Ethics of Nursing Research
Conducting quality research requires the researcher to perform within both ethical and legal guidelines. “Ethics is the study of right and wrong” (Houser, J., 2012, pg.50). Ethics provide the avenue for decision making and are guided by the researcher’s integrity. Legal guidelines provide direction to the researcher by specifying what is required by law to conduct research. As a nurse researcher, it is an ethical duty to advocate for patients when incompetent, unethical or illegal practices are observed.
There are three basic principles to consider when evaluating the ethics of a study: 1) respect for persons, 2) beneficence, and 3) justice (Houser, J., 2012, pg. 54-56). To apply these principles in research is detrimental to the quality and validity of the study. Respect for person involves allowing the patient to make his/her own decisions. In order to accomplish this, the researcher must b e certain that the participant is capable of making a cognitive decision. Beneficence is accomplished through assurance that no harm will come to the participant for voluntary participation in the study. Beneficence is determined through assessment of the risks and benefits of the study design. Justice is accomplished when participant rights to fair treatment are honored. Justice includes subject selection. When the researcher has applied the basic principle of respect for persons, beneficence, and justice to determine if the study meets ethical criteria, the next step is to obtain informed consent.
Informed consent is “a process of information exchange in which participants are provided understandable information needed to make a participation decision, full disclosure of the risk and...
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...data collection, subject selection process and competency issues are resolved. I would report all concerns to the Institutional Review Board (IRB) to assure that the patients are protected and that breaches of ethical or legal nature are resolved. Any further research would be discontinued until all concerns are appropriately managed. Once concerns are resolved, research design would be modified, informed consents would be re-obtained and study would continue as planned.
Works Cited
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Houser, J. (2012). Ethical and Legal Considerations in Research. Nursing research:
reading, using, and creating evidence (2nd ed., pp. 49-77). Sudbury, MA: Jones & Bartlett
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Those who were affected by the testing in hospitals, prisons, and mental health institutions were the patients/inmates as well as their families, Henrietta Lacks, the doctors performing the research and procedures, the actual institutions in which research was being held, and the human/health sciences field as a whole. Many ethical principles can be applied to these dilemmas: Reliance on Scientific Knowledge (1.01), Boundaries of Competence (1.02), Integrity (1.04), Professional and Scientific Relationships (1.05), Exploitative Relationships (1.07, a), Responsibility (2.02), Rights and Prerogatives of Clients (2.05), Maintaining Confidentiality (2.06), Maintaining Records (2.07), Disclosures (2.08), Treatment/Intervention Efficacy (2.09), Involving Clients in Planning and Consent (4.02), Promoting an Ethical Culture (7.01), Ethical Violations by Others and Risk of Harm (7.02), Avoiding False or Deceptive Statements (8.01), Conforming with Laws and Regulations (9.01), Characteristics of Responsible Research (9.02), Informed Consent (9.03), and Using Confidential Information for Didactic or Instructive Purposes (9.04), and Debriefing (9.05). These particular dilemmas were not really handled until much later when laws were passed that regulated the way human subjects could be used for research. Patients
The IRB is an administrative body which has been established to make sure research participants' rights are protected. IRBs review all aspects of the researchers' project: the study design, the recruitment process, the participant population, the informed consent document and process, the risk/benefit ratio, privacy and confidentiality, data storage and protection, and safeguards for vulnerable participants (University of St. Francis, n.d.). In this way, participants' rights are protected because the effort is made even before the research begins. The review process ensures that participants are chosen fairly and informed adequately and the information collected during research is safeguarded through collection, use, and storage. Research using human participants is such an important part of medicine that it is imperative it is performed in a way that its intrigue is not compromised.
Every nurse will be faced with a decision making dilemma at some point in his or her career. Being familiar with the nursing code of ethics, what is ethically and morally expected in society and how to approach the situations can help make dilemmas less of a nightmare. “The purpose of nursing ethics is to inspire questions and examine what would be the ethically right action in health care situations demanding a choice between at least two undesirable alternatives” (Toren & Wagner, 2010, p. 394). There are many different ways one can approach a situation to reach a resolution, finding a method that works best with the situation at hand is ideal.
Nurses are faced with ethical dilemmas on a daily basis, each situation being unique and requiring the nurse to set aside their own values and beliefs in order to properly care for their patients. Situations requiring nurses to make an ethical decision are diverse and dynamic; the values set out by the College of Nurses of Ontario code of ethics remains the same. Therefore, all decision based on these vales regardless of the setting and circumstances ensure consistent solutions. The scenario involves a woman who was admitted to the NICU due to complications during her sixth month of pregnancy. The patient indicated that no extraordinary measures should be made to save her baby; she became further detached when the baby developed a bleed that resulted in some permanent brain damage. The ethical dilemma arose when the mother decided to put the baby up for adoption, stating she did not have time to take care of a special needs child. This paper attempts to explain the ethical values implicated in the scenario detailed below, in which the nurse cares for both mother and baby.
In conclusion, patients with AD can participate in research provided that their decision- making ability is thoroughly examined. Otherwise, a proxy can decide because he usually acts in the best interest of the patient. To be considered ethical, the research project involving AD patients has to follow the guidelines of TCPS and be approved by a Research Ethics Board. In additon, autonomy, clinical equipoise and careful evaluation of benefits versus risks should be among the main ethical concerns of the study.
There are ethical implications at every stage of the research process, including the choiceof topic to research, the selection of the design and the publication of the findings. There are 6 etical principles (ICN 2003) the health care professionals can use to guard their patients (or) clients from harm.
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
Ethical dilemmas are the issues that nurses have to encounter everyday regardless of where their workplaces are. These problems significantly impact both health care providers and patients. Patient safety is the most priority in nursing and it can be jeopardized by a slight mistake. Medication errors and reporting medication errors have been major problems in health care. Errors with medications have been found to be the most common cause of adverse drug effects (Brady, Malone, Fleming, 2009). Northwestern Memorial Hospital in Chicago conducted a research in 2012 that approximately forty percent of the hospitalized clients have encountered a medication error (Lahue et al., 2012). A nurse’s role is to identify and report these medication errors immediately in order to stop or minimize any possible harm to the patients. Ethical moral dilemmas arise when reporting the mistakes that have been made by one’s own colleagues, acquaintances, peers, or physicians.
During my employment as a LPN in a rural hospital I have witnessed several episodes related to the ethical dilemma of workplace bullying. This behavior is unacceptable based upon the professional standards of nursing. The objective of this paper will be to focus on the controversial topic of how to deal with a workplace bully. The purpose is to highlight accountability of all involved personnel: bully, victim and management.
Davis J. Anne Diane Marsha and Aroskar A. Mila (2010). Ethical Dilemmas and Nursing Practice. Pearson
In the United States, the basis for ethical protection for human research subjects in clinical research trials are outlined by the Belmont Report developed in the late 1970’s. This document, published by the Nation Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, highlights three important basic principles that are to be considered when any clinical trial will involve human research subjects. They are; respect for persons, beneficence, and justice. (Chadwick & Gunn, 2004)
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.
The article titled “Contemporary Ethical Analyses: A Shortfall in Scientific Knowledge” describes the ethics through the public’s eye. One of the major ethical issues brought up is informed consent.