation or scholarly inquiry-are determined by both traditional and changing social values.
These values vary within and among cultures worldwide; therefore, as international nursing research increases, nurse researchers must be attuned to the ethics of conducting research in other countries (Olsen, 2003).
However, within the preceding context, two points cannot be disputed:
(a) all research has ethical dimensions.
(b) all research must be ethical.
Advancement and Ethical Considerations
Rapid advances in science and technology have led to several important policy documents and ethical guidelines for nursing research. The policy documents include the 1980, 1995, and 2003 American Nurses as society's (ANA) Nursing's social policy statement.
The ethical guidelines for nursing research include
the ANA's 1975 and 1985 Human Rights guidelines for nurses in clinical and
other research, as well as part of Provision 7 of the 2001 ANA Code of ethics
for nurses with interpretive statements.
Ethical Considerations In Research and Nursing Responsibilities
The conduct of research with humans imposes strong moral obligations on nurse researchers, especially in the light of genetic advances and the use of human biological materials in nursing research (Jeffers, 2001).
Nevertheless, once the ethics of the research have been approved by an institutional review board or its equivalent, subject or participant selection (or human biological materials selection) occurs.
The decision of whom or what to include and exclude from a study places the following moral burdens related to the ethical principle of justice on the researcher:
(a) how to weigh the ethical pros and cons of using human biological materials or vulnerable persons as subjects
(b) how to avoid consistently selecting human biological materials or subjects based solely or primarily on case of accessibility or any attribute that is not essential to the study's objectives
(c) how to avoid overuse or underuse of human biological materials or any group of research subjects
Once human subjects are selected, they should be given sufficient and unbiased information about all important aspects of the study and their roles in the study before agreeing to participate. In addition, subjects' comprehension of information about the study and the informed consent process should be ascertained initially and throughout the study as indicated.
Subjects have the right to
stop participation in a study at any time and without fear of retaliation. The
preceding steps are based on the ethical principles of autonomy and respect for
autonomy. If subjects are not autonomous, proxy consents must be obtained.
Types of Ethical Principals and Considerations
The ethical conduct of research also focuses on the ethical principle of non maleficence (do no harm). The researcher must understand that the possibility of harm or potential harm can occur to subjects at any time while conducting research.
Therefore, the researcher must carefully weigh any
benefits against therapeutic harms (ie, harms that are necessary to produce a
greater good in the conduct of the research). However, therapeutic harms always
require moral justification, and under no circumstance the subject should be
used solely as a means for the advancement of science.
The ethical principle of non maleficence also applies to scientific misconduct. Scientific misconduct is viewed as an intended act of deception that deviates from a discipline's ethical norms. It typically takes the form of plagiarism, irresponsible authorship, data falsification, data fabrication, and questionable research practices.
Nurse researchers should be familiar with
their organization's policies and procedures about scientific misconduct, as
well as federal regulations to determine scientific misconduct. In addition,
nurse researchers should be aware of three reports authored by the Institute of
Medicine on scientific integrity (James, N., Burrage, & Smith, 2003).
Ethical Board or Committee
When an interdisciplinary team is involved in the conduct of research, the principal investigator should be clearly designated and should assume overall accountability for the study. He or she is responsible for the supervision of all team members, including research assistants.
Each team member must not only
assume accountability for a part of the research but also must understand how
that research builds on that of other team members. Finally, all members of the
interdisciplinary research team must come to a common understanding of what the
ethics of research means for their study.
Guidelines for ethical Principles
The conduct of research with animals also has ethical import because of past and current cruelty to them and because of the increased need for basic research in nursing. The guiding ethical principles for researchers are:
(a) to use animals for studies only when necessary.
(b) to inflict the least amount of harm and suffering to the fewest number of animals while still attaining research objectives.
(c) to obtain the approval of institutional animal care and use committees or their equivalent.
Some scholars and ethicists would argue that significant research of high quality that is not disseminated presents an ethical issue because persons who could benefit from that research are denied that benefit. Further- more, disseminated research cannot be implemented into practice.
The ethics of the dissemination of research also involves researchers and peer reviewers.
Researchers as authors have an ethical obligation to clarify primary and coauthor credits as soon as possible during the preparation of a manuscript; to designate when the manuscript is part of a larger study; to submit a manuscript to only one editor at a time; to present accurate, unbiased, relevant, and appropriately.
Documented information in the manuscript;
to notify appropriate persons when scientific misconduct is detected in one's
own or other's studies; to avoid the use of retracted or invalid study results;
and to understand the ethical issues involved in internet research (Mi &
Chee, 2003).
Peer Review and Ethical Obligation
Researchers as peer reviewers have an ethical obligation to be objective in their review of research manuscripts and timely in their return of them; to offer constructive criticisms that demonstrate respect; to avoid any conflicts of interest; and to maintain anonymity of authors and confidentiality of content until the manuscript is published.
The research literature indicates that many practitioners of nursing lack the education needed to understand research or to use the findings in practice. This lack of knowledge and comprehension diminishes nurses' autonomy and puts them at risk for potentially unsound ethical decision making about research utilization.
Therefore, persons responsible for implementation of research into practice must assist practitioners of nursing to critical research for scientific and ethical merit and for clinical applicability. This critique includes the insight that studies typically are replicated before being implemented into practice.
Furthermore, persons implementing research into practice must ensure that strong and ethical administrative support exists so that implementation can begin, continue, and terminate if necessary without causing harm to patients, staff, or the organization.
Conclusion
In
summary, the most important aspect of research is that it be ethical. Although
the ethics of research are complex, nurse researchers should respect these
ethics and incorporate them into their studies or scholarly inquiries now and
in the future.
Give your opinion if have any.