Escolar Documentos
Profissional Documentos
Cultura Documentos
Alvin Concha, MD
Davao Medical School Foundation
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Objectives
Research
What we hope to achieve
Ethical guidelines
Ethical principles
Other issues At the end of the session, you will be able to:
Animal research − describe ethical principles in research
Bottomlines
− define informed consent
− enumerate the contents of an informed
consent form
− describe practical issues in participants’
autonomy
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Objectives
Research
Outline
Ethical guidelines
Ethical principles
Other issues
Why do research
Animal research
Origins of international guidelines (from
Bottomlines
lecture of Prof Edlyn Jimenez)
Tuskegee videos
Ethical principles
Other issues: privacy, confidentiality,
deception, inducement, authorship
Animal research
Summary
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Objectives
Research
Research
Ethical guidelines
Ethical principles
Asking questions
Other issues
Generating answers through a rigorous process
Animal research
Communicating the new information
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• Knowledge/information production
• Advancement of medicine through research
What we What we
already already
know know
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Objectives
Research
Life expectancy over the decades
Ethical guidelines
Ethical principles
The increased longevity of humans over the past century can be
significantly attributed to advances resulting from medical research.
Other issues (http://wisconsinmedicalresearch.com)
Animal research
75 years
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67 years
65 years
Source: Chernin, E. Richard Pearson Strong and the iatrogenic plague disaster in Bilibid Prison, Manila, 1906. Rev Infect Dis. 1989
Nov-Dec;11(6):996-1004.
Objectives
Research
The thing about research
Ethical guidelines
Ethical principles
Other issues
Research participants may be unduly harmed
Animal research − 1970: Laud Humphreys published Tearoom Trade, a
Bottomlines study on “deviant behavior”; the book described how
he pretended to be a lookout for men who had fellatio
in public restrooms. Humphreys copied their car plate
numbers to get their addresses, and interviewed the
men by pretending to be a market researcher.
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Objectives
Research
The thing about research
Ethical guidelines
Ethical principles
Other issues
Animal research
Bottomlines
Nazi
Medical
Experiments
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Source: http://www.ushmm.org/wlc/media_ph.php?lang=en&ModuleId=10005168&MediaId=859
Objectives
Research
The thing about research
Ethical guidelines
Ethical principles
Other issues
Tuskegee Syphilis Study
Animal research
Bottomlines
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Objectives
Research
Ethical guidelines
Ethical guidelines
Ethical principles
Other issues
Nuremberg code (1947)
Animal research − Principles resulting from the Nuremberg Trials (the
Bottomlines Doctors’ Trial) (1945-49)
− 23 leading German physicians and administrators – for
conspiracy, war crimes, crimes against humanity,
membership in criminal organization
− principles
informed consent (autonomy)
absence of coercion (autonomy)
properly formulated scientific experimentation
beneficence towards experiment participants
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Objectives
Research
Ethical guidelines
Ethical guidelines
Ethical principles
Other issues
Declaration of Helsinki (1964)
Animal research − By World Medical Association, amended several
Bottomlines times
− First significant effort of the medical community to
regulate itself
− Principles
respect for the individual
right to self determination (autonomy)
research should be based on a thorough knowledge of the
scientific background
research must have a reasonable likelihood of benefit to the
population studied (beneficence)
research must be conducted by suitably trained investigators
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Cell Research
− Ethical Guidelines for International Collaborative Research
Objectives
Research
Ethical principles
Ethical guidelines
Ethical principles
Beneficence
Other issues
− Research should make a positive contribution towards
Animal research
the welfare of people.
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Justice
− The benefits and risks of research should be fairly
distributed among people.
Autonomy
− Research must respect and protect the rights and
dignity of participants.
Non-maleficence
− Research must not cause harm to the participants in
particular and to people in general.
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NON-MALEFICENCE:
Objectives
Research Harms that research can cause
Ethical guidelines
Ethical principles
Other issues
psychological harm
Animal research
social harm
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legal harm
harm to dignity
deception: non-disclosure of adequate
information, or giving of incorrect information
about the research; may be allowed in certain
circumstances
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AUTONOMY:
Objectives
Research Informed consent
Ethical guidelines
Ethical principles
• Consent given by a
Other issues
Animal research
competent individual who
Bottomlines
has received the necessary
information, who has
adequately understood the
information, and who after
considering the
information, arrived at a
decision without having
been subjected to coercion,
undue influence or
intimidation.
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AUTONOMY:
Objectives
Research Voluntariness
Ethical guidelines
Ethical principles
Other issues
• Non-written consent
Animal research must be documented
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• For a minor child
(below 18 years),
insane, deaf-mutes or
those who cannot
write, consent of a
legally authorized
representative PLUS
assent of the mentally
competent participant
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are required
AUTONOMY:
Objectives
Research Voluntariness
Ethical guidelines
Ethical principles
A man’s supplemental consent may be accepted, but in no
Other issues
case may a competent adult woman be enrolled in
Animal research
research solely upon the consent of another person. Her
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individual consent is always required
If the community consents to participate, individuals may
still refuse to participate; if the community does not
consent, individual members of the community should not
be approached for study enrollment
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AUTONOMY:
Objectives
Research Contents of informed consent
Ethical guidelines
Ethical principles
Other issues
Title, aims and duration of the study
Animal research
What you will do to the participants and what
Bottomlines
their participation will be
Risks in joining the study
Benefits in joining the study, including fees for
participation
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AUTONOMY:
Objectives
Research Contents of informed consent
Ethical guidelines
Ethical principles
Other issues
Declaration of the following participant rights:
Animal research − Right to refuse consent
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− Right to withdraw from the study anytime
− Right to confidentiality of personal
information
− Right to access of information of study results
and anything pertinent to participation
A statement, below which the participant signs
that he or she has understood all the provisions in
the form and has given voluntary consent to join
the study.
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Objectives
Research
Privacy and confidentiality
Ethical guidelines
Ethical principles
Other issues
Privacy is the right of persons not to share
Animal research information about themselves. (Dunn and
Bottomlines
Chadwick 2004)
Confidentiality is the obligation to keep
private information that has been collected
from being shared with others. (Dunn and
Chadwick 2004)
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Objectives
Research
Identifiers
Ethical guidelines
Ethical principles
• Names • Certificate/license numbers
Other issues • •
all geographic information Vehicle identifiers and serial
Animal research • all elements of dates (except numbers including license plate
Bottomlines year), including birth, death, numbers
admission and discharge dates • Device identifiers and serial
• Telephone numbers numbers
• Fax numbers • Web URL
• Email addresses • IP address
• Social security numbers • Biometric identifiers, including
• Medical record numbers finger and voice prints
• Full face photographic images
• Health plan beneficiary numbers
and any comparable images
• Account numbers
• Any other unique identifying
number, characteristic or code
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Thank you!