Research - Ethics: Nursing

Debbie is a client who’s being discharged from the hospital after having a portable chest tube placed following a spontaneous lung collapse. Before leaving, Debbie is approached by Nurse Randy, a nurse researcher, who says, “I’m conducting a study to learn about peoples’ experience being discharged home with a chest tube. Would you be interested in participating?” Debbie says, “I’m not sure, I’m a little worried about my personal information being shared with strangers.” Nurse Randy informs Debbie of the ethical considerations of his study and explains how he plans to protect each participant’s human rights, including privacy. After listening to Nurse Randy, Debbie agrees to participate in the study and Nurse Randy obtains informed consent from her.

Okay, so research is a systematic process of validating, refining, and generating knowledge; and ethics refers to moral principles that guide a person’s behavior and choices, like deciding between right or wrong. When conducting a study, researchers should adhere to principles of research ethics by following ethical principles which protect human rights, such as Nurse Randy obtaining Debbie’s informed consent by explaining the purpose of the study; how Debbie would participate in the study; any possible risks or benefits of the study; and giving her the choice whether or not to participate in the study. When research ethics are not upheld, research misconduct occurs.

Research misconduct is intentional behavior in research that is considered unethical. There are several historical incidences of research misconduct which served as catalysts in the formation of the ethical codes and guidelines which direct ethical research today. One example is the Tuskegee syphilis study. In this study, which lasted from 1932 to 1972, researchers observed the effect of untreated syphilis in Black men. The participants were examined by doctors, but never administered penicillin, even though it became standard treatment in the 1940s. This resulted in preventable participant harm and even death. An investigation of the Tuskegee study found it to be unethical and, in 1997, President Clinton publicly apologized for the government’s role in the event.

Another example of research misconduct occurred during World War II when Nazi doctor’s performed research on disabled, mentally ill Jewish individuals who couldn’t or didn’t consent. The research consisted of exposing participants to high altitudes and freezing temperatures as well as poisons and experimental surgeries. In 1945, the doctors who performed these experiments were brought to trial in Nuremberg, Germany. Following the trials, the defense team presented guidelines for future research with human participants, known as the Nuremberg Code.

Among the guidelines were the need for a participant’s voluntary consent for research; the right of participants to withdraw from studies; protection of participants from physical and mental suffering, injury, disability, and death during studies; and lastly, an assessment of the benefits and risks in a study. In 1976, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research created the Belmont Report, which identified three ethical principles as crucial in human research. These ethical principles included respect, or having regard for someone’s feelings and wishes; beneficence, which means doing good, and justice, or treating all people fairly.

Alright, so it’s your responsibility as a nurse researcher to uphold the ethical principles associated with research to protect the rights of the subjects participating in the study. You can uphold the ethical principles of respect by protecting the participant’s right to self-determination, meaning that they can make their own decisions, and that potential study subjects should never be coerced into participating. Nurse Randy upheld self-determination by informing Debbie about the details of the study as well as respecting her choice to voluntarily participate or not; and to reassess her feelings about participation throughout the data collection process.