Ethics in nursing
research
SUPERVISION: DR Khadijah Alhnafawy.
CONTENTS:
• Introduction.
• Ethical approval.
• Historical background.
• Code of ethics.
• Ethical principles.
• Veracity.
• Confidentiality.
• Informed consent.
• Ethics committee.
• Risk/benefit assessment.
• Right to anonymity and confidentiality.
• Conclusion.
• References.
INTRODUCTION
When we are discussing about ethics in research and
research publications, we are speaking about what is right
and what is wrong, what is good and what is bad. Ethics is
the cornerstone in every research. Ethical considerations are
needed to guarantee the quality of scientific work. They also
make visible researchers’ right their study.to conduct
INTRODUCTION
Taking care of the ethical questions is the responsibility of
the researcher and publisher, but at the same time, it also
gives protection for them and most importantly for the study
participants. High‐quality publication forums publish only
ethically approved studies and articles based on them.
Ethical principles must be on researchers’ mind during the
whole research process, and ethics belongs to every phase
of the process.
Ethical approval:
The approval from ethical board gives both the researchers
and study participants verification that the research process
is well prepared and it acknowledges the rights a study
participant has. The rights are respecting the autonomy of
research subjects, avoiding harm and privacy and data
protection – not harming her or him, anonymity, how
receiving the informed consent to participate and the
possibility to discontinue the study without reason. Research
integrity is a term that emphasises the honesty and integrity
that all researchers are required to adopt in their research
activities..
Historical background
-In 1789, Edward Jenner first inoculated his son, aged 1 year,
with swinepox against smallpox in England. This vaccination
method proved to be ineffective, and later Jenner used
cowpox on other human subjects. This approach was
successful and led the way for effective inoculation against
smallpox, a lethal disease (Reich, 1995).-1930-1972– USA-
medical treatment deliberately withheld in order to study the
course of untreated disease - (Tuskegee Syphilis study,
sponsored by US Public Health service)
Historical background
1940s- Germany-The most egregious documented atrocities
were probably the Nazi experiments that were conducted
mainly on prisoners during World War II. These experiments
included “putting subjects to death by long immersion in
subfreezing water, deprivation of oxygen to learn the limits of
bodily endurance, or deliberate infection by lethal organisms
in order to study the effect of drugs and vaccines" (Reich,
1995, p. 2253).
Codes of Ethics :
Codes of Ethics have been developed in response to these
violations of human rights
1949 - Nuremburg code
1964 - Declaration of Helsinki accepted by the World medical
Assembly
2000 - Declaration of Helsinki revised -Many organizations or
disciplines have established their own code of ethics
Codes of Ethics :
Nurses have developed their own Code:
-ANA - Ethical Guidelines in the Conduct, Dissemination and
Implementation of Nursing Research
-ICN - Code for Nurses
•The Belmont Report - a model for many guidelines “The Belmont
Report “
-Code of Ethics which was adopted by the National Commission
forProtection of Human Subjects by the Federal Govt of the USA.
-Used widely and many of the guidelines adopted
The three major ethical principles incorporated into most guidelines
are beneficence, respect for human dignity, and justice.
1- Beneficence involves the protection of partici-pants from
physical and psychological harm, protection of participants from
exploitation, and the performance of some good.In deciding to
conduct a study, researchers must carefully weigh therisk/benefit
ratio of partic- ipation to individuals and also the risks to par-
ticipants against potential benefits to society.
2--Respect for human dignity also encompasses the right to full
disclosure, which means that researchers have fully described to
prospective participants their rights and the full nature of the
study.
•When full disclosure poses the risk of biased results,
researchers sometimes use :-concealment (the collection of
information without the participants' knowledge or consent) or-
deception (either withholding information from participants or
providing false information).
•If deception or concealment is deemed necessary, extra
precautions should be used to minimize risks and protect other
rights.
3- Justice includes the right to fair treatment (both in the
selection of participants and during the course of the study) and
the right to privacy.Privacy can be maintained through anonymity
(wherein not even researchers know participants' identities) or
through formal confidentiality procedures that safeguard the
information participants provide.
Veracity
The ethical principle of telling the truth'. You, as a
researcher, must be honest with participants and inform
them of potential risks and benefits, as well as of their right
to decide whether to participate or not, without any
coercion, and to withdraw at any time.
The principle of veracity also links to the need for
researchers to consider how to establish a trusting
relationship, and how they will respect the rights of
participants. This includes a duty to respect the autonomy
and dignity of participants.
Informed Consent
The purpose of informed consent is to protect research
participants and allow them to make informed choices.
Obtaining written informed consent to participate in
research is one of the most important ethical
considerations in the research process and it ensures that
the principle of “respect for persons” is acknowledged and
adhered to. The voluntary essential.consent of the human
subject is absolutely
This means that the person involved should have legal capacity
to give consent; should be so situated as to be able to exercise
free power of choice, without the intervention of any element of
force, fraud, deceit, duress, over-reaching or other ulterior form of
constraint or coercion ;
The four essential components required for a valid informed
consent are :
a. Disclosure of information.
b. Comprehension.
c. Competency.
d. Voluntariness.
Confidentiality
Confidentiality Participants in research have a right to expect
that any information that they provide will be treated
confidentially and that any disclosure of information about
them will only be done with their consent. There must be a
clear understanding between the researcher and participant
concerning the use to be made of the data provided and how
personal information will be stored.
Confidentiality
Participants must be given details mation sheet, of who will
have access to their data other than the researcher. Research
participants should not be discussed beyond the needs of the
project team and the data must be kept secure at all times.
and an ethics committee will normally expect electronic data
to be password protected. Access to the data should be
restricted to only those people who have a legal reason to see
it.
Risks/Benefits Assessment
Risk-Benefit Assessments One strategy that researchers use
to protect participants is to conduct a risk- benefit assessment.
Such an assessment is designed to determine whether the
benefits of participating in a study are in line with the costs,
be they financial, physical, emotional, or social (i.e., whether
the risk-to-benefit ratio is acceptable.
Risks/Benefits Assessment
The risk-to-benefit ratio should also be considered in terms of
whether the risks to participants are commensurate with the
benefit to society and to nursing in terms of the quality of
evidence produced. The general guideline is that the degree
of risk to be taken by participants should never exceed the
potential humanitarian benefits of the knowledge to be
gained.
ETHICS
COMMITTEE
Major responsibility of com't'e or IRB:: Review research
proposals at convened meetings to ensure that ethical
guidelines are followed Ensures no violation of human
participant The committee will include scientists, research
experts, lay persons, lawyers, ministers of religion.
•Review procedures of selection, protection, voluntary consent,
confidentiality
Conclusion
The generation of research evidence is crucial to the
provision of safe and effective health and social care. If
research is based on a robust design and is conducted in a
safe and ethical manner, the process and outcome of
knowledge generation can be of benefit to everyone involved
.
THANKS for
listening
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Resources
Introduction + approval: Scandinavian Journal of Caring Science (page 449) jun 1 , 2018
Historical: Introduction to Nursing Research “Incorporating Evidence-Based Practice
(page 63)
Ethical Principales : Nursing Research : principal and methods (page 159)
Veracity: Nursing Research : An Introduction (page 102)
Confidentiality: Moule , Pam, Helen Aveyard , and Margaret Goodman.
Nursing research:An introduction. Sage, 2016.Informed consent:Risk/benefit assessment
: Polit , D. F., & Beck, C. T. (2009).
Essentials of nursing research:Appraising evidence for nursing practice. Lippincott
Williams & Wilkins.Right to anonymity and confidentiality : ANA guidelines for protecting
human rights
