Ethics in Research
HSC320 – Applied Medical and Healthcare Ethics
Instructor Rick Hall
Arizona State University
August 3, 2015
Ethics in Research
From bench to bedside
Developing new treatments or studying physiological/pathophysiological processes require different methods of research. Some tests require humans and others require animals. How do we know when each one is necessary? Well, it really depends on the type of research that is being conducted. Animals are studied so that researchers can learn more about how living organisms work and how diseases affect their bodies. There are many laws in place in the U.S. to protect research animals and human subjects. At the moment there are no alternatives to conducting …show more content…
In other words, they want animals to be tested with drugs and experimented on before they move on to test the human participants to protect the welfare of the humans. In order to protect the welfare of animals, they are not the initial test for medicines. Computers and test tubes are the initial screenings and tests in research studies to protect the human subjects and the animals. So I think that there are a lot of steps in the process before we get to animals and humans.
Clinical Research Ethics
Our history has plenty of examples of ethical violations in clinical research. It wasn’t until 1906 that the Pure Food and Drug Act was passed and started the road to protecting human participants in research. Before then, there were no regulations regarding the ethical usage of humans in research. There are several cases of what you could call unethical medical research studies in our history. From 1932-1972, the Tuskegee Syphilis Study (which was sponsored by the U.S. Department of Health), studied the effects of untreated syphilis in 400 African American men by withholding treatment. The subjects were not even told that they were in an experiment and most of the subjects believed that they were getting treated for “bad blood”. During World War 2, concentration camp prisoners were conducted upon by the German scientists for research. On December 9, 1946, 23 scientists and administrators were put on trial for allowing these crimes against humanity and war crimes. The
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According to the U.S Department of Health and Human Services, the Affordable care Act from President Obama gives consumers more options and benefits when seeking coverage from insurance company. It offers lowering cost as well as gets more access to high quality of care. This law creates Patient’s Bill of Rights that is very effective to protect consumers from any abuses or fraud from insurance company. Some preventive services are available to many Americans especially Medicare recipients at no cost. Not just that, they also receive a special offer of 50 percent discount for any well-known drugs in the market place under Medicare named “donut hole.” The Affordable Care Act helps other organizations and programs to convince healthcare providers
(1.1) In the healthcare profession various dilemmas can be encountered, sometimes everyday that put a professional in a position where they must make certain choices that can be classified as difficult or complicated depending on the individual or the situation. In the nursing profession not only do they have to consider the welfare of the patients but they also have to regard their wishes, which may create a conflict of interests in regards to promotion of well-being which would lead to the importance of informed consent. Respect for a person 's autonomy as well as respect for the individual are essential requirements; however so is promoting public interest.
The ethical dilemma I encountered at my placement involves a male in his late-sixties, who has recently suffered a stroke. Mr. A’s situation is unique as he has been unable to speak and his cognitive abilities have declined since. The Fraser Health agency protocol is to contact the patient’s family to determine who would be the temporary substitute decision makers (“Information for temporary substitute,” 2015). The health care consent and care facility admission act describes how decisions are to be made if a patient is determined incapable (Nidus Personal Planning Resource Centre, 2012). The next steps required liaising with the home health team in the community to determine if Mr. A had ever listed any family members as his emergency contacts.
The discussion on Patrick Dismuke's condition concentrated on his incapability to improve. After reviewing his symptoms and considering possible scenarios resulting from certain kinds of treatment, such as the tube that delivered nutrients into his veins that "broke the barrier between blood and air" and became "a bacteria-laden Trojan horse, opening the door to infection", we attempted to come to a consensus on what would constitute a quality life, as deliberated among the committee. We took into consideration that after every kind of surgery, his status would be temporarily improved but ultimately decline in keeping with his body's proclivity. We acknowledged that the idea of a successful stomach transplant was remote since, as
Medical Ethics has been around since the very beginning concepts of medicine. In A Short History of Medical Ethics, Albert R. Jonsen gives a brief 120-page synopsis of the differences and advances in medical ethics through different time periods and cultures. Jonsen jumps from one philosopher to the next, covering the similarities and differences between such a wide ranged topic over time. Throughout the chapters, I did notice that there was one unifying theme that stayed consistent: decorum, deontology, and politic ethics. Decorum is the appropriateness of behavior or conduct, deontology is the study of nature of duty and obligation, and politic ethics is the practice of making moral judgments about political actions.
I have spent a good deal of time in the past week reflecting on my emergency medicine clerkship experience, specifically in regards to illustrative ethical situations I have encountered. Despite by best efforts, I could not come up with a true “ethical dilemma” I encountered, in the sense that there was never a situation in which there was significant doubt or disagreement between the healthcare team and/or patients and their families about the proper or ethical course of action. In many ways, this is fortunate. Nevertheless, there were several cases that did serve to illustrate some of the core ethical principles in action that would be useful to discuss. One in particular that comes to mind involves the question of advanced directives and
At a time when patients’ health record could be accessed by almost everyone who cares for the patients, it brings to one’s attention the ideals proposed by Plato, Aristotle, Socrates, and the other philosophers and ethicists (McGonigle & Mastrian, 2015). One has to understand though, that in spite of the great headway that the Health Information Technology (HIT) has come to, there are certain worldviews on “basic values that remain unchanged, the standards for living out these values will take on new meanings as professionals confront new and different moral dilemmas brought on by the adoption of technological tools for information management” (McGonigle & Mastrian, 2015, p. 68).
Ethical standards for all healthcare professions include principles of informed consent, veracity, and beneficence to provide best care (Kornblau & Burkhart, 2012). However, the definition of best practice can still differ among patients depending on their diagnosis, age, personality, and personal culture. Best practice gets further complicated when the patient is a child. The law concerning medical decisions for children states that children are unable to make their own decisions soundly (Goldstein, 1977). A parent must stand in as the decision-maker giving consent to treatments. Parents have the right to establish and dictate the course of healthcare without interference by the state. Parents can choose to accept or decline treatments,
“For as long as medical science has existed, animal experimentation has played a major role in research.” (Parks 9) When animals are in trials they are forced to eat and inhale substances, are exposed to harsh chemicals, and their organs are removed to observe internal effects (Yashiki 1). Millions of mice, rabbits, primates, cats, dogs, and other animals are being used for experimentations across the United States (Animal 1). Primates will be tested on if there is a scientific question that can not be answered by using other animals (Parks 25). Animals can spend their entire lives being studies because they have such short life spans (Parks 10). Up to 92 percent of the drugs that are tested on those animals and were considered safe will be proved unsafe in human trials (Yashiki 12). The FDA requires that any new drug be tested on animals first to determine the impact it will have on the human body (Parks 11). Although scientists are primarily the one's who test on animals, they also have been trying to make new ways of testing products (Yashiki 4). Researchers have discovered ways of creating cell and tissue models that replicate those of humans. These models can be used in place of mice, rats, rabbits, etc. (Alternatives 4). Testing on animals, especially in the medical research department, can be beneficial. It has helped provided safe drugs and panaceas to people
We test animals, and as a result, there is ongoing debate. There are alternatives but they are still developing and aren’t always available. So when we do have to test, for things such as medicine, there are rules. Reduce, Refine, and Replace. Also known as the three R’s, this is a more humane way to test on animals. Reduce being they reduce the amount of animals to use in the tests. Refine is a test method that refines animal use; and replace is replacing animals for systems such as computer models, biomedical or cell-based
Before, animal experimentation was something that people needed to do to find cures but it is not needed anymore. “For many laboratory scientists, this waning approval isn't cause for concern, because a near-identical trend is emerging within the research community, and more and more U.S. labs are using innovative cross-disciplinary technologies to spare at least some of the 25 million animals used for research annually”(Ericson).Now, in the 21st century scientist have developed countless things that can be used for experimentation than animals. So many labs and scientists are using theses new ways to end animal experimentation. Also, scientist can test and do experiments for countless things without worrying about laws and the amount of animals that are dying now.“The innovation takes the place of animal mediums: Instead of running the drug through an animal liver, a chemist can now force the drug to react with the chemosynthetic liver. "(Ericson).This is just one of the things that scientist have discovered to do experimentation with animals. This method is so much better than using animals. This is not just beneficial to animals but it is also beneficial to scientist because now they can know more about what is happening when they test things. These new ways of experimenting do not just save the lives of animals but they also help scientist do
Health and healthcare systems interrelate with the economy to determine if accessibility to health care should be provided based on individual's need or ability to pay (“Achieving Equity,” n.d.). The role of receiving health care is to ensure that equal access to health services does not differ depending on individual's economic or social status (Merson, Black, & Mills, 2012, pg. 624). To underline this debate, there are views on the ethical basis of a health system. The first view discussed on how access to health services is similar to access to other goods. For example, people in poverty-stricken communities receiving government assistance for clothing or food based off of the economic level. According to this view, every individual should
Health care professionals often face ethical dilemmas and have to mostly rely on their own judgments when making decisions for their patients. However, the patients often have their own beliefs and decide on what kind of treatments they would like to receive for the sake of their health. As health care professionals try their best to promote the well-being of the patients, they may run into conflicts when the patients disagree with the recommended treatments and forgo any treatments to avoid more suffering and pain. This paper will delve into the issues of the right to refuse life-sustaining treatment
Everyday, healthcare professionals are faced with ethical dilemmas in their workplace. These ethical dilemmas need to be addressed in order to provide the best care for the patient. Healthcare professionals have to weigh their own personal beliefs, professional beliefs, ethical understandings, and several other factors to decide what the best care for their patient might be. This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brains hemispheres which has left her unconscious. She only has some brain stem reflexes and requires a ventilator for support. She is unable to communicate how she wishes to proceed with her healthcare. Mrs. Smith’s children, Sara and Frank have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life, as Sara would like to do, or stop all treatments and care, as Frank feels his mother would want. In the healthcare field, there are situations similar to this case that happen daily where moral and ethical judgment is necessary to guide the decision that would be best for the patient. The purpose of this paper is to explore and discuss, compare and contrast the personal and professional values, ethical principles, and legal issues regarding Mrs. Smith’s quality of life and further plan of care.