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Ethical Issues in Health Science
Conducting ethical research in health science requires courage and consistency to resist
social conditions that may influence integrity and compromise values. Researchers must
establish a sense of identity consisting of a professional ethical philosophy steeped in core values
that will assist them in good decision making. Without it, misconduct results as evidenced by
issues in publication, data management, and protection of human and animal subjects.
The development of identity is a dynamic process that occurs over time, but much of it
happens while learning at university (Mathews et al., 2019). Academic institutions need to build
scholarly communities that foster the ethical conduct of research, one practical means is by
establishing effective Institutional Review Boards (IRBs). IRBs ensure human subjects are
protected through the informed consent process by thoroughly reviewing research proposals
(Protection of Human Subjects, 2023). Institutions can also verify identity through mentorship
programs which allows self-reflection and interaction between mentors and peer-groups (Atkins
et al., 2020).
Personal and Professional Mission Statement
Values inform our work as researchers in health science (Douglas, 2023). In the West, the
values that undergird ethical philosophy in scientific research are rooted in Christian perspectives
like the value of truth and the pursuit of knowledge (Fox, 2023). As a Christian, it is important to
draw attention to shared values of respect, truthfulness and humility by defending the worldview
and being transparent in the values that inform our research rather than hiding it from others who
may draw those same values from other philosophical backgrounds (Fox, 2023). Secular and
Christian scientists can co-exist, in fact, they complement each other by approaching the
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advancement of science by seeking knowledge from different perspectives (Bulger, 2002). My
personal and professional mission statement is to remain steadfast in my values and transparent
as a Christian scientist so I can be an example to others in my field.
Professional Ethical PhilosophyDefined
God gifted mankind with curiosity and a mandate to seek knowledge, but my work is not
original as those facts are already known to Him. Therefore, I honor him by how I conduct
myself in that pursuit of knowledge. I must acknowledge I am human and prone to failure; it is
important to recognize relevant past indiscretions and perform frequent self-examinations (Fox,
2023), so I do not make the same mistakes others have made. I understand my identity is only
established though purposeful and consistent application of my values and that I must seek
verification of my identity through my peers and mentors. (Atkins et al., 2020).
HowEthical Philosophy Guides Decision Making
The ethical philosophy of a researcher provides a framework for decision-making. Good
decision making is a deliberate process. Living with values and applying an ethical philosophy to
decision making is all about making the right choice, it is living with integrity. No system is
infallible, ethical philosophy guides decision making when you recognize when you are
vulnerable and most at risk to falling in your values.
Publication
The inherent purpose of research is to advance science by building on the works of others
which in most cases requires publishing. However, this process is not effective if the results are
not trustworthy (Bulger, 2002). Researchers may feel pressure to publish especially if they are in
an academic or competitive setting. It is during these times it is important to assess risk and
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reflect on values and professional ethical philosophy. A good exercise may be to look at when
colleagues have been at their most vulnerable. For example, the Covid-19 pandemic presented an
opportunity for many researchers to investigate novel concepts, and many did. Over 500,000
articles were published between 2020 and 2021. Unfortunately, the retraction rate was five times
higher for Covid-19 related articles (Taros, 2023). Plagiarism, concerns with data validity, lack
of 3rd party review, and other issues of misconduct were cited as reasons for the retraction of
Covid-19 related articles (Shimray, 2022).
Data Management
Along with the premise of publishing and sharing data for the purpose of advancing
science, is the concept of data management. Data management policies are important for every
institution because it sets the expectation for all researchers to maintain high quality,
appropriately recorded, and accessible data associated with their research (Bulger, 2002). In
science, resources should always be considered scarce which means when data is not proprietary
or protected, it should be disseminated for others to use and build upon (Bulger, 2002).
An excellent example of a tool used for collaboration is the Open Science Framework
(OSF). The OSF is a free online project management tool hosted by the Center for Open Science.
The tool was established to allow researchers to manage the project lifecycle online and to make
the results available to the public if the research is available and valid according to the SCORE
methodology (Open Science Network, n.d.).
Protection of Human Subjects
Protection of Animal Subjects
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Role of the IRB in Informed Consent and Protection of Subjects
Participation of human subjects in research can present an ethical challenge if not fully
contemplated. Informed consent requires study participants to be made aware of the nature of the
study along with all potential risks and benefits prior to participating in a study. The patient must
sign an informed consent document stating they have been informed of the risks and benefits and
that they understand their treatment alternatives if applicable. They also understand their
participation is voluntary and they may withdraw without penalty and without a loss of benefits
at any time during the study. The IRBs role is to review the informed consent and research
protocol to ensure federal requirements are met in accordance with 45 CFR 46. There are three
major types of review: exempt review, expedited review procedure, and full review (Protection
of Human Subjects, 2023).
Exempt Review
Studies determined to be exempt by the IRB are still considered human subject research.
Exempt research may be considered such if it involves no greater than minimal risk to
participants in accordance with the revised Common Rule. Examples include research,
conducted in educational settings that involves normal educational practices. Interactions
involving cognitive, aptitude, achievement, surveys, interviews, or other similar studies that
cannot be directly linked to human subjects. Secondary research involving biospecimens and
private information if the information is publicly available (Protection of Human Subjects,
2023).
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Expedited Review Procedure
Studies that involve minimal risk but do not meet the criteria for exempt status may be
eligible for an expedited review procedure. According to the CFR, minimal risk is@defined as
“the probability and magnitude of harm or discomfort anticipated in the research are not greater
in and of themselves than those ordinarily encountered in daily life or during the performance of
routine physical or psychological examinations or tests” (Protection of Human Subjects, 2023).
Studies eligible for expedited review may not involve vulnerable populations (i.e., children,
prisoners, individuals with impaired decision-making capacity, and/or economically or
educationally disadvantaged persons).
Examples include collection of data from images, video, voice recordings. Research on
group behavior or characteristics which may include research on motivation, perception, identity,
communication, or social behavior). Collection of data through noninvasive procedures routinely
used in clinical practice. Minimally invasive procedures like collection of blood samples through
finger stick or venipuncture on certain classified vulnerable populations as specified by 45 CFR
46 (Protection of Human Subjects, 2023).
Full Review
If the proposed research does not qualify for Exempt or Expedited Review, the proposal
is required to submit to a Full Review. Of all the reviews, a Full Board Review carries the
greatest risk for the process of informed consent because of the special considerations for
vulnerable populations.
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The Importance of Research Mentorship
Mentors can have a positive or negative impact on those they mentor. Positive mentors
establish relationships of trust, understanding, and respect. They build confidence and encourage
independent thought. They are not afraid to provide introductions so younger researchers can
network and build professional associations (Bulger, 2002). Inevitably, seasoned researchers will
pass on whatever behaviors, good or bad, to younger scientist because they will emulate the
behaviors of their mentors. If an institution aims to have high standards for planning, conducting,
and reporting research, then mentors need to be aware of the influence they have on others. If
science is to remain autonomous, then we must be accountable to each other (Fox, 2023).
Summary and Biblical Perspectives on Ethics in Research
Humility is a value that lends itself well to research because the pursuit of truth is more
important than recognition. Researchers are often tempted by our nature to be recognized by our
hard work, but it is important to remember we are simply instruments of God. If we publish, it
should be for the good of others and to reveal God’s greatness. Philippians 2:3, “Do nothing out
of selfish ambition or vain conceit.@Rather, in humility value others above yourselves” (NIV).
As Christians, how we conduct ourselves professionally should be the same in everything
we do in life. It requires discipline, respect, and integrity. It is a choice; it is not easy to defend
your beliefs especially in a world that does not believe what you do. But God has a purpose for
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suffer The principles that govern our research should be the same as the ones that affect
everything that we do, requiring right habits, virtue and a respect for others. ‘Food gained by
fraud tastes sweet, but one ends up with a mouth full of gravel’ (Proverbs 20:17). As in any
profession we should ‘work at it with all your heart, as working for the Lord, not for human
masters, since you know that you will receive an inheritance from the Lord as a reward. It is the
Lord Christ you are serving’ (Colossians 3:23f). Every Christian’s primary duty is to God, and
this should show itself in the way we approach our everyday lives.
We should be determined to do what is right, even when it is difficult: ‘… as long as I have life
within me, the breath of God in my nostrils, my lips will not say anything wicked, and my
tongue will not utter lies… till I die, I will not deny my integrity’ (Job 27:3–5).
We also know that our ways are not hidden from the Lord.[33]@Integrity is doing the right thing
when no one else is looking. As Nobel Laureate Max Perutz said, ‘Scientists may not believe in
God, but they should be taught why they ought to behave as if they did.’[34]@
A Christian’s value before God does not depend on his or her abilities, knowledge or discoveries.
Our status does not depend on our cleverness or our discoveries and we acknowledge that our
scientific abilities are gifts from God. We are merely discovering what God has done, in our role
as stewards of the created order. This assurance should free us from the pressures to find
fulfilment in professional recognition. A Christian will acknowledge God’s providence, even in
unsuccessful grant submissions. This is not an excuse for laziness, or passively to accept poor
assessments, but to be assured that God is in control. Being a Christian should free a researcher
to resist all these pressures and should release us to collaborate with others in seeking to mitigate
them. We need not be envious of the success of colleagues or competitors, neither should we
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need to manipulate or use other people. ‘Do nothing out of selfish ambition or vain conceit.
Rather, in humility value others above yourselves, not looking to your own interests but each of
you to the interests of the others’ (Philippians 2:3).@
Conclusion
@Provides a brief summary of your paper as well as gives some ideas as to your future
evaluation/reflection of your current ethical philosophy.
References
10 sources [peer reviewed research and textbooks]).
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