Chapter 5

Reviewing the Ethical

Aspects of a Nursing
Study
1
Codes of Ethics
• Nuremberg Code
• Declaration of Helsinki
• Belmont Report
• Government-imposed codes
• Codes for professional disciplines (e.g., by
the American Nurses’ Association)

2
Ethical Dilemma in
Conducting Research:

• A situation in which the rights of

study participants are in direct
conflict with requirements for a
rigorous study.

3
Ethical Principles from the
Belmont Report
1. Principle of Beneficence: Above
all, do no harm
• Right to protection from harm and
discomfort
– Beneficence—maximize good
– Non-maleficence —minimize harm
• Right to protection from exploitation
4
Ethical Principles from the
Belmont Report (cont.)

2. Principle of Respect for Human

Dignity
• Right to self-determination (absence of
coercion)
• Right to full disclosure (absence of deception
or concealment)

5
Ethical Principles from the
Belmont Report (cont.)

3. Principle of Justice
• Right to fair treatment
• Right to privacy (confidentiality,
anonymity)

6
Procedures for Protecting
Study Participants
• Risk-benefit assessments
• Informed consent
• Confidentiality procedures
• Debriefings and referrals
• Treatment of vulnerable groups
• Institutional Review Boards and
external reviews
7
Box 5.2 Potential Benefits and
Risks To Study Participants

8
Informed Consent

Informed consent means that

participants:
• have adequate information about the
research
• can comprehend that information
• have free choice in deciding whether to
participate in or withdraw from the study
9
Informed Consent (cont’d)

• Typical documentation: A consent

form
• Implied consent (e.g., self-
administered questionnaires)
• Process consent (qualitative
studies)
10
 Confidentiality Procedures

• Anonymity
• Confidentiality Pledge

11
Special Treatment of
Vulnerable Groups
• Children
• Mentally or emotionally disabled people
• Severely ill or physically disabled
people
• Terminally ill people
• Institutionalized people
• Pregnant women
12
External review

• Human subjects committees

• Institutional Review Boards (IRBs)

• Research Ethics Boards (REBs—in

Canada)

13
Other ethical issues

• Ethical use of animal subjects

• Research misconduct

14