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Ethics in research

Ethics in research. Biomedical research ethics came about as a result of abuse to research participants in the past Nazis concentration camp experiments The Tuskegee Syphilis Study

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Ethics in research

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  1. Ethics in research • Biomedical research ethics came about as a result of abuse to research participants in the past • Nazis concentration camp experiments • The Tuskegee Syphilis Study • Research was often carried out on prisoners, orphans, or mentally ill; many times without the subjects’ knowledge

  2. Ethics in research (cont.) • The Nuremberg Code (1947) • Developed from the Nuremberg Military Tribunals • Had no legal authority (unenforceable) • Only dealt with research on healthy participants • Left the control of research entirely up to scientists

  3. Ethics in research (cont.) • Declaration of Helsinki (1964) • Developed by the World Medical Association to remedy deficiencies of the Nuremberg Code • Has been amended five times, most recently in 2000 • Required medical researchers to clearly define study protocols • Protocols had to be submitted to independent ethical review committees (IRB) for approval

  4. Ethics in research (cont.) • The Belmont Report (1979) • Included 3 principles of research ethics • Autonomy – the principle of respect for persons; especially those with diminished autonomy • Beneficence – supports the well-being of research subjects by maximizing benefits while minimizing harms • Justice – the distribution of the benefits, burdens, and risks of research should be equitable between societal groups

  5. Informed consent • Nuremberg Code • “. . . the voluntary consent of the human subject is absolutely essential.” • Belmont Report • Respect for research participants • Research subjects must be given the opportunity to choose what shall or shall not happen to them

  6. Informed consent (cont.) • Signed informed consent must be obtained from every research participant • However, it is a process, not just a form • The document should be thought of as a teaching tool, not as a legal instrument • The document must be written in “lay language” that is understandable to the people being asked to participate

  7. Informed consent (cont.) • The consent document should explain • The purpose of the research • The benefits and risks • Confidentiality matters • A study contact person if questions arise • That participation is voluntary and subjects have the right to withdraw at any time • How adverse events are dealt with

  8. Chiropractic philosophy and EBC • “The foundation of chiropractic includes philosophy, science, art, knowledge, and clinical experience.” The Chiropractic Paradigm The Association of Chiropractic Colleges • However, many chiropractors have a limited understanding of the concepts of philosophy

  9. Philosophy and EBC (cont.) • Many chiropractors think of philosophy as it relates to their fundamental beliefs and underlying principles about the profession • Thus, one is said to have a philosophy of chiropractic • This perception only comprises a small part of the word’s complete definition

  10. Philosophy definition • The love and pursuit of wisdom by intellectual means and moral self-discipline • Investigation of the nature, causes, or principles of reality, knowledge, or values, based on logical reasoning rather than empirical methods • The critical analysis of fundamental assumptions or beliefs • A set of ideas or beliefs relating to a particular field or activity; an underlying theory • A system of values by which one lives

  11. Philosophy and dogma • A belief system taken to an extreme becomes dogma; defined as • An authoritative principle, belief, or statement of ideas or opinion, especially one considered to be absolutely true • Dogmatic practitioners may be reluctant to acknowledge new information and change their practices in response

  12. Dogmatism • The chiropractic profession at large is plagued with dogmatism that affects both sides of the political fenceSeaman • Dogmatism is the principle barrier to a rational and unifying depiction of the role of chiropractors, as well as the furtherance of chiropractic scienceKeating

  13. The solution for dogmatism • When used effectively, philosophy leads to a willingness to critically examine one’s beliefs • Rather than being dogmatic, one should welcome new (better) evidence and try to incorporate it into patient care

  14. EBC and philosophy are complementary • There are no sacrosanct truths in chiropractic that should never be questioned • Any conceivable chiropractic-related topic should be open for discussion

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