Ethics & Human Subjects Flashcards
protect subjects, and are carried out using scientific principles
ethical studies
unethical research includes…
- scientific misconduct
- fraud, research protocol violations
- fabrication, falsification, forging of data
- plagiarism
- putting subjects at risk without consent
elements of ethical research
- protecting human rights
- understanding informed consent
- understanding institutional review of research
- balancing benefits and risks in a study
unethical studies
Nazi medical experiments
Tuskegee syphilis study
Willowbrook study
Jewish chronic disease hospital study
ethical codes and regulations
Nuremburg Code (1949)
Declaration of Helsinki (1964)
DHEW (1973)
National Commission for the protection of human subject of biomedical and behavioral research (1978)
the voluntary consent of the human subject is absolutely essential… experiment should be such as to yield fruitful results by other methods or means of study and not random and unnecessary in nature
Nuremburg Code (1949)
results might benefit participants
therapeutic research
results are not of benefit to participants, but might be in the future
non-therapeutic research
principle of respect for persons, principles of beneficence, principle of justice; may be seen in the DHHS Belmont Report (1978)
ethical principles within the national commission for the protected of human subjects
self-determination (participation and withdrawing)
no coercion
full disclosure, no deception
voluntary consent
persons with diminished autonomy have special protections
principle of respect for persons
freedom from harm
freedom from exploitation
risk/benefit ratios
principle of beneficence
fair treatment, right to privacy (anonymity, confidentiality)
principle of justice
protection of human subjects in research
documentation of informed consent
implementation of IRB process
Protection of Human Subjects Regulations (title 45, part 46)
Public Law 104-191;
Implemented in 2003 to protect individuals’ private health information; very strict; affects research studies by requiring patient consent so as to use private health information
HIPAA
Human Rights include…
right to self-determination right to privacy right to anonymity and confidentiality right to fair treatment right to protection from discomfort and harm
human are autonomous agents with freedom to conduct their lives as they choose
self-determination
forcing someone to be in the study
coercion
subjects are unaware study is taking place
covert data
misinforming subjects about the study
deception
principle of self-determination can be violated by…
coercion
covert data
deception
are given extra protection of right to self-determination because of decreased ability or inability to give informed consent
people with diminished autonomy
people with diminished autonomy include…
- legally and mentally incompetent subjects
- neonates and children
- terminally ill subjects
- people confined to an institution
- pregnant women and fetuses
the freedom that an individual has to determine the time, extent, and general circumstances under which private information will be shared with or withheld from others
right to privacy
protects individually identifiable health information; de-identifying protected health information is allowed only if the following are removed (name, SS, dates, phone #…); covered entities
HIPAA privacy rule
researcher refrains from sharing information with others
confidentiality
unauthorized access to raw data
breach of confidentiality
no one, not even the researcher, knows the identity of the subjects
anonymity
based on the principle of justice; selection of subjects and their treatment during the study are fair for all; prevents coercion of subjects (i.e. eating subjects large sums of $ to participate)
right to fair treatment
no anticipated effects temporary discomfort; unusual levels of temporary discomfort; risk of permanent damage; certainty of permanent damage
right to protection from discomfort and harm
essential information for consent;
comprehension of consent information;
competent to give consent;
voluntary consent
informed consent
1974 National Research Act requires research study review
IRB (Institutional Review Board)
functions of IRB
protection of rights and welfare
voluntary informed consent
benefits exceed risks
Exempt from review procedures
no risk
Expedited review procedures
minimal risk
complete institutional review procedures
- review studies using vulnerable populations
- have greater than minimal risk