Ethical Principle of Justice: How It Relates to Nursing Research

Nursing research is continual and it is consistently improving the healthcare field. When understanding research and evidence-based practice, ethics is one of the first things to consider for proper results. Evidence-based practice will not be demonstrated unless ethical research is supported. Ethics is always a topic of concern and a standard to be maintained when participating in research, especially evidence based practice in the nursing field.
Not all research studies or trials are ethical, and many haven’t been ethical in the past. For example, The Stanford Prison Experiment, The Tuskegee Study, and The Monster Study are just a few examples of well-known unethical research trials. Today, the chances seem promising when it comes to establishing ethical clinical research and advocating for subjects. The reason ethics is considered in research is for accurate outcome results and beneficence of subjects.
When thinking about ethical principles that should be upheld within nursing research, a few prominent principles come to mind. Beneficence is the understanding to promote or advocate for the betterment and positive well-being of the subject/patient. Respect is a very important ethical principle because subjects have a right to their own decisions, options, and existence in a trial. Justice is the ethical principle being discussed in this paper, and seems to be a common necessity for patient protection. Justice, in reference to nursing research and its importance, will be explained.

According to Shaké Ketefian, the author of the article Ethical considerations in research. Focus on vulnerable groups, Justice has several meanings; there is the meaning of retribution. Another meaning is justice as fairness.” (Kettefian, 2015). The Introduction to Nursing Research textbook written by Carol Boswell ; Sharon Cannon refers the definition of justice as “fairness and equality to another. It encompasses a general guideline of “what is due or owed to persons” and it “implies the rights of fair treatment and privacy, including anonymity and confidentiality”” (Burkhart ; Nathaniel, 2014, p. 528)(Boswell ; Cannon, 2017, p.179).
When justice comes to mind, fairness is the initial definition. When considering research, fairness isn’t always present. There are different control groups, or categories of subjects, and different variables of a study. Sometimes one category of a study is deprived of what’s owed to them, in other words, a lack of justice. The reason justice is crucial in research is that of equal opportunity, fair treatment, and successful unbiased participation.
Without justice before, during, and after the study, there is not a chance for accurate results/evidence. Justice also includes the discussion of all resources and information, relating to that particular patient, about their situation. Occasionally, prognoses will be shared with the family first as opposed to the patient first. The patient has a right to know all about their diagnosis, prognosis, and current options. In the article written by Sahreen Malik Bhanji, which is about Health Care Ethics, he says “It is believed that and especially in healthcare industry that all individuals have equal rights in terms of seeking health care and to participate in their plan of care” (Bhanji, 2013, p. 2).
It is due to them, especially during a study. The subject should be informed of all possible treatment options that are available during the timing of their study according to their current state. If not informed, this would fall under unethical and injustice due to the insufficient amount of resources and information offered. Justice is important to research mainly because of the right to be informed and the fairness to be fully included/advocated for.
The University of Washington School of Medicine explains ways to ensure justice is not compromised in a study, this would include avoiding the selection of participants that might be unfairly coerced into participating, such as prisoners and institutionalized children (Adams, 2013). This will automatically determine that there isn’t an assumed subject of injustice. Another step in designing a research study that includes proper justice consists of consistent privacy and the right to confidentiality. Sharing of personal or specific information would include injustice.
Each patient, no matter the study, should be free of judgment, and offered privacy as well as trusted confidentiality. When creating a study, fairness should always be considered, no matter the variables. To make sure this is upheld, the researchers have to be unbiased and informed of patient rights included in the subjects’ contracts. In a research study, justice includes promotion of the patient on an equality level. One subject isn’t favored or discriminated, all are equally valued. This guideline can be a written & signed measure when designing the research study standards that will continually be abided by.
That would be a step to instill justice. These two ways of design would be implemented before the study actually takes place. During a study, justice requirements would include offering all information (new & even poor prognosis), treating each subject with complete fairness, and demonstrating total unbiased opinion with zero judgment. Both the nurse in the nursing research study and the subject will be treated with justice by offering reward or treatment options, if applicable.
The main ethical concern is effective communication in regard to patient rights, justice falls under this idea. The greatest take-away about the ethical principle of justice within a research study is that the patient is fully informed, treated with total fairness & no judgment, and offered equality in confidentiality.
To conclude, justice is an ethical principle that needs to be upheld in every nursing research study. Majority of people strive to live by justice every day. Being fair to one another is a part of expected moral human interaction. It means fairness for each patient or subject. In a study, without fairness and equality, results are inconclusive and inaccurate because it’s considered unethical. Justice in the nursing world means that an individual is given what they are due or obligated to.
Whether that is the best care possible, or the highest standard of treatment/observation in a research study. There are measures that can & should be taken to focus on maintaining justice in a research study. According to Bhanji, justice includes “considering the best possible outcome in favor of the direct recipient of care (patient)” (Bhanji, 2013, p. 2). Therefore, justice is important to the field of nursing research because it includes patient advocacy, entitlement to proper communication involving the health care team & patient, and it fulfills patient rights for the best care possible.
References

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Adams, Lizabeth, Timothy Callahan. 2013. Research Ethics. University of Washington School of
Medicine. https://depts.washington.edu/bioethx/topics/resrch.html
Bhanji SM (2013) Health Care Ethics. J Clinic Res Bioeth 4:142. doi: 10.4172/2155-
9627.1000142
Boswell, C., & In Cannon, S. (2017). Introduction to nursing research: Incorporating evidence-
based practice.
Ezekiel, J. Emmanuel, David Wendler, and Christine Grady. 2000. “What Makes Clinical
Research Ethical?” Journal of American Medical Association, Vol.280 No.20, May
24/31, 2000, pp.2701-2711.
Keteian, S. (2015). Ethical considerations in research. Focus on vulnerable groups. Investigation
; Education in Intermedia, 33(1), 164–172.
https://doiorg.ezproxy.samford.edu/10.1590/S0120-53072015000100019

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