Case Study 2 Overview
Question:
Discuss about the Ethical Issues in Healthcare Research for Bio-Medical Field.
The issue of ethics is a vital one in the context of conducting research in the healthcare or bio-medical field. Ethics relates to the understanding various moral issues that can be raised in the carrying out of clinical research. The domain of ethics concerns the choices taken up and the actions committed by both clinicians and patients in the conducting of biomedical research. The term ethics also connotes to the various responsibilities that that clinicians have towards their patients (Thatte, 2007). Ethics is required in medical research in order to prevent abuse of human beings under the pretext of carrying out research (Geneva: World Health Organization, 2000). In May 1947 the Nuremberg Code which was formulated to prevent the recurrences of events like the Holocaust which witnessed the most dreadful kinds of experimentation on human subjects by Nazi doctors was the first of its kind to standardize a code of guidelines that was mandatory for clinicians to maintain while conducting research on human subjects. This assignment shall aim at exploring the various ethical issues related to human rights/dignity, professionalism and legislature from the given Case Study 2 in order to arrive at a practical understanding of ethical issues in healthcare research.
In Case Study 2 we see that the students Justin and Daisy have resorted to fraudulent activities in order to facilitate their research project on determining whether pilates was an effective treatment in the maintenance of mobility and balance in men having Parkinson’s disease. 18 months into their project, they saw that 60 percent of the patients who had previously opted for research withdrew from the programme on account of lack of interest and inability to enjoy the classes. However, Justin and Daisy, in order to somehow continue with the research project made a monetary agreement with the participants which involved a $200 payment each time a participant attended a pilates class. The amount was funded through Justin and Daisy’s part time job at a private physiotherapy practice and some false claims made to private health insurance companies. In doing so, it becomes apparent that the clinicians violated ethics of medical research. However, the specific nature of the violation needs to be explored and the various issues related to it.
First, by making a monetary deal with the participants the fundamental code of voluntariness and informed consent of participants was violated. Ideally, participants have the right to not be a part of the research project and they can withdraw their consent any time they want. A monetary incentive destroys the possibility of participants exercising their free will in determining whether they want to be a part of the research and brings in a bias in the project.
The fraudulent claims made to the private insurance companies will necessarily affect their policies in insuring the costs related to the treatment of Parkinson’s in old men. It can be seen that the companies have agreed to cover the cost of pilate classes for older patients with Parkinson’s disease but very few of the patients claim the costs as mostly they are not interested in opting for pilates. The false basis of knowledge formed by the research manifests itself in practical life and leads insurance companies to make redundant changes in their existing policies. Therefore, it can be observed that this research does not conform to the principle of maximization of public interest and distribution of justice.
Violation of Voluntariness and Informed Consent of Participants
The research being published in an acclaimed international journal will be referred to by clinicians throughout the world. Moreover, this shall also encourage clinicians to use pilates as a means of treating Parkinson’s Disease in spite of it not being really effective. This creates the possibility of wrong treatment of patients and exposes them to various health related risks or vulnerabilities. This stands in conflict with the issue of human rights and dignity as this experimentation might lead to the harm of patients. Moreover, professionally, healthcare practitioners cannot accede to something that might have adverse effects on their patients’ well-being.
Legal issues related to the regulation of healthcare services have to be raised as well. The research violates a number of laws as it had not been conducted on a voluntary basis. In spite of the lack of authentic information on the subject, the research makes claims that are not grounded on reality.
The way that the given research project was conducted stands in opposition to the principles of human rights and dignity. Biomedical research should only be conducted when the clinicians, through the extensive application of existing scientific knowledge, can be sure about the need of the research. The research should also contribute towards the well-being and benefit of the patients and not make them susceptible to any kind of risks. However, the basic premise of this research is based upon an unfair activity where the participants were offered money on being a part of the project. This makes money and not well-being of people the primary motivator of the project. It must be mentioned that such a project without having authentic and reliable data might subject people to various risks that might seriously affect their health.
According to ethics in biomedical research clinicians are strictly forbidden to resort to unfair means in order to facilitate their research. This is primarily directed towards the prevention of malpractices in the healthcare sector as healthcare professional have a commitment to fulfil towards their customers and their practices should always be properly informed through existing scientific knowledge (Murphy, 2017). In this case, Justin and Daisy does not consider the importance of their professional codes as healthcare professionals in the carrying out of their research. Their activity shows that they are not really concerned with the well-being of their patients as much they are with their own acclaim as clinicians. Such practices are utterly despicable and conflicts the fundamental principles of healthcare.
It is needless to mention that the government has laws that seek to safeguard patients against such malpractices of clinicians. Moreover, there are laws to prevent such malpractices from occurring in the first place. Legislations related to offences like these are severe in nature and might result in the cancellation of licenses of fraudulent professionals. The research lacks transparency which is a basis legal requirement of any kind of biomedical research (Hall, Orentlicher & Bobinski, 2018).
As a prospective professional of healthcare services I would like to make certain professional recommendations that would attempt at alleviating the current standard of healthcare services to patients by addressing this current situation and arriving at a general understanding of how to prevent the occurrence of such unfair practices in biomedical research.
Healthcare professionals should be more communicative with their patients. This forms the basis of quality healthcare. A clinician’s occupation directly relates to the taking care of patients and therefore, it is every clinicians task to inquire into the needs of their patients. The clinician, instead of creating friction with patients and imposing his/her ideas upon the patient should rather align the nature of his/her services with the requirements of the patients and develop friendly terms with them (Runciman, Merry, & Walton, 2017). Had Justin and Daisy been more inquisitive about the actual needs of their participants then they would surely have been able to make their project more interesting.
Clinicians should be updated with the latest developments in medical science so that they can offer the best possible treatment to their patients. This will ensure that professionals make informed decisions and not work according to their presuppositions (McKie, 2013). In the context of our case study, the students should have gathered more knowledge regarding their subject and found a more relevant area of research.
In order to produce authentic and reliable research it is imperative for professionals to obtain informed consent about their experiments from their prospective participants. They should be duly informed about the risks and costs that might be associated with the research. They should also be open towards recommendations from the patients and conduct the research in accordance with the needs of the patients (Lepping, 2003). This was definitely not the case in our given Case Study. The participants were surely not communicated well-enough about what the pilate program would involve. Therefore, the patients saw that the program was not quite what they expected or wanted. Thus, money had to be used to keep them hooked to it.
Conclusion
The assignment highlights the various ethical issues related to biomedical research through the analysis of the given case study. The various ethical issues that were involved with the case was taken up and were put to analysis in order to understand how to prevent such malpractices occurring the domain of healthcare.
References
Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right. CRC Press.
MCKIE, A. (2013). ETHICS IN HEALTHCARE RESEARCH. The Essentials of Nursing and Healthcare Research, 229.
Hall, M. A., Orentlicher, D., Bobinski, M. A., Bagley, N., & Cohen, I. G. (2018). Health care law and ethics. Wolters Kluwer Law & Business.
Thatte U. (2007) Basic Principles of Clinical Research and Methodology.1st ed. New Delhi: Jaypee Brothers; Ethical issues in Clinical Research; pp. 58–73.
Geneva: World Health Organization. (2000). Operational Guidelines for Ethics Committees that Review Biomedical Research.
Murphy, E. (2017). Qualitative methods and health policy research. Routledge.
Lepping P. (2003). An ethical review of consent in medicine. Psychiatric Bulletin;27:285–90
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