Appraisal, Synthesis and Generation of Evidence Discussion Paper

Human Research Protection

Video 1: Caring Corrupted: The Killing Nurses of the Third Reich (https://www.youtube.com/watch?v=Rz8ge4aw8Ws)

What stands out is the ethical and professional duty of nurses and other medical personnel to protect the life, dignity, health, integrity, right to confidentiality, privacy, and self-determination of humans, whether as patients or research subjects. The nurses in the Third Reich failed in this regard by being complicit in the Holocaust. As a nurse and medical professional, it is shocking and horrifying to know that nurses were integral in the killing programs conducted by the Nazis, going on to support and encourage the killing of persons whose lives are deemed “not worth living”. This is a ghastly aberration that is unthinkable in today’s nursing and healthcare practice environment. It is important to understand the mechanisms that existed to encourage nurses of the Third Reich to participate in genocide against persons whose lives were deemed “not worth living”, as this can help to explain why nurses participated in the killings of hundreds of thousands of helpless women, men, and children. This can act as a model for teaching nursing ethics by encouraging nursing students to question and examine nursing practices and ethical principles, as well as their values within the healthcare system. Such ethical violations and crimes should not happen again, and the key to preventing this is education and exposure of nurses to the reality of what occurred (Murray, 2022). Appraisal, Synthesis and Generation of Evidence Discussion Paper

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Video 2: Research Ethics involving Human Subjects (https://www.youtube.com/watch?v=-O5gsF5oyls)

The video presents a brief overview of the history of human research ethics in the USA, exploring how the Nuremberg trials and Tuskegee syphilis study led to the Belmont Report, which acts as a regulatory framework for research ethics. An important lesson from the video is an understanding of the need for informed consent as a basic ethics principle with a focus on voluntariness, comprehension of information, and capacity. Informed consent is an agreement from a human subject to participate voluntarily in a research study, showing a willingness to participate voluntarily after understanding what the research entails, including the benefits, risks, and duration. In applying the principles of informed consent, it is noted that human participants in any medical research study have the right to know precisely the subject of the research, the benefits to expect from participation, and the risks that could be involved in the study. After being so informed, human participants then have the right to refuse to participate in the study or terminate their participation. If a human participant is unable to give consent (maybe because of age, inability to communicate or diminished mental capacity), then a family member, legal guardian or parent can be allowed to give consent, typically in written form presented in accessible language and accurate in detailing aspects of the research. An understanding of informed consent is important for ensuring that human participants retain their autonomy and right to make decisions (Hall & Roussel, 2022). Appraisal, Synthesis and Generation of Evidence Discussion Paper

Videos 3 and 4: The Belmont Report (Part One: Basic Ethical Principles) (https://www.youtube.com/watch?v=86zWBjDaXPk) and (Part Two: Applying the Principles) (https://www.youtube.com/watch?v=cIafASIIU70)

The two videos clarify the meaning of the Belmont report, particularly the ethical principles it presents, and how they apply to human research cases. The report identifies basic ethical principles and guidelines that address ethical issues that arise from conducting research with human subjects. The report presents the basic ethical principles that underlie the conduct of behavioral and biomedical research involving human guidelines. In addition, the report develops guidelines to ensure that research involving human subjects is conducted following ethical principles. Given the human subjects abuses that occurred in the Second World War and the Tuskegee syphilis study, it is clear that researchers could not be trusted to exercise their judgment in protecting human subjects. However, what stands out is the areas of ambiguity found in applying the principles. The principles are not easily supported and are easily challenged to arrive at the best decision with only limited information. It becomes clear that although the Belmont principles provide a solid ethical foundation, how the principles are applied can vary. They are simply the main guiding principles. Real-world cases involving human beings in research can be complex. In essence, there is a need to understand that the Belmont report provides a theoretical background adequate to evaluate the ethical code of conduct for researchers. Understanding this is important because ethical principles are invented and reinvented as time and circumstances change. A good ethical intervention is good because it is good for something. The ethical system is basic and less formal, with the ethical authority residing in a shared system of rules understood and enforced by everyone in general and by no one in particular, representing a kind of ethical common sense. Assuming that the Belmont report presents three ethical principles (respect for persons, justice, and beneficence) that are the most relevant ethical rules, then it becomes clear that they may not be sufficient to cover all ethical concerns. The report is too vague to offer much help in resolving difficult ethical questions concerning research involving human subjects (Hall & Roussel, 2022). Appraisal, Synthesis and Generation of Evidence Discussion Paper

Video 5: Guiding Principles of Institutional Review Boards (IRB) (https://www.youtube.com/watch?v=iFik0of3iUM)

The video explores the IRB’s role in research involving human subjects, and the guiding principles by which the board operates, particularly respect for persons, risk and benefit analysis, and justice, and fairness. It makes it clear that human research will continue as an imperative for medical progress to include expanding understanding and capability to treat serious health issues. However, research into humans must take into account the ethical dimensions of the reasons for engaging human subjects and the proper procedural steps that must be applied to reflect good science. Protecting human participants is the top priority and must be given great consideration in conducting ethical research because the exact benefits and risks of research may be uncertain. Human rights, particularly those enshrined in constitutional frameworks, have often been ignored in public perceptions concerning research involving human subjects. Historical events bear this, showing that human rights have not always been considered. An example is Edward Jenner who tested the smallpox vaccine on his own son and neighborhood children. The IRB is a consequence of historical failures and other groundbreaking medical research that affected public perception of human rights in clinical research. The IRB is an important body of research supervision that protects human research participants. Accreditation by the IRB is an indication of human subjects being protected (Gray & Grove, 2020). Appraisal, Synthesis and Generation of Evidence Discussion Paper

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References

Gray, J. R., & Grove, S. K. (2020). Burns and Grove’s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (9^th ed.). Elsevier Inc.

Hall, H. R., & Roussel, L. A. (2022). Evidence-Based Practice: An Integrative Approach to Research, Administration, and Practice (3^rd ed.). Jones & Bartlett Learning, LLC.

Murray, E. (2022). Nursing Leadership and Management for Patient Safety and Quality Care (2^nd ed.). F.A. Davis Company.

Search YouTube for the following videos to review:

Caring Corrupted: The Killing Nurses of the Third Reich Appraisal, Synthesis and Generation of Evidence Discussion Paper
Research Ethics involving Human Subjects
The Belmont Report (Part One: Basic Ethical Principles)
The Belmont Report (Part Two: Applying the Principles)
Guiding Principles of Institutional Review Boards (IRB)
After viewing the videos, in a Microsoft Word document of 2-3 pages formatted in APA style, address the following criteria for each video:

Describe one point from each video that you think is important regarding protecting human subjects in research.
Your rationale for why you think the point you described is important. Site all references on a separate sheet of paper in APA format Appraisal, Synthesis and Generation of Evidence Discussion Paper