The Belmont Principles of Autonomy, Beneficence, and Justice

Values such as these do not give answers as to how to handle a particular situation, but provide a useful structure for understanding conflicts. The Tuskegee Syphilis Study violated several of these guidelines in order to continue their research. In the past and especially today this study was an unacceptable form of research that lead to the inhumane treatment of many men. The Tuskegee Syphilis Study was extremely unethical and should have been put to a stop much earlier in the process. When the study began there may not have been specific guidelines as to how to conduct a study, but after the

They used these participants for study. This study lasted 40 years. In 1979, the Ethical Principles and Guidelines for the Protection of Human Subjects of Research were published (The Belmont Report). The Belmont Report proposed the following three basic principles for the evaluation of research involving human subjects:

Throughout the history of psychological studies unprincipled violations have constructed ethical standards that are essential in today’s research. These moral dilemmas created established professional and federal standards for performing research with human and animal participants, known as, psychological ethical codes. The Tuskegee syphilis study and the Stanford prison experiment highlighted a psychological study without proper patients’ consent and appropriate treatment, resulting in a research disaster with unethical incidents.

Ethics, in our society, are the moral principles that govern our behavior, dictating what is right from wrong. The specifics of ethics changes as values in our society change and evolve. This occurs in Rebecca Skloots book, The Immortal Life of Henrietta Lacks. One major reoccurring theme in the book is the lack of informed consent and autonomy. Fortunately, now there are safeguards which protect human rights in regard to health care and research. The Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, now part of the Department of Health and Human Services, created The Belmont Report, which is one such safeguard establishing principles for all human research (USDHHS, 1979). This paper will discuss the ethical issue of informed consent within The Immortal Life of Henrietta Lacks, the disregard to parts of the Belmont Report, as well as compare the role of the nurse in charge of Henrietta’s care versus the standards of care set for modern nurses.

After termination of the study, the government implemented and has regulated several changes that impact nursing and public policy today. After ethical concerns had been publically raised and the study was terminated, the National Research Act was signed into law in 1974. This policy was used in the creation of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, which proved helpful in identifying policy issues such as the lack of identified basic principles of research conduct and lack of informed consent. Regulations were passed according to this panel’s recommendations that required voluntary consent from all persons involved in studies which are funded or conducted by the Department of Health, Education and Welfare (DHEW) (CDC, 2013). For nurses, this involves a responsibility to ensure that research participants are advocated for and the consent being obtained is used as an educational, informative

The Nuremburg Code of ethics, was established after human research atrocities in World War II created a standard of ethics. This ethical standard provided the general public with confidence and trust in that human participants involved in research will be respected and receive moral treatment. Unfortunately, the Tuskegee study undermined established ethical boundaries and it violated many aspects of informed consent, autonomy, nonmaleficence as well as many other ethical principles (Riggs,

The first one states that there should be voluntary consent and the person should be capable to give it (The Nuremberg Code, 1949). It also states that it should not cause any physical or mental harm to an individual. The participant has the right to end it if they feel it becomes impossible for them to continue and the scientist who is conducting the experiment has the responsibility to terminate it if they believe it will injure or disable the subject (The Nuremburg Code, 1949). The primary purpose of the Belmont Report is to protect the subject’s rights. Respect for person, justice, and beneficence was violated in the Tuskegee Study because the participants were chosen based on their race and social economic status.

The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research. Retrieved December 13, 2011, from hhs.gov/ohrp/humansubjects/guidance/belmont.html

The research ethics, especially with the human subjects, is a very complex topic, and the completion of the certification opened my eyes on many aspects of research process. I learned how important it is to fully understand the research purpose and the methodology especially when selecting participants. I learned which populations are considered vulnerable, how to balance risk and potential benefits of research, and the importance of obtaining an informed, voluntary consent. I learned how important it is for researchers to ensure subjects confidentiality and privacy. Hardicre (2014) said that the research would be impossible without volunteers, and that the researchers “must act as patient advocates to ensure that every stage of the research

I believe the guidelines put forth in the Belmont Report and implemented into the Common Rule are necessary to ensure the safety of human research subjects. These rules are designed to protect both the research subject(s) and the scientists/doctors conducing the research.

The three Belmont Principles (respect for persons, beneficence, and justice) were violated during the Tuskegee Syphilis Study. For example, the researchers violated the respect for person’s principle, because roughly 600 African-American men were recruited without voluntary informed consent. The researchers also did not ensure that participants understood that enrolling in the research is voluntary and that they are free to withdrawn from the study at any time without penalty or loss of benefits. The men were pressured to participate due to implied threats (coercion) and excessive compensation (undue influence). The beneficence principle was likewise violated by the Tuskegee Study in that the researchers did not obliged to give forethought

The Belmont Report identified three principles essential to the ethical conduct of research with humans:

Now we have the Belmont Report and the Declaration of Helsinki to guide researchers in the most ethical direction when they are conducting their research for studies. Luckily now researchers have to basically write out their entire plan throughout the study step by step. They must write out any way that the human subject may be harmed, what they will do if someone is harmed, any potential costs, and much more. Once all of this is written out researchers then have to get their study approved before they can move forward with their study (Neutens & Rubinson, 2014). The steps that have to be taken to conduct research may seem like a lot, however, it may save a lot of time and energy in court if something happens to go wrong during the trial.

In an article by “Vulnerable individuals represent a broad and vaguely defined group of people. Participants can be said to be vulnerable to the extent that their ability to give informed consent may be affected by physical, mental or emotional responses to their situation” (Nordentoft & Kappel, p. 369). When planning a research project, a researcher or IRB should consider the vulnerable participant as there is often diminished capacity to participate in their care thereby bringing into question the validity of understanding informed consent and the ability to withdraw from participation at any time. The Institutional Review Board (IRB) serves to protect vulnerable populations such as children, prisoners, pregnant women, and the physically

The experiment conducted on the children was justified in several different ways and appeared to be for the greater good. However, it would never be conducted in our society today because it violated many of the principles in the Belmont Report. Benefiance is one of the first principles that was violated. The well-being of the mentally challenged children was not secure as the researchers were purposely injecting them with the actual hepatitis disease. Due to this, the children were sick and had to endure all the short and long term effects of the disease. As mentioned previously, the disease causes cirrhosis which is something the children would have to live with forever. Justice is the next principle that was violated. These were not fair procedures in the experiment because the children are mentally challenged and unable to make coherent decisions. They were also chosen by the researchers for this study because the disease was already