Question

Why is Informed consent one of the major ethical issue in conducting research?

Answer 1

Ans. The protection of dignity of subjects and the publication of the information in the research. However , when nurses participate i research they have it cope with three value system, nursing and science which may be in conflict with the values of subjects, communities, and societies and create tensions and dilemmas in nursing. After a short description of the nature of nursing, and the advocacy role of nurses, the writer will attempt to highlight the possible conflicts that nurses have to deal with, when undertaking or participating in research. The major ethical issues in conducting research are: a) Informed consent, b) Beneficence- Do not harm c) Respect for anonymity and confidentiality d) Respect for privacy. However, both the nature of nursing which focuses on caring, preventing harm and protecting dignity and the advocates role of nurses which calls for defending the rights of subjects, are sometimes incongruent with the ethics in research. Ethical issues, conflicting values, and ambiguity in decision making, are recurrently emerging from literature review on nursing research.

Informed consent is one of the means by which a patient's right to autonomy is protected. define autonomy as the ability for self determination in action according to a personal plan. Informed consent seeks to incorporate the rights of autonomous individuals through self- determination. It also seeks to prevent assaults on the integrity of the patient and protect personal liberty and veracity. Of course individuals can make informed decisions in order to participate in research voluntarily only if they have information on the possible risks and benefits of the research. Free and informed consent needs to incorporate an introduction to the study and its purpose as well as an explanation about the selection of the research subjects and the procedures that will be followed. It is essential to describe any physical harm or discomfort, any invasion of privacy and any threat to dignity as well as how the subjects will be compensated in that case. The researcher must inform the subjects about the methods which will be used to protect anonymity and confidentiality and indicate a person with whom they can discuss the study. He must also provide a "Noncoersive Disclaimer" which states that participation is voluntary and no penalties are involved in refusal to participate. Moreover, the subject must be told that some information has been deliberately withheld in order to avoid altered behaviours. The researcher must also take into account that persons with physical, cultural and emotional barriers may require a very simple language in order to understand him. Finally, the freedom to withdraw must be explained. This is very important but raises the issue of how difficult the subjects can withdraw after developing a personal and sometimes friendly relationship with the researcher. With regard to withdrawal a researcher may be in a dilemma in case many subjects choose to withdraw at an advanced stage of the study, because this can affect the validity of the result. According to this, the will of the subject must be respected at any cost for the research.

Another major ethical issue is obtaining an informed consent from groups with diminished autonomy which will be further discussed later. From what has been discussed, it becomes clear that disclosure, comprehension, competency and voluntariness are the four essential parts of a consent.