Ethical Considerations of Research Paper

Module 7: Assignment Ethics and Evidence-Based Research Write a 1250-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment. Part 1: Describe why ethical safeguards designed for clinical research may not be feasible or appropriate for evidence-based practice or evidence-based practice implementation projects. Part 2: Review the sectioned headed, Two Ethical Exemplars in Chapter 22 of the textbook (Melnyk and Fineout-Overholt, 2015, pages 518-519). Discuss three main ethical controversies related to implementing Evidence-Based Quality Improvement (EBQI) Initiatives. Describe how these controversies relate to the four core ethical principles. Part 3: Identify which ethical principles may be in conflict with the concept of “patients having an ethical responsibility in improving healthcare.” Discuss how these conflicts may be resolved. Assignment Expectations: Length: 1250 – 1500 words Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion. References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

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In research, ethics govern the standards of conduct for all researchers in science. It is imperative that researchers adhere to the relevant ethical principles governing their fields so as to protect the rights, dignity, and welfare of the participants of their studies. Because of this, all research that involves human participants needs to be reviewed by an ethics committee to guarantee that all appropriate ethical standards have been met (Das and Sil 2017). An analysis of the ethical principles of beneficence, nonmaleficence, justice, and autonomy are central to reviews by this committee. Over the past few decades, a debate has arisen in the field of healthcare research on whether or not these principles are universal. They should be employed in all healthcare research endeavors. This is particularly the case when it comes to clinical research and evidence-based research, with many stating that not all clinical research ethical safeguards apply to evidence-based research.Ethical Considerations of Research Paper

Clinical research is conducted to advance the understanding of science and the promotion of human health. However, it is worth remembering that the participants of clinical studies need to be protected. Researchers need to take precautions in the planning of the research, its implementation, and the follow-up of the studies. Ethical guidelines and safeguards for clinical research are established not only to protect volunteers but to protect the integrity of science as well (Das and Sil 2017). This research is aimed at generating new knowledge or for the validation of knowledge that is theory-based. To protect participants, therefore, beneficence, nonmaleficence, justice, and autonomy must be observed.

However, unlike clinical research, evidence-based research is not about developing new knowledge or validation of the theory. It is instead about the translation of evidence into best practice. The best evidence derived from an evidence-based research endeavor is used in clinical decision making (Melnyk and Fineout-Overholt, 2015). Evidence-based practice transcends research and includes clinical expertise and patient preferences and values. It takes into account the fact that at the time, the best evidence comes from the opinion of experts and leaders in a field even though no definitive knowledge resists from research results. Evidence-based research involves innovation when it comes to discerning and translating the best evidence into clinical practice (Das and Sil 2017).

The principle of nonmaleficence, for example, may not apply for research-based. This is because evidence-based practice is based on practices that have been proven to be safe, and there is, therefore, no chance that they will negatively affect a patient. On the other hand, clinical research needs to be based on this principle as some experiments may bring harm to a patient. This is also the case for the principle of beneficence. In evidence-based practice, beneficence is guaranteed as the project being implemented is based on evidence that has proved successful at benefiting patients (Melnyk and Fineout-Overholt, 2015). Ethical Considerations of Research Paper

As far as the debate mentioned above is concerned, three controversies have emerged regarding the universal application of ethical principles in healthcare research. The first controversy relates to whether evidence-based evidence-based quality initiatives require the same level of patient consent as clinical research (Melnyk and Fineout-Overholt, 2015). The case of Henrietta Lacks comes to mind when discussing this controversy. Doctors at Johns Hopkins Hospital recovered cells from Lacks and used them to conduct research more included in clinical research. Since then, the subject of consent has been debated with the consensus that Lack’s was owed an opportunity to consent to the studies. The debate would end with informed consent being dubbed the normal when it comes to both research and treatment in health care settings. However, had the experimentation done on lacks been evidence-based and aimed towards improving her outcomes, it is unlikely that such a debate would have occurred.

The second controversy relates to whether or not it is ethical to implement evidence-based practice in a setting while continuing with traditional practice in another (Melnyk and Fineout-Overholt, 2015). It is important to remember that evidence-based research aims to provide the best evidence that can be applied in clinical settings. Part of this is to compare evidence with current practice and prove that this evidence constitutes best practice. In such a scenario, it may be necessary to conduct evidence-based practice in one setting and traditional setting at the same time to make a comparison.

Finally, the jury is still out on whether informed consent will need to be obtained from the patients receiving traditional care (Melnyk and Fineout-Overholt, 2015). It is worth noting that in double-blind studies, getting consent from patients would negate the study’s purpose. Once clinical studies have shown that a drug works, evidence-based research designed in the form of a double-blind would prove if this drug provides better outcomes than traditional treatment. In such a case, the issue of informed consent would be a non-issue as it would constitute levels of disclosure that would affect the structure of the study. Instead, informed consent should be obtained from all patients stating that they could receive either treatment.Ethical Considerations of Research Paper

As history has had it, much of the focus on ethics in medicine and research has been placed on patients’ obligations and the importance of the relationship between healthcare professionals and patients. Very little attention has been placed on the patient end of the above relationship. Many have raised the question as to whether or not patients have specific moral responsibilities. If so, what are these responsibilities? There is also the question of how patients are kept accountable to these responsibilities. The American Medical Association in 1847 published the very first Code of Medical Ethics. In it lies a section entitled “Of the Duties of Physicians to Their Patients and of the Obligations of Patients to Their Physicians.” The section states that:

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“for the welfare of those who avail themselves of their services, certainly have a right to expect and require, that their patients should entertain a just sense of the duties which they owe to their medical attendants” (Reiser et al., 1977).

The roles of patients include;

• Provide healthcare officers with all details necessary for the diagnosis and development of an appropriate treatment plan.
• Informing medical officials on all details pertaining to the illness that may endanger the lives of the officials, especially in infectious diseases.
• Where infectious diseases are concerned, patients are responsible for naming the people they contracted the disease from and those they have subsequently infected.
• Inform medical officers of any medical statements they have made concerning healthcare.
• Complying with all instructions given relating to their medical intervention.
• Observing the rules of the healthcare facility
• Paying all fees determined by the healthcare provider and prescribed by law.
• Show evidence of their personal data.

With these roles in mind, one may conclude that the ethical principle of autonomy conflicts with the concept of “patients having an ethical responsibility in improving healthcare.” Patient autonomy refers to the patient’s right to decide on their medical care without medical officials trying to influence their decision (Das and Sil 2017). This principle does not prohibit healthcare providers from educating patients but insists that the patient make the decision exclusively. This principle conflicts with the patient’s role and responsibility to comply with all instructions given relating to their medical intervention.

Ethical Considerations of Research Paper

The above conflict can, however, be resolved. This will involve taking full advance of the patient education allowance that the principle allows. Even if the patient has the final say, healthcare workers in the line of advanced practice nurses and physicians can ensure they have exhausted all relevant information and advise the patient on the best course of action to ensure favorable outcomes. This advice may also involve recommending evidence-based practices to the patient. With this information in place, the patient can choose to employ it or ignore it. Either way, the decision will be out of the health care worker’s hands, and autonomy will have been achieved. However, it would be the role of the ethics committee to determine the degree to which healthcare practitioners can advise a patient’s decisions. For instance, some cancer patients refuse to undertake chemotherapy once diagnosed with stage three cancers or higher. Some healthcare providers continue to pressure treatment for the patient after they have declined it to the extent of having them see a psychiatrist. It is up to the ethics committee to decide where the hypothetical “line” lies.

References

Das, N. K., & Sil, A. (2017). Evolution of ethics in clinical research and ethics committee. Indian journal of dermatology, 62(4), 373.

Melnyk, B. M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.) Philadelphia, PA: Wolters Kluwer Health. ISBN: 978-1-4511-9094-6.

Reiser, S. J., Dyck, A. J., & Curran, W. J. (1977). Ethics in Medicine Historical Perspectives and Contemporary Concerns. Ethical Considerations of Research Paper