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Muthanna A, Chaaban Y, Qadhi S. A model of the interrelationship between research ethics and research integrity. Int J Qual Stud Health Well-being 2024; 19:2295151. [PMID: 38126140 PMCID: PMC10763899 DOI: 10.1080/17482631.2023.2295151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose: The purpose of this article is to explore the interrelationship between research ethics and research integrity with a focus on the primary forms of research misconduct, including plagiarism, fabrication, and falsification. It also details the main factors for their occurrence, and the possible ways for mitigating their use among scholars.Methods: The method employed a detailed examination of the main ethical dilemmas, as delineated in literature, as well as the factors leading to these ethical breaches and the strategies to mitigate them. Further, the teaching experiences of the primary author are reflected in the development of the model.Results: The results of this article are represented in a model illustrating the interrelationship between research ethics and research integrity. Further, a significant aspect of our article is the identification of novel forms of research misconduct concerning the use of irrelevant or forced citations or references.Conclusion: In conclusion, the article highlights the substantial positive effects that adherence to research ethics and integrity have on the academic well-being of scholars.
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Affiliation(s)
- Abdulghani Muthanna
- Department of Teacher Education, Norwegian University of Science and Technology, Trondheim, Norway
| | - Youmen Chaaban
- Educational Research Center, Qatar University, Doha, Qatar
| | - Saba Qadhi
- Core Curriculum Program, Qatar University, Doha, Qatar
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Shaw J, Ali J, Atuire CA, Cheah PY, Español AG, Gichoya JW, Hunt A, Jjingo D, Littler K, Paolotti D, Vayena E. Research ethics and artificial intelligence for global health: perspectives from the global forum on bioethics in research. BMC Med Ethics 2024; 25:46. [PMID: 38637857 PMCID: PMC11025232 DOI: 10.1186/s12910-024-01044-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/01/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. METHODS The GFBR is an annual meeting organized by the World Health Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was "Ethics of AI in Global Health Research". The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. RESULTS We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. CONCLUSIONS The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research.
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Affiliation(s)
- James Shaw
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
- Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Joseph Ali
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Caesar A Atuire
- Department of Philosophy and Classics, University of Ghana, Legon-Accra, Ghana
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Judy Wawira Gichoya
- Department of Radiology and Informatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Adrienne Hunt
- Health Ethics & Governance Unit, Research for Health Department, Science Division, World Health Organization, Geneva, Switzerland
| | - Daudi Jjingo
- African Center of Excellence in Bioinformatics and Data Intensive Science, Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Katherine Littler
- Health Ethics & Governance Unit, Research for Health Department, Science Division, World Health Organization, Geneva, Switzerland
| | | | - Effy Vayena
- Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
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Haar M, Sonntagbauer M, Kluge S. [Significance of natural language processing and chat-based generative language models]. Med Klin Intensivmed Notfmed 2024; 119:181-188. [PMID: 38108880 DOI: 10.1007/s00063-023-01098-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Natural language processing (NLP) has experienced significant growth in recent years and shows potential for broad impacts in scientific research and clinical practice. OBJECTIVE This study comprises an exploration of the role of NLP in scientific research and its subsequent effects on traditional publication practices, as well as an evaluation of the opportunities and challenges offered by large language models (LLM) and a reflection on necessary paradigm shifts in research culture. MATERIALS AND METHODS Current LLMs, such as ChatGPT, and their potential applications were compared and assessed. An analysis of the literature and case studies on the integration of LLMs into scientific and clinical practice was conducted. RESULTS AND CONCLUSION LLMs provide enhanced access to and processing capabilities of text-based information and represent a vast potential for (medical) research as well as daily clinical practice. Chat-based LLMs enable efficient completion of often time-consuming tasks, but due to their tendency for hallucinations, have a significant limitation. Current developments require critical examination and a paradigm shift to fully exploit the benefits of LLMs and minimize potential risks.
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Affiliation(s)
- Markus Haar
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
| | - Michael Sonntagbauer
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland
| | - Stefan Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland
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Jayasinghe K, Chamika WAS, Jayaweera K, Abhayasinghe K, Dissanayake L, Sumathipala A, Ives J. All you Need is Trust? Public Perspectives on Consenting to Participate in Genomic Research in the Sri Lankan District of Colombo. Asian Bioeth Rev 2024; 16:281-302. [PMID: 38586568 PMCID: PMC10994890 DOI: 10.1007/s41649-023-00269-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 04/09/2024] Open
Abstract
Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are concerns about participants' understanding of genomic research, including the validity of informed consent. This article reports a qualitative study aiming to explore the understanding, knowledge, and attitudes of the Sri Lankan public towards genomic medicine and to inform the development of an effective and appropriate process for informed consent in that setting. Purposive sampling was employed. Participants were recruited from a sub-group of the public in Colombo, Sri Lanka who had either consented or refused to donate genetic material for a biobank. Data were collected using face-to-face semi-structured interviews. Interview data were transcribed verbatim and translated into English. Conventional content analysis was used. The analysis developed three key themes: a) 'Scientific literacy' describes an apparent lack of scientific knowledge that seems to affect a participant's ability to understand the research, b) 'Motivation' describes narratives about why participants chose (not) to take part in the research, despite not understanding it, and c) 'Trust' describes how trust served to mitigate the apparent ethical deficit created by not being fully informed. In this article, we argue that informed trust is likely an acceptable basis for consent, particularly in settings where scientific literacy might be low. However, researchers must work to be worthy of that trust and ensure that misconceptions are actively addressed.
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Affiliation(s)
- Krishani Jayasinghe
- Institute for Research and Development in Health & Social Care, Battaramulla, Sri Lanka
| | - W. A. S. Chamika
- Institute for Research and Development in Health & Social Care, Battaramulla, Sri Lanka
| | - Kaushalya Jayaweera
- Institute for Research and Development in Health & Social Care, Battaramulla, Sri Lanka
| | - Kalpani Abhayasinghe
- Institute for Research and Development in Health & Social Care, Battaramulla, Sri Lanka
| | - Lasith Dissanayake
- Institute for Research and Development in Health & Social Care, Battaramulla, Sri Lanka
| | - Athula Sumathipala
- Institute for Research and Development in Health & Social Care, Battaramulla, Sri Lanka
| | - Jonathan Ives
- Centre for Ethics in Medicine, Bristol Medical School, University of Bristol, Bristol, UK
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Avery J, Bell JAH, Baryolay K, Rodin G, Nissim R, Balneaves LG. Decision-making and autonomy among participants in early-phase cancer immunotherapy trials: a qualitative study. BMC Cancer 2024; 24:373. [PMID: 38528488 DOI: 10.1186/s12885-024-12119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Participants considering early-phase cancer clinical trials (CTs) need to understand the unique risks and benefits prior to providing informed consent. This qualitative study explored the factors that influence patients' decisions about participating in early-phase cancer immunotherapy CTs through the ethical lens of relational autonomy. METHODS Using an interpretive descriptive design, interviews were conducted with 21 adult patients with advanced cancer who had enrolled in an early-phase CT. Data was analyzed using relational autonomy ethical theory and constant comparative analysis. RESULTS The extent to which participants perceived themselves as having a choice to participate in early-phase cancer immunotherapy CTs was a central construct. Perceptions of choice varied according to whether participants characterized their experience as an act of desperation or as an opportunity to receive a novel treatment. Intersecting psychosocial and structural factors influenced participants' decision making about participating in early-phase cancer immunotherapy trials. These relational factors included: (1) being provided with hope; (2) having trust; (3) having the ability to withdraw; and (4) timing constraints. CONCLUSIONS Findings highlight the continuum of perceived choice that exists among patients with cancer when considering participation in early-phase cancer immunotherapy CTs. All participants were interpreted as exhibiting some degree of relational autonomy within the psychosocial and structural context of early-phase CT decision making. This study offers insights into the intersection of cancer care delivery, personal beliefs and values, and established CT processes and structures that can inform future practices and policies associated with early-phase cancer immunotherapy CTs to better support patients in making informed decisions.
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Affiliation(s)
- Jonathan Avery
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Supportive Care Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jennifer A H Bell
- Department of Supportive Care Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
- Department of Clinical and Organizational Ethics, University Health Network, Toronto, ON, Canada.
- The Institute for Education Research, University Health Network, Toronto, ON, Canada.
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Princess Margaret Cancer Centre, Department of Supportive Care, Research Division, 700 Bay St., 23rd Floor, Toronto, ON, M5G 1Z6, Canada.
| | - Khotira Baryolay
- Department of Supportive Care Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Gary Rodin
- Department of Supportive Care Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Cancer Experience, University Health Network Cancer Program, University Health Network, Toronto, ON, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Rinat Nissim
- Department of Supportive Care Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lynda G Balneaves
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada
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Lewis NV, Kalichman B, Azeredo YN, Bacchus LJ, d'Oliveira AF. Ethical challenges in global research on health system responses to violence against women: a qualitative study of policy and professional perspectives. BMC Med Ethics 2024; 25:32. [PMID: 38504254 PMCID: PMC10949724 DOI: 10.1186/s12910-024-01034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 03/08/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Studying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-income country (HIC) and four universities in low-and middle-income countries (LMICs). This study aimed to investigate professional and policy perspectives on the types, causes of, and solutions to ethical challenges specific to the ethics approval stage of the global research projects on health system responses to VAW. METHODS We used the Network of Ethical Relationships model, framework method, and READ approach to analyse qualitative semi-structured interviews (n = 18) and policy documents (n = 27). In March-July 2021, we recruited a purposive sample of researchers and members of Research Ethics Committees (RECs) from the five partner countries. Interviewees signposted policies and guidelines on research ethics, including VAW. RESULTS We developed three themes with eight subthemes summarising ethical challenges across three contextual factors. The global nature of the group contributed towards power and resource imbalance between HIC and LMICs and differing RECs' rules. Location of the primary studies within health services highlighted differing rules between university RECs and health authorities. There were diverse conceptualisations of VAW and vulnerability of research participants between countries and limited methodological and topic expertise in some LMIC RECs. These factors threatened the timely delivery of studies and had a negative impact on researchers and their relationships with RECs and HIC funders. Most researchers felt frustrated and demotivated by the bureaucratised, uncoordinated, and lengthy approval process. Participants suggested redistributing power and resources between HICs and LMICs, involving LMIC representatives in developing funding agendas, better coordination between RECs and health authorities and capacity strengthening on ethics in VAW research. CONCLUSIONS The process of ethics approval for global research on health system responses to VAW should be more coordinated across partners, with equal power distribution between HICs and LMICs, researchers and RECs. While some of these objectives can be achieved through education for RECs and researchers, the power imbalance and differing rules should be addressed at the institutional, national, and international levels. Three of the authors were also research participants, which had potential to introduce bias into the findings. However, rigorous reflexivity practices mitigated against this. This insider perspective was also a strength, as it allowed us to access and contribute to more nuanced understandings to enhance the credibility of the findings. It also helped to mitigate against unequal power dynamics.
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Affiliation(s)
- Natalia V Lewis
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Beatriz Kalichman
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Yuri Nishijima Azeredo
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Loraine J Bacchus
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Ana Flavia d'Oliveira
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
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Thompson K, Hammond N, Lynch D, Van Der Merwe M, Modra L, Yong SA, Grattan S, Stokes-Parish J. Perceptions of gender equity among critical care and other health professionals: A cross-sectional survey. Aust Crit Care 2024; 37:265-272. [PMID: 37574389 DOI: 10.1016/j.aucc.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/29/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the association between gender and perceived gender equity in the critical care workforce and other health specialties. DESIGN AND SETTING We conducted an online cross-sectional survey between September and November 2020. Data on demographics and perceptions of equity including the representation of women across departments and in leadership roles, knowledge of and access to flexible work practices and carers leave, and opportunities for promotion were collected. PARTICIPANTS The study population included health professionals from critical care (defined as intensive care and emergency) and other specialties. We conducted a descriptive gender-disaggregated analysis. RESULTS A total of 478 respondents (70% women) completed the survey. The mean age of respondents was 43.9 ± 11.2 years. Approximately half of respondents were medical practitioners (n = 235, 54%), followed by nurses (n = 135, 36%)-the remainder were from other professions. The critical care workforce accounted for 280 (64%) of responder practice settings. Statistically significant differences were reported between genders on issues such as having confidence that their department would resolve equity issues (87 [70.7%] men vs. 146 [48.2%] women; p = 0.007), access to flexible work practices (5/124 [4.0%] men vs. 20/305 [6.6%] women p = 0.001), and taking unpaid leave for carer responsibilities (91 [30.3%] women vs 9 [7.4%] men, p < 0.001). CONCLUSIONS This work highlights differences in how men and women perceive gender equity, particularly in the critical care workforce. These findings are important to understand health care practitioners' perceptions of gender equity, as these perceptions inform behaviour.
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Affiliation(s)
- Kelly Thompson
- The George Institute for Global Health, UNSW, Sydney, Australia; Nepean and Blue Mountains Local Health District, Kingswood, Australia
| | - Naomi Hammond
- The George Institute for Global Health, UNSW, Sydney, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Doug Lynch
- EMR & Informatics Directorate, Monash Health, Clayton, Victoria, Australia
| | | | - Lucy Modra
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia; ICU, Austin Hospital, Melbourne, Victoria, Australia
| | - Sarah A Yong
- Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, Victoria, Australia; ANZIC-RC, Department of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Sarah Grattan
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Jessica Stokes-Parish
- Bond University, Gold Coast, Australia; Intensive Care, John Flynn Private Hospital, Tugun, Queensland, Australia.
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Dadkhah M, Oermann MH, Hegedüs M, Raman R, Dávid LD. Diagnosis Unreliability of ChatGPT for Journal Evaluation. Adv Pharm Bull 2024; 14:1-4. [PMID: 38585462 PMCID: PMC10997925 DOI: 10.34172/apb.2024.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/10/2023] [Indexed: 04/09/2024] Open
Abstract
Purpose Academic and other researchers have limited tools with which to address the current proliferation of predatory and hijacked journals. These journals can have negative effects on science, research funding, and the dissemination of information. As most predatory and hijacked journals are not error free, this study used ChatGPT, an artificial intelligence (AI) technology tool, to conduct an evaluation of journal quality. Methods Predatory and hijacked journals were analyzed for reliability using ChatGPT, and the reliability of result have been discussed. Results It shows that ChatGPT is an unreliable tool for journal quality evaluation for both hijacked and predatory journals. Conclusion To show how to address this gap, an early trial version of Journal Checker Chatbot has been developed and is discussed as an alternative chatbot that can assist researchers in detecting hijacked journals.
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Affiliation(s)
- Mehdi Dadkhah
- Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Amritapuri, Kerala, India
- Technology Forecasting Department, SnowaTec Technology Center and Innovation Factory, Entekhab Industrial Group, Isfahan, Iran
| | | | - Mihály Hegedüs
- Tomori Pál College, Chamber of Hungarian Auditors, Budapest, Hungary
| | - Raghu Raman
- Amrita School of Business, Amrita Vishwa Vidyapeetham, Amritapuri, Kerala, India
| | - Lóránt Dénes Dávid
- Faculty of Economics and Business, John von Neumann University, Kecskemét, Hungary
- Institute of Rural Development and Sustainable Economy, Hungarian University of Agriculture and Life Sciences, Gödöllő, Hungary
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Abstract
Through the New Drugs and Clinical Trials Rules, 2019 (2019 Rules), India has developed the rules governing post-trial access (PTA) to new drugs or investigational new drugs. However, inconsistencies and interpretational challenges exist in the application of the 2019 Rules and the Indian Council of Medical Research Guidelines 2017. This conflation poses a real harm to the trial participants, specifically the ones with limited access to healthcare facilities. Since drug laws in India do not expressly deal with other forms of access like the 'Compassionate Use' or 'Expanded Access' mechanism, demarcating the scope and describing the strategies for PTA are the need of the hour. We propose possible strategies to address inadequacies in the regulatory regime and establish 'win-win' situations among all stakeholders. We further argue that India is well positioned to provide leadership by developing detailed PTA provisions and may set a potential path for the other clinical trial host countries.
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Affiliation(s)
- Nidhi Mehrotra
- Rajiv Gandhi School of Intellectual Property Law, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Padmavati Manchikanti
- Rajiv Gandhi School of Intellectual Property Law, Indian Institute of Technology Kharagpur, Kharagpur, India
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Kimani M, Molyneux S, Charo A, Zakayo SM, Sanga G, Njeru R, Davies A, Kelley M, Abubakar A, Marsh V. Layered vulnerability and researchers' responsibilities: learning from research involving Kenyan adolescents living with perinatal HIV infection. BMC Med Ethics 2024; 25:21. [PMID: 38378641 PMCID: PMC10877892 DOI: 10.1186/s12910-023-00972-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/16/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Carefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/AIDS, without increasing burdens. Such studies, however, must navigate a 'vulnerability paradox', since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/AIDS (ALH) in Kenya, we develop an account of researchers' responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency as 'interacting layers'. METHODS Using a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders' perspectives on vulnerability and resilience of young people living with HIV/AIDS, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna's layered account of vulnerability. RESULTS ALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences. CONCLUSIONS The most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers' responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities.
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Affiliation(s)
- Mary Kimani
- Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
| | - Sassy Molyneux
- Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya.
- Health Systems Collaborative, Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Anderson Charo
- Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
| | - Scholastica M Zakayo
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Gladys Sanga
- Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
| | - Rita Njeru
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alun Davies
- Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
- Health Systems Collaborative, Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Maureen Kelley
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Amina Abubakar
- Aga Khan University, Institute for Human Development, Nairobi, Kenya
| | - Vicki Marsh
- Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Biology, 3 South Parks Road, Oxford, OX13SY, UK
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Shen FX, Baum ML, Martinez-Martin N, Miner AS, Abraham M, Brownstein CA, Cortez N, Evans BJ, Germine LT, Glahn DC, Grady C, Holm IA, Hurley EA, Kimble S, Lázaro-Muñoz G, Leary K, Marks M, Monette PJ, Jukka-Pekka O, O’Rourke PP, Rauch SL, Shachar C, Sen S, Vahia I, Vassy JL, Baker JT, Bierer BE, Silverman BC. Returning Individual Research Results from Digital Phenotyping in Psychiatry. Am J Bioeth 2024; 24:69-90. [PMID: 37155651 PMCID: PMC10630534 DOI: 10.1080/15265161.2023.2180109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants' locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant's real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas.
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Affiliation(s)
- Francis X. Shen
- Harvard Medical School
- Massachusetts General Hospital
- Harvard Law School
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mason Marks
- Harvard Law School
- Florida State University College of Law
- Yale Law School
| | | | | | | | - Scott L. Rauch
- Harvard Medical School
- McLean Hospital
- Mass General Brigham
| | | | | | | | - Jason L. Vassy
- Harvard Medical School
- Brigham and Women’s Hospital
- VA Boston Healthcare System
| | | | - Barbara E. Bierer
- Harvard Medical School
- Brigham and Women’s Hospital
- Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard
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12
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Jamrozik E, Littler K, Meln I, Van Molle W, Morel S, Olesen OF, Rubbrecht M, Balasingam S, Neels P. Ethical approval for controlled human infectious model clinical trial protocols - A workshop report. Biologicals 2024; 85:101748. [PMID: 38350349 PMCID: PMC11004724 DOI: 10.1016/j.biologicals.2024.101748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
Abstract
Controlled Human Infectious Model studies (CHIM) involve deliberately exposing volunteers to pathogens. To discuss ethical issues related to CHIM, the European Vaccine Initiative and the International Alliance for Biological Standardization organised the workshop "Ethical Approval for CHIM Clinical Trial Protocols", which took place on May 30-31, 2023, in Brussels, Belgium. The event allowed CHIM researchers, regulators, ethics committee (EC) members, and ethicists to examine the ethical criteria for CHIM and the role(s) of CHIM in pharmaceutical development. The discussions led to several recommendations, including continued assurance that routine ethical requirements are met, assurance that participants are well-informed, and that preparation of study documents must be both ethically and scientifically sound from an early stage. Study applications must clearly state the rationale for the challenge compared to alternative study designs. ECs need to have clear guidance and procedures for evaluating social value and assessing third-party risks. Among other things, public trust in research requires minimisation of harm to healthy volunteers and third-party risk. Other important considerations include appropriate stakeholder engagement, public education, and access to health care for participants after the study.
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Affiliation(s)
- Euzebiusz Jamrozik
- The Ethox Centre & Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, United Kingdom
| | - Katherine Littler
- Health Ethics and Governance Unit, Research for Health Department, Science Division, World Health Organization, Geneva, Switzerland
| | - Irina Meln
- European Vaccine Initiative, Heidelberg, Germany
| | | | | | - Ole F Olesen
- European Vaccine Initiative, Heidelberg, Germany
| | | | | | - Pieter Neels
- International Alliance for Biological Standardization (IABS), Lyon, France.
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13
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Kiwanuka GN, Bajunirwe F, Alele PE, Oloro J, Mindra A, Marshall P, Loue S. Public health and research ethics education: the experience of developing a new cadre of bioethicists at a Ugandan institution. BMC Med Educ 2024; 24:1. [PMID: 38172860 PMCID: PMC10763195 DOI: 10.1186/s12909-023-04974-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
Research ethics education is critical to developing a culture of responsible conduct of research. Many countries in sub-Saharan Africa (SSA) have a high burden of infectious diseases like HIV and malaria; some, like Uganda, have recurring outbreaks. Coupled with the increase in non-communicable diseases, researchers have access to large populations to test new medications and vaccines. The need to develop multi-level capacity in research ethics in Uganda is still huge, being compounded by the high burden of disease and challenging public health issues. Only a few institutions in the SSA offer graduate training in research ethics, implying that the proposed ideal of each high-volume research ethics committee having at least one member with in-depth training in ethics is far from reality. Finding best practices for comparable situations and training requirements is challenging because there is currently no "gold standard" for teaching research ethics and little published information on curriculum and implementation strategies. The purpose of this paper is to describe a model of research ethics (RE) education as a track in an existing 2-year Master of Public Health (MPH) to provide training for developing specific applied learning skills to address contemporary and emerging needs for biomedical and public health research in a highly disease-burdened country. We describe our five-year experience in successful implementation of the MPH-RE program by the Mbarara University Research Ethics Education Program at Mbarara University of Science and Technology in southwestern Uganda. We used curriculum materials, applications to the program, post-training and external evaluations, and annual reports for this work. This model can be adapted and used elsewhere in developing countries with similar contexts. Establishing an interface between public health and research ethics requires integration of the two early in the delivery of the MPH-RE program to prevent a disconnect in knowledge between research methods provided by the MPH component of the MPH-RE program and for research in ethics that MPH-RE students are expected to perform for their dissertation. Promoting bioethics education, which is multi-disciplinary, in institutions where it is still "foreign" is challenging and necessitates supportive leadership at all institutional levels.
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Affiliation(s)
- Gertrude N Kiwanuka
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Francis Bajunirwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul E Alele
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph Oloro
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Arnold Mindra
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Patricia Marshall
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Sana Loue
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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14
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Udoh U, Dewar B, Nicholls S, Fedyk M, Fahed R, Perry J, Hill MD, Menon B, Swartz RH, Poppe AY, Gocan S, Brehaut J, Dainty K, Shepherd V, Dowlatshahi D, Shamy M. Advance Consent in Acute Stroke Trials: Survey of Canadian Stroke Physicians. Can J Neurol Sci 2024; 51:122-125. [PMID: 36799025 DOI: 10.1017/cjn.2023.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Advance consent presents a potential solution to the challenge of obtaining informed consent for participation in acute stroke trials. Clinicians in stroke prevention clinics are uniquely positioned to identify and seek consent from potential stroke trial participants. To assess the acceptability of advance consent to Canadian stroke clinic physicians, we performed an online survey. We obtained 58 respondents (response rate 35%): the vast majority (82%) expressed comfort with obtaining advance consent and 92% felt that doing so would not be a significant disruption to clinic workflow. These results support further study of advance consent for acute stroke trials.
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Affiliation(s)
- Ubong Udoh
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Brian Dewar
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Stuart Nicholls
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Mark Fedyk
- School of Medicine, University of California, Davis, Davis, CA, USA
| | - Robert Fahed
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jeff Perry
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
- Department of Emergency Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Michael D Hill
- Department of Clinical Neurosciences, University of Calgary and Calgary Stroke Program, Calgary, Alberta, Canada
| | - Bijoy Menon
- Department of Clinical Neurosciences, University of Calgary and Calgary Stroke Program, Calgary, Alberta, Canada
| | - Richard H Swartz
- Department of Medicine, University of Toronto & Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Alexandre Y Poppe
- Department of Neurosciences, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Sophia Gocan
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jamie Brehaut
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Katie Dainty
- Department of Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Dar Dowlatshahi
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Michel Shamy
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
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15
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Godskesen T, Björk J, Juth N. Challenges regarding informed consent in recruitment to clinical research: a qualitative study of clinical research nurses' experiences. Trials 2023; 24:801. [PMID: 38082434 PMCID: PMC10712041 DOI: 10.1186/s13063-023-07844-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Clinical research nurses (CRNs) have first-hand experience with ethical challenges and play a crucial role in upholding ethical conduct and adherence to the principles of informed consent in clinical research. This study explores the ethical challenges encountered by CRNs in the process of obtaining informed consent for clinical research. METHODS A qualitative exploratory design. Semistructured interviews (n = 14) were conducted with diverse CRNs in Sweden. These CRNs covered a wide range of research fields, including pharmaceutical and academic studies, interventions, and observational research, spanning different trial phases, patient categories, and medical conditions. The interviews were analysed using inductive qualitative content analysis. RESULTS The analysis identified three main categories: (i) threats to voluntariness, (ii) measures to safeguard voluntariness, and (iii) questionable exclusion of certain groups. CRNs face challenges due to time constraints, rushed decisions, information overload, and excessive reliance on physicians' recommendations. Overestimating therapeutic benefits in stages of advanced illness emerged as a risk to voluntariness. CRNs outlined proactive solutions, such as allowing ample decision-making time and offering support, especially for terminally ill patients. Concerns were also voiced about excluding certain demographics, such as those with language barriers or cognitive impairments. CONCLUSIONS In conclusion, upholding ethical research standards requires recognising various factors affecting patient voluntariness. Researchers and CRNs should prioritise refining the informed consent process, overcoming participation challenges, and aligning scientific rigour with personalised care. Additionally, a concerted effort is vital to meet the diverse needs of patient populations, including equitable inclusion of individuals with language barriers or cognitive limitations in clinical studies. These findings have significant implications for enhancing the ethics of clinical research and advancing person-centred care.
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Affiliation(s)
- Tove Godskesen
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
| | - Joar Björk
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Stockholm, Sweden
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Niklas Juth
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Stockholm, Sweden
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16
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Abstract
This letter to the editor points out weaknesses in the editorial policies of some academic journals regarding the use of ChatGPT-generated content. Editorial policies should provide more specific details on which parts of an academic paper are allowed to use ChatGPT-generated content. If authors use ChatGPT-generated content in the conclusion or results section, it may harm the academic paper's originality and, therefore, should not be accepted.
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Affiliation(s)
- Gengyan Tang
- Sichuan Academy of Social Sciences, Chengdu, China.
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17
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Smith EMR, Rakestraw C, Farroni JS. Research integrity during the COVID-19 pandemic: Perspectives of health science researchers at an Academic Health Science Center. Account Res 2023; 30:471-492. [PMID: 35038939 PMCID: PMC9356114 DOI: 10.1080/08989621.2022.2029704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
During the coronavirus disease 2019 pandemic, a complex mix of political pressure, social urgency, public panic, and scientific curiosity has significantly impacted the context of research and development. The goal of this study is to understand if and how researchers are shifting their practices and adjusting norms and beliefs regarding research ethics and integrity. We have conducted 31 interviews with Health Science Researchers at the University of Texas Medical Branch which were then analyzed using integrated deductive and inductive coding. We categorized participant views into four main areas: 1) limitations to the research design, 2) publication, 3) duplication of studies, and 4) research pipeline. Although certain researchers were in keeping to the status quo, more were willing to modify norms to address social need and urgency. Notably, they were more likely to opt for systemic change rather than modifications within their own research practices.
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Affiliation(s)
- Elise M R Smith
- Department of Preventive Medicine and Population Health, Institute for Translational Sciences, Institute for Bioethics and Health Humanities, University of Texas Medical Branch, Galveston, TX, USA
| | - Corisa Rakestraw
- Department of Preventive Medicine and Population Health, Institute for the Medical Humanities, University of Texas Medical Branch, Galveston, TX, USA
| | - Jeffrey S Farroni
- Department of Preventive Medicine and Population Health, Institute for Translational Sciences, Institute for Bioethics and Health Humanities, University of Texas Medical Branch, Galveston, TX, USA
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18
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Lipworth W, Kerridge I, Stewart C, Silva D, Upshur R. The Fragility of Scientific Rigour and Integrity in "Sped up Science": Research Misconduct, Bias, and Hype and in the COVID-19 Pandemic. J Bioeth Inq 2023; 20:607-616. [PMID: 38064166 DOI: 10.1007/s11673-023-10289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/20/2023] [Indexed: 03/16/2024]
Abstract
During the early years of the COVID-19 pandemic, preclinical and clinical research were sped up and scaled up in both the public and private sectors and in partnerships between them. This resulted in some extraordinary advances, but it also raised a range of issues regarding the ethics, rigour, and integrity of scientific research, academic publication, and public communication. Many of the failures of scientific rigour and integrity that occurred during the pandemic were exacerbated by the rush to generate, disseminate, and implement research findings, which not only created opportunities for unscrupulous actors but also compromised the methodological, peer review, and advisory processes that would usually identify sub-standard research and prevent compromised clinical or policy-level decisions. While it would be tempting to attribute these failures of science and its translation solely to the "unprecedented" circumstances of the COVID-19 pandemic, the reality is that they preceded the pandemic and will continue to arise once it is over. Existing strategies for promoting scientific rigour and integrity need to be made more rigorous, better integrated into research training and institutional cultures, and made more sophisticated. They might also need to be modified or supplemented with other strategies that are fit for purpose not only in public health emergencies but in any research that is sped-up and scaled up to address urgent unmet medical needs.
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Affiliation(s)
- W Lipworth
- Department of Philosophy, Macquarie University, Sydney, NSW, Australia.
| | - I Kerridge
- Department of Philosophy, Macquarie University, Sydney, NSW, Australia
- Royal North Shore Hospital and Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia
| | - C Stewart
- Sydney Law School, University of Sydney, Sydney, NSW, Australia
| | - D Silva
- Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - R Upshur
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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19
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Swirsky ES, Boyd AD, Gu C, Burke LA, Doorenbos AZ, Ezenwa MO, Knisely MR, Leigh JW, Li H, Mandernach MW, Molokie RE, Patil CL, Steffen AD, Shah N, deMartelly VA, Staman KL, Schlaeger JM. Monitoring and responding to signals of suicidal ideation in pragmatic clinical trials: Lessons from the GRACE trial for Chronic Sickle Cell Disease Pain. Contemp Clin Trials Commun 2023; 36:101218. [PMID: 37842321 PMCID: PMC10569945 DOI: 10.1016/j.conctc.2023.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/11/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023] Open
Abstract
Sickle cell disease (SCD) is a hemoglobin disorder and the most common genetic disorder that affects 100,000 Americans and millions worldwide. Adults living with SCD have pain so severe that it often requires opioids to keep it in control. Depression is a major global public health concern associated with an increased risk in chronic medical disorders, including in adults living with sickle cell disease (SCD). A strong relationship exists between suicidal ideation, suicide attempts, and depression. Researchers enrolling adults living with SCD in pragmatic clinical trials are obligated to design their methods to deliberately monitor and respond to symptoms related to depression and suicidal ideation. This will offer increased protection for their participants and help clinical investigators meet their fiduciary duties. This article presents a review of this sociotechnical milieu that highlights, analyzes, and offers recommendations to address ethical considerations in the development of protocols, procedures, and monitoring activities related to suicidality in depressed patients in a pragmatic clinical trial.
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Affiliation(s)
| | | | - Carol Gu
- University of Illinois Chicago, Chicago, IL, USA
| | | | | | | | | | | | - Hongjin Li
- University of Illinois Chicago, Chicago, IL, USA
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20
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Potthoff S, Hempeler C, Gather J, Gieselmann A, Vollmann J, Scholten M. Research ethics in practice: An analysis of ethical issues encountered in qualitative health research with mental health service users and relatives. Med Health Care Philos 2023; 26:517-527. [PMID: 37639076 PMCID: PMC10725844 DOI: 10.1007/s11019-023-10169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/29/2023]
Abstract
The ethics review of qualitative health research poses various challenges that are due to a mismatch between the current practice of ethics review and the nature of qualitative methodology. The process of obtaining ethics approval for a study by a research ethics committee before the start of a research study has been described as "procedural ethics" and the identification and handling of ethical issues by researchers during the research process as "ethics in practice." While some authors dispute and other authors defend the use of procedural ethics in relation to qualitative health research, there is general agreement that it needs to be supplemented with ethics in practice. This article aims to provide an illustration of research ethics in practice by reflecting on the ways in which we identified and addressed ethical and methodological issues that arose in the context of an interview study with mental health service users and relatives. We describe the challenges we faced and the solutions we found in relation to the potential vulnerability of research participants, the voluntariness of consent, the increase of participant access and the heterogeneity of the sample, the protection of privacy and internal confidentiality, and the consideration of personal and contextual factors.
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Affiliation(s)
- Sarah Potthoff
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Markstr. 258a, 44799, Bochum, Germany.
| | - Christin Hempeler
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Markstr. 258a, 44799, Bochum, Germany
| | - Jakov Gather
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Markstr. 258a, 44799, Bochum, Germany
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Astrid Gieselmann
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Markstr. 258a, 44799, Bochum, Germany
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Jochen Vollmann
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Markstr. 258a, 44799, Bochum, Germany
| | - Matthé Scholten
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Markstr. 258a, 44799, Bochum, Germany
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21
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Zucchi EM, Ferguson L, Magno L, Dourado I, Greco D, Ferraz D, Tupinambas U, Grangeiro A. When Ethics and the Law Collide: A Multicenter Demonstration Cohort Study of Pre-Exposure Prophylaxis Provision to Adolescent Men Who Have Sex With Men and Transgender Women in Brazil. J Adolesc Health 2023; 73:S11-S18. [PMID: 37953003 DOI: 10.1016/j.jadohealth.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 06/16/2023] [Accepted: 08/04/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE To explore legal and ethical challenges related to adolescents' participation in human immunodeficiency virus (HIV) research that may affect their best interests. METHODS We analyzed the ethical principles and legal aspects of the participation of 15-17-year-old men who have sex with men and transgender women in the pre-exposure prophylaxis (PrEP) 1519 study, a PrEP demonstration cohort study in three Brazilian cities. The analyses of ethics review committees' (ERCs) evaluations and court decisions followed ethical and human rights principles. An HIV vulnerability score was created, and descriptive statistics and multivariate logistic regression were performed using data from 347 participants. RESULTS The ERCs evaluated the benefits and risks of research participation, all finding that the benefits outweighed the risks. ERCs deferred responsibility for decisions about waiving parental consent to the judiciary. State courts reached different decisions about waiving parental consent, reflecting variation in recognition of adolescents' evolving capacities and the adolescent as a subject of sexual rights and the primary agent capable of deciding on their health and best interests. The most vulnerable adolescent participants were found in sites where the blanket waiver was in place. DISCUSSION Judicializing the ethical review process is detrimental to fulfilling the ethical principle of justice and vulnerable adolescents' access to health research. ERCs must be sufficiently independent and autonomous and have the capacity to respect, protect, and help fulfill the rights of participants while ensuring the generation of adequate evidence to inform public health practice.
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Affiliation(s)
- Eliana Miura Zucchi
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Católica de Santos, Santos, São Paulo, Brazil.
| | - Laura Ferguson
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Dirceu Greco
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Dulce Ferraz
- Fundação Oswaldo Cruz (Fiocruz), Diretoria Regional de Brasília, Brasília, Brazil; UMR Inserm 1296 - Radiations: Défense Santé Environnement, Université Lumière Lyon 2, Lyon, France
| | - Unai Tupinambas
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Grangeiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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22
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Jacobs E, Murphy-Beiner A, Rouiller I, Nutt D, Spriggs MJ. When the Trial Ends: The Case for Post-Trial Provisions in Clinical Psychedelic Research. NEUROETHICS-NETH 2023; 17:3. [PMID: 37942467 PMCID: PMC10627912 DOI: 10.1007/s12152-023-09536-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023]
Abstract
The ethical value-and to some scholars, necessity-of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status of psychedelics, the nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association's Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem.
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Affiliation(s)
- Edward Jacobs
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Ashleigh Murphy-Beiner
- Department of Brain Sciences, Imperial College London, London, UK
- Department of Psychology, Royal Holloway University, London, UK
| | - Ian Rouiller
- Psychedelic Participant Advocacy Network (PsyPAN), London, UK
| | - David Nutt
- Department of Brain Sciences, Imperial College London, London, UK
| | - Meg J. Spriggs
- Department of Brain Sciences, Imperial College London, London, UK
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Grosek S, Pleterski Rigler D, Podbregar M, Erčulj V. Knowledge of and attitudes towards medical research ethics among first year doctoral students in Slovenia at the Faculty of Medicine, University of Ljubljana. BMC Med Educ 2023; 23:828. [PMID: 37924025 PMCID: PMC10623751 DOI: 10.1186/s12909-023-04809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Research ethics and attitudes should be the main concern of those who are conducting and publishing research in medicine. METHODS A cross-sectional study was conducted using a questionnaire among first year postgraduate doctoral students in Biomedicine at the Faculty of Medicine, University of Ljubljana during the academic year 2022/2023. RESULTS There were 54 out of 57 doctoral students included in the study, with a mean age (SD) of 29.7 (4.7) years, with predominantly female doctoral students, 66.7%. The number of correct answers out of 39 considered to illustrate students' knowledge of medical research ethics was 31, meaning that they gave correct answers to 80% of all the questions. The mean number (SD) of correct answers was 18.9 (5.8), which significantly differed from 31 (p < 0.001). The previous experience of the doctoral students in research was significantly correlated with their knowledge of medical research ethics, even when controlling for the age, gender and workplace of respondents. CONCLUSION This study clearly showed that insufficient knowledge and a poor level of attitudes exist about the main questions pertaining to medical research ethics. Overall knowledge is well below the expected positive answers. Further studies are needed to compare the knowledge of doctoral students with that of their tutors and what implications this might have for further teaching of research ethics.
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Affiliation(s)
- S Grosek
- Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.
- Department of Medical Ethics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - D Pleterski Rigler
- National Committee of Medical Ethics of Republic Slovenia, Ljubljana, Slovenia
| | - M Podbregar
- Department of Internal Intensive Medicine, General Hospital Celje, Celje, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - V Erčulj
- Rho Sigma Research & Statistics, Ljubljana, Slovenia
- Faculty of Criminal Justice and Security, University of Maribor, Ljubljana, Slovenia
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Al-Madaney MM, Fässler M. Development and validation of a tool to assess researchers' knowledge of human subjects' rights and their attitudes toward research ethics education in Saudi Arabia. BMC Med Ethics 2023; 24:94. [PMID: 37919701 PMCID: PMC10623786 DOI: 10.1186/s12910-023-00968-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Researchers must adhere to ethical and scientific standards in their research involving human subjects; therefore, their knowledge of human subjects' rights is essential. A tool to measure the extent of this knowledge is necessary to ensure that studies with participants are conducted ethically and to enhance research integrity. Currently, no validated instrument is available for such an assessment. Therefore, the primary purpose of this study is to develop a reliable and valid instrument to assess researchers' knowledge of human subjects' rights in clinical settings, as well as a reliable and valid measure of their attitudes toward clinical research ethics education in Saudi Arabia. METHODS The current study involves the development of a questionnaire about the rights of human subjects in research and the researchers' attitudes toward research ethics education. The content was developed based on an extensive review of research ethics guidelines. A panel of experts tested the questionnaire for face validity (n = 5) and content validity (n = 8). The reliability of the questionnaire was established by a split-half reliability coefficient and item analysis among a sample (n = 301) of clinical researchers. RESULTS Face validity demonstrated that the questionnaire was quick to complete and easy to answer. The global content validity indices (S-CVIs) were greater than 0.78 for all questionnaire sections; the split-half reliability coefficient was 0.755 for knowledge items; Cronbach's alpha was 0.77 for researchers' attitudes, showing good internal consistency. The difficulty index ranged from 12.0% to 98.7% for all knowledge items. Most questions were at an acceptable level of reliability and discrimination criteria. The final version of the questionnaire contained 89 items, distributed as 15 questions on demographic and professional characteristics, 64 questions items on knowledge, and 10 items on attitudes. CONCLUSIONS The questionnaire is a valid and reliable tool to assess biomedical researchers' knowledge of human subjects' rights and their attitudes toward research ethics education. This instrument could help address the gap in researchers' knowledge of the rights and facilitate the development of educational intervention programs to set appropriate learning objectives.
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Affiliation(s)
- May M Al-Madaney
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006, Zurich, Switzerland.
- Research Center, King Fahad Medical City, Riyadh Second Health Cluster, P.O. Box. 59046, 11525, Riyadh, Kingdom of Saudi Arabia.
| | - Margrit Fässler
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006, Zurich, Switzerland
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Ezell JM. The Health Disparities Research Industrial Complex. Soc Sci Med 2023:116251. [PMID: 37865583 DOI: 10.1016/j.socscimed.2023.116251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/14/2023] [Indexed: 10/23/2023]
Abstract
Research focused on health disparities-whether relating to one's race/ethnicity, gender expression, sexual orientation, citizenship status, income level, etc.-constitutes a large, generative, and highly profitable portion of scholarship in academic, clinical, and government settings. Health disparities research is expressed as a means of bringing greater attention to, and ultimately addressing via evidence-based implementation science, acts of devaluation and oppression that have continually contributed to these inequities. Philosophies underlying health disparities research's expansive and growing presence mirror the formal logic and ethos of the Military Industrial Complex and the Prison Industrial Complex. The "Health Disparities Research Industrial Complex," operationalized in this article, represents a novel mutation and extension of these complexes, primarily being enacted through these three mechanisms: 1) The construction and maintenance of beliefs, behaviors, and policies in healthcare, and society more broadly, that create and sustain disadvantages in minority health; 2) the creation and funding of research positions that inordinately provide non-minoritized people and those without relevant lived experiences the ability to study health disparities as "health equity tourists"; and 3) the production of health disparities research that, due to factors one and two, is incapable of fully addressing the disparities. In this piece, these and other core elements of the Health Disparities Research Industrial Complex, and the research bubble that it has produced, are discussed. Additionally, strategies for reducing the footprint and impact of the Health Disparities Research Industrial Complex and better facilitating opportunities for meaningful implementation in the field are presented.
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Affiliation(s)
- Jerel M Ezell
- Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
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Stowers P, Fontanilla T, Elia J, Salcedo J, Kaneshiro B, Tschann M, Soon R. A qualitative study of perspectives on research participation among individuals who recently experienced an abortion in Hawai'i. Contraception 2023; 126:110107. [PMID: 37390947 DOI: 10.1016/j.contraception.2023.110107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVES The United States Code of Federal Regulations mandates extra protections for research involving pregnant participants seeking abortions. This study aims to understand the perspectives of abortion patients regarding recruitment, decision-making, and participation in research. STUDY DESIGN We recruited adults in Hawai'i who reported at least one induced abortion in the previous 6 months. Recruitment strategies included online advertisements and flyers posted in reproductive health clinics. We conducted in-person, semistructured interviews exploring research preferences. The authors collaboratively reviewed the resulting transcripts and created a code dictionary. We reviewed, organized, condensed, and diagrammed the resulting data to identify dominant themes. RESULTS Between February and November 2019, we interviewed 25 participants aged 18-41 years who had medication (n = 14) or procedural (n = 11) abortions. Interviews ranged from 32 to 77 minutes (mean = 48 minutes). Four themes emerged: (1) people having abortions are capable of making informed decisions about research participation, (2) abortion-related stigma influences research decision-making, (3) people having abortions prefer to learn about study opportunities early and through participant-driven recruitment methods, and (4) the ideal role of the abortion provider in research is unclear. CONCLUSIONS Abortion patients in this study want to be informed of research opportunities and feel capable of deciding about participation in research studies. Current federally mandated protections and common research practices could be revisited and revised to better reflect these preferences. IMPLICATIONS Revision of federal regulations and optimization of recruitment methods may allow researchers to improve the research experience for patients having an abortion.
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Affiliation(s)
- Paris Stowers
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States.
| | - Tiana Fontanilla
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Jennifer Elia
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Jennifer Salcedo
- School of Medicine, Department of Obstetrics and Gynecology, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Bliss Kaneshiro
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Mary Tschann
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Reni Soon
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
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Takimoto Y, Shimanouchi A. Ethics Guideline Development for Neuroscience Research involving Patients with Mental Illness in Japan. Asian Bioeth Rev 2023; 15:365-375. [PMID: 37808451 PMCID: PMC10555971 DOI: 10.1007/s41649-023-00240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 02/12/2023] Open
Abstract
This study aims to develop guidelines of key concepts and specific considerations to make the research more ethical when conducting neurological examinations and treatment interventions in mentally ill patients. We analyzed guideline development theory and literature, previous issues, and discussions with specialists of philosophy, medicine, sociology, and bioethics. The selection of research participants, drafting of intervention plans, and informed consent process were examined with reference to the dual burden; the minimal risk as a general rule of ethical allowance levels, assent and dissent to assess the individual's judgment capacity for consent, relational autonomy for personal consent with assistance by the proxy, and risk/benefit assessments. When conducting studies, this guideline requires that these three processes be set up appropriately on a case-by-case basis. Supplementary Information The online version contains supplementary material available at 10.1007/s41649-023-00240-x.
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Kamisato A, Hong H, Okubo S. Public Awareness of Medical Research Terminology in Japan, and the Accuracy of Physicians' Predictions regarding that Awareness. Asian Bioeth Rev 2023; 15:397-416. [PMID: 37808447 PMCID: PMC10555973 DOI: 10.1007/s41649-023-00247-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/31/2023] Open
Abstract
One of the ethical principles of medical research involving human subjects is obtaining proper informed consent (IC). However, if the participants' actual awareness of medical research terminology is lower than the researchers' prediction of that awareness, it may cause difficulty obtaining proper IC. Therefore, this study aims to clarify the presence of "perception gaps" and then discuss IC-related issues and measures based on the insights obtained. We conducted two online surveys: a "public survey" to understand the Japanese public's awareness of 11 medical research terms and a "physicians' survey" to investigate physicians' predictions regarding public awareness. In the "public survey," for each term, respondents were instructed to select their situation from "understand," "have heard," or "have never heard." In the "physicians' survey," respondents were asked to estimate the proportions of the general public who would "have understood," "have heard," or "have never heard" by using an 11-step scale. We analyzed separately in two age groups to understand the age-related difference. We received 1002 valid responses for the "public survey" and 275 for the "physicians' survey." Of the public respondents, more than 80% had never heard of terms such as interventional study, prospective clinical study, cohort study, Phase I clinical trial, or double-blind study. Concurrently, physicians overestimated general public awareness of the terms placebo, cohort study, double-blind study, and randomized clinical trial (in the group of people under 60). The results revealed the perception gap between the general public and physicians which raise serious concerns about obtaining proper IC from clinical research participants. Supplementary Information The online version contains supplementary material available at 10.1007/s41649-023-00247-4.
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Affiliation(s)
- Ayako Kamisato
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hyunsoo Hong
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Suguru Okubo
- Ritsumeikan University, Kyoto, Japan
- BMS Yokohama Inc., Yokohama, Kanagawa Japan
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Kraft SA, Duenas DM, Shah SK. Patient priorities for fulfilling the principle of respect in research: findings from a modified Delphi study. BMC Med Ethics 2023; 24:73. [PMID: 37735658 PMCID: PMC10512546 DOI: 10.1186/s12910-023-00954-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. METHODS We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas of agreement among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item's mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. RESULTS Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. CONCLUSIONS Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research.
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Affiliation(s)
- Stephanie A Kraft
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 1900 Ninth Ave., M/S JMB-6, Seattle, WA, 98101, USA.
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
| | - Devan M Duenas
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 1900 Ninth Ave., M/S JMB-6, Seattle, WA, 98101, USA
| | - Seema K Shah
- Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Bak MA, Vroonland JC, Blom MT, Damjanovic D, Willems DL, Tan HL, Corrette Ploem M. Data-driven sudden cardiac arrest research in Europe: Experts' perspectives on ethical challenges and governance strategies. Resusc Plus 2023; 15:100414. [PMID: 37363125 PMCID: PMC10285638 DOI: 10.1016/j.resplu.2023.100414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Background Observational studies using large-scale databases and biobanks help improve prevention and treatment of sudden cardiac arrest (SCA) but the lack of guidance on data protection issues in this setting may harm patients' rights and the research enterprise itself. This qualitative study explored the ethical aspects of observational SCA research, as well as solutions. Methods European experts in SCA research, medical ethics and health law reflected on this topic through semi-structured interviews (N = 29) and a virtual roundtable conference (N = 18). The ESCAPE-NET project served as a discussion case. Findings were coded and thematically analysed. Results The first theme concerned the potential benefits and harms (at individual and group level) of observational data-based SCA studies and included the following sub-themes: societal value, scientific validity, data privacy, disclosure of genetic findings, stigma and discrimination, and medicalisation of sudden death. The second theme involved governance through 'privacy by design', 'privacy by policy' and associated regulation and oversight. Sub-themes were: de-identification of data, informed consent (broad and deferred), ethics review, and harmonisation. Conclusions Researchers and scientific societies should be aware that ethico-legal issues may arise during data-driven studies in SCA and other emergencies. These can be mitigated by combining technical data protection safeguards with appropriate informed consent policies and proportional ethics oversight. To ensure responsible conduct of data research in emergency medicine, we recommend the establishment of 'codes of conduct' which should be developed in interdisciplinary groups and together with patient representatives.
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Affiliation(s)
- Marieke A.R. Bak
- Department of Ethics, Law and Humanities, Amsterdam UMC, University of Amsterdam, The Netherlands
| | | | - Marieke T. Blom
- Department of Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, The Netherlands
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Chronic Disease & Health Behaviour, Amsterdam, The Netherlands
| | - Domagoj Damjanovic
- Department of Cardiovascular Surgery, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Dick L. Willems
- Department of Ethics, Law and Humanities, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Hanno L. Tan
- Department of Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - M. Corrette Ploem
- Department of Ethics, Law and Humanities, Amsterdam UMC, University of Amsterdam, The Netherlands
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Pérez-Blanco A, Seoane JA, Pallás TA, Nieto-Moro M, Calonge RN, de la Fuente A, Martin DE. Uterus Transplantation as a Surgical Innovation. J Bioeth Inq 2023; 20:367-378. [PMID: 37382845 PMCID: PMC10624705 DOI: 10.1007/s11673-023-10272-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/20/2022] [Indexed: 06/30/2023]
Abstract
Uterus transplantation (UTx) research has been introduced in several countries, with trials in Sweden and the United States producing successful outcomes. The growing interest in developing UTx trials in other countries, such as Spain, the Netherlands, Japan, and Australia, raises important questions regarding the ethics of surgical innovation research in the field of UTx. This paper examines the current state of UTx in the context of the surgical innovation paradigm and IDEAL framework and discusses the ethical challenges faced by those considering the introduction of new trials. We argue that UTx remains an experimental procedure at a relatively early stage of the IDEAL framework, especially in the context of de novo trials, where protocols are likely to deviate from those used previously and where researchers are likely to have limited experience of UTx. We conclude that countries considering the introduction of UTx trials should build on the strengths of the reported outcomes to consolidate the evidence base and shed light on the uncertainties of the procedure. Authorities responsible for the ethical governance of UTx trials are advised to draw on the ethical framework used in the oversight of surgical innovation.
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Affiliation(s)
| | - José-Antonio Seoane
- Philosophy, Constitution and Rationality Research Group, Faculty of Law, Universidade da Coruña, A Coruña, Spain
| | | | - Montserrat Nieto-Moro
- Paediatric Critical Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | | | - Dominique E Martin
- Geelong Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
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Green B. Should infectious disease modelling research be subject to ethics review? Philos Ethics Humanit Med 2023; 18:11. [PMID: 37537645 PMCID: PMC10401793 DOI: 10.1186/s13010-023-00138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/17/2023] [Indexed: 08/05/2023] Open
Abstract
Should research projects involving epidemiological modelling be subject to ethical scrutiny and peer review prior to publication? Mathematical modelling had considerable impacts during the COVID-19 pandemic, leading to social distancing and lockdowns. Imperial College conducted research leading to the website publication of a paper, Report 9, on non-pharmaceutical interventions (NPIs) and COVID-19 mortality demand dated 16th March 2020, arguing for a Government policy of non-pharmaceutical interventions (e.g. lockdowns, social distancing, mask wearing, working from home, furlough, school closures, reduced family interaction etc.) to counter COVID 19. Enquiries and Freedom of Information requests to the institution indicate that there was no formal ethical committee review of this specific research, nor was there any peer review prior to their online publication of Report 9. This paper considers the duties placed upon researchers, institutions and research funders under the UK 'Concordat to Support Research Integrity' (CSRI), across various bioethical domains, and whether ethical committee scrutiny should be required for this research.
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Affiliation(s)
- Ben Green
- The Medical School, University of Central Lancashire, Preston, Lancashire, UK.
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Accogli A, Vergano M. Be an ethicist not a stranger! : The critical patient stuck between the right to evidence-based medicine, informed consent, and social duty. Are we still "Strangers at the bedside"? J Anesth Analg Crit Care 2023; 3:26. [PMID: 37542327 PMCID: PMC10401863 DOI: 10.1186/s44158-023-00110-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/06/2023]
Affiliation(s)
- Agnese Accogli
- Department of Surgical Science, University of Turin, Turin, Italy.
| | - Marco Vergano
- Department of Anesthesia and Intensive Care, San Giovanni Bosco Hospital, Turin, Italy
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Abstract
Growing interest in embedded research approaches-where research is incorporated into clinical care-has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators' obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise-and its corresponding implications-are challenged when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems.
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Cornock M, Rees M. Research ethics, consent and publication. Heliyon 2023; 9:e18419. [PMID: 37701397 PMCID: PMC10493426 DOI: 10.1016/j.heliyon.2023.e18419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 09/14/2023] Open
Affiliation(s)
- Marc Cornock
- Wellbeing, Education and Language Studies, The Open University, Milton Keynes, MK7 6AA, UK
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK
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Liu X, Lu X, Zhou W, Hahne J, Khoshnood K, Shi X, Zhong Y, Wang X. Informed consent in cancer clinical drug trials in China: a narrative literature review of the past 20 years. Trials 2023; 24:445. [PMID: 37415240 DOI: 10.1186/s13063-023-07482-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/27/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Although the number of cancer clinical drug trials is increasing rapidly in China, issues concerning informed consent in this research context are understudied. By performing a narrative literature review, we aim to describe the current situation and identify the most salient challenges affecting informed consent in cancer clinical drug trials among adult patients in China since 2000. METHODS We searched Web of Science (WOS), PubMed, Scopus, EMBASE, the Cochrane Library databases, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database on Disc (CBMdisc), Chinese Scientific Journals Fulltext Database (CQVIP), and WANFANG Data to identify relevant publications since 2000. Data were extracted by three reviewers on six items pertaining to study type, theme, and challenges. RESULTS We identified 37 unique manuscripts, from which 19 full texts were obtained and six were included in the review. All six studies were published in Chinese journals, and the publication years of the majority (five out of six) of the studies were 2015 or later. The authors of the six studies were all from clinical departments or ethical review committees at five hospitals in China. All of the included publications were descriptive studies. Publications reported challenges related to the following aspects of informed consent: information disclosure, patient understanding, voluntariness, authorization, and procedural steps. CONCLUSION Based on our analysis of publications over the past two decades, there are currently frequent challenges related to various aspects of informed consent in cancer clinical drug trials in China. Furthermore, only a limited number of high-quality research studies on informed consent in cancer clinical drug trials in China are available to date. Efforts toward improvement of informed consent practice, in the form of guidelines or further regulations in China, should draw on both experience from other countries and high-quality local evidence.
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Affiliation(s)
- Xing Liu
- Medical Ethics Committee, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Xiaoran Lu
- School of Humanities, Central South University, Changsha, 410075, Hunan, People's Republic of China
| | - Wei Zhou
- School of Public Administration, Hunan University, Changsha, 410023, Hunan, People's Republic of China
| | - Jessica Hahne
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Kaveh Khoshnood
- Yale School of Public Health, Yale University, 60 College Street, New Haven, CT, 06520, USA
| | - Xiaoting Shi
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College St, New Haven, CT, 06520, USA
| | - Yuqiong Zhong
- School of Humanities, Central South University, Changsha, 410075, Hunan, People's Republic of China
| | - Xiaomin Wang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, People's Republic of China.
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Morgan J, Neufeld SD, Holroyd H, Ruiz J, Taylor T, Nolan S, Glegg S. Community-Engaged Research Ethics Training (CERET): developing accessible and relevant research ethics training for community-based participatory research with people with lived and living experience using illicit drugs and harm reduction workers. Harm Reduct J 2023; 20:86. [PMID: 37415145 DOI: 10.1186/s12954-023-00818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Community-based participatory research (CBPR) can directly involve non-academic community members in the research process. Existing resources for research ethics training can be inaccessible to team members without an academic background and do not attend to the full spectrum of ethical issues that arise through community-engaged research practices. We detail an approach to capacity building and training in research ethics in the context of CBPR with people who use(d) illicit drugs and harm reduction workers in Vancouver's Downtown Eastside neighborhood. METHODS A project team comprised of academic and community experts in CBPR, research ethics, and harm reduction met over five months to develop the Community-Engaged Research Ethics Training (CERET). The group distilled key principles and content from federal research ethics guidelines in Canada, and developed case examples to situate the principles in the context of research with people who use(d) illicit drugs and harm reduction workers. In addition to content related to federal ethics guidelines, the study team integrated additional content related to ethical issues that arise through community-based research, and ethical principles for research in the Downtown Eastside. Workshops were evaluated using a pre-post questionnaire with attendees. RESULTS Over the course of six weeks in January-February 2020, we delivered three in-person workshops for twelve attendees, most of whom were onboarding as peer research assistants with a community-based research project. Workshops were structured around key principles of research ethics: respect for persons, concern for welfare, and justice. The discussion-based format we deployed allowed for the bi-directional exchange of information between facilitators and attendees. Evaluation results suggest the CERET approach was effective, and attendees gained confidence and familiarity with workshop content across learning objectives. CONCLUSIONS The CERET initiative offers an accessible approach to fulfill institutional requirements while building capacity in research ethics for people who use(d) drugs and harm reduction workers. This approach recognizes community members as partners in ethical decision making throughout the research process and is aligned with values of CBPR. Building capacity around intrinsic and extrinsic dimensions of research ethics can prepare all study team members to attend to ethical issues that arise from CBPR.
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Affiliation(s)
- Jeffrey Morgan
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada.
| | - Scott D Neufeld
- Department of Psychology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Heather Holroyd
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- University of British Columbia, Learning Exchange, 612 Main St, Vancouver, BC, V6A 2V3, Canada
| | - Jean Ruiz
- University of British Columbia, Office of Research Ethics, 6190 Agronomy Rd., Vancouver, BC, V6T 1Z3, Canada
| | - Tara Taylor
- Overdose Prevention Society, 390 Columbia St., Vancouver, BC, V6A 4J1, Canada
- SpencerCreo Foundation, 610 Main St, Vancouver, BC, V6A 2V3, Canada
| | - Seonaid Nolan
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Stephanie Glegg
- BC Centre on Substance Use, 400-1045 Howe St., Vancouver, BC, V6Z 2A9, Canada
- Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Westbrook Mall, Vancouver, BC, V6T 2B5, Canada
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Liu X, Wang X, Wu Y, Yu H, Yang M, Khoshnood K, Luo E, Wang X. Knowledge and attitudes of Chinese medical postgraduates toward research ethics and research ethics committees: a cross-sectional study. BMC Med Educ 2023; 23:482. [PMID: 37380977 DOI: 10.1186/s12909-023-04459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Research ethics provides the ethical standards for conducting sound and safe research. The field of medical research in China is rapidly growing and facing various ethical challenges. However, in China, little empirical research has been conducted on the knowledge and attitudes of medical postgraduates toward research ethics and RECs. It is critical for medical postgraduates to develop a proper knowledge of research ethics at the beginning of their careers. The purpose of this study was to assess the knowledge and attitudes of medical postgraduates toward research ethics and RECs. METHODS This cross-sectional study was conducted from May to July 2021 at a medical school and two affiliated hospitals in south-central China. The instrument of the study was an online survey that was distributed via WeChat. RESULTS We found that only 46.7% were familiar with the ethical guidelines for research with human subjects. In addition, 63.2% of participants were familiar with the RECs that reviewed their research, and 90.7% perceived RECs as helpful. However, only 36.8% were fully aware of the functions of RECs. In the meantime, 30.7% believed that review by an REC would delay research and make it more difficult for researchers. Furthermore, most participants (94.9%) believed that a course on research ethics should be mandatory for medical postgraduates. Finally, 27.4% of the respondents considered the fabrication of some data or results to be acceptable. CONCLUSION This paper serves to suggest that research ethics education should be prioritized in medical ethics curriculum, and course syllabi or teaching methods should be revised to provide medical postgraduates with a deeper understanding of the principles, regulations, and specifics of research ethics. We also recommend that RECs provide diverse approaches in their review procedure to facilitate the understanding of medical postgraduates of the functions and processes of RECs and to enhance their awareness of research integrity.
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Affiliation(s)
- Xing Liu
- Medical Ethics Committee, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Xianxiong Wang
- School of Humanities, Central South University, Changsha, Hunan, 410012, People's Republic of China
| | - Ying Wu
- School of Humanities, Central South University, Changsha, Hunan, 410012, People's Republic of China
| | - Haitao Yu
- School of Humanities, Central South University, Changsha, Hunan, 410012, People's Republic of China
| | - Min Yang
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, People's Republic of China
| | - Kaveh Khoshnood
- Yale School of Public Health, Yale University, 60 College Street, New Haven, CT, 06520, USA
| | - Esther Luo
- Yale School of Public Health, Yale University, 60 College Street, New Haven, CT, 06520, USA
| | - Xiaomin Wang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, People's Republic of China.
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Yeo-Teh NSL, Tang BL. Post-publication Peer Review with an Intention to Uncover Data/Result Irregularities and Potential Research Misconduct in Scientific Research: Vigilantism or Volunteerism? Sci Eng Ethics 2023; 29:24. [PMID: 37378894 DOI: 10.1007/s11948-023-00447-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/04/2023] [Indexed: 06/29/2023]
Abstract
Irregularities in data/results of scientific research might be spotted pre-publication by co-workers and reviewers, or post-publication by readers typically with vested interest. The latter might consist of fellow researchers in the same subject area who would naturally pay closer attention to a published paper. However, it is increasingly apparent that there are readers who interrogate papers in detail with a primary intention to identify potential problems with the work. Here, we consider post-publication peer review (PPPR) by individuals, or groups of individuals, who perform PPPRs with a perceptible intention to actively identify irregularities in published data/results and to expose potential research fraud or misconduct, or intentional misconduct exposing (IME)-PPPR. On one hand, such activities, when done anonymously or pseudonymously with no formal discourse, have been deemed as lacking in accountability, or perceived to incur some degree of maleficence, and have been labelled as vigilantism. On the other, these voluntary works have unravelled many instances of research misconduct and have helped to correct the literature. We explore the tangible benefits of IME-PPPR in detecting errors in published papers and from the perspectives of moral permissibility, research ethics, and the sociological perspective of science. We posit that the benefits of IME-PPPR activities that uncover clear evidence of misconduct, even when performed anonymously or pseudonymously, outweigh their perceived deficiencies. These activities contribute to a vigilant research culture that manifests the self-correcting nature of science, and are in line with the Mertonian norms of scientific ethos.
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Affiliation(s)
- Nicole Shu Ling Yeo-Teh
- Research Compliance and Integrity Office, National University of Singapore, Singapore, Singapore.
| | - Bor Luen Tang
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Candal-Pedreira C, Rey-Brandariz J, Varela-Lema L, Pérez-Ríos M, Ruano-Ravina A. Challenges in peer review: how to guarantee the quality and transparency of the editorial process in scientific journals. An Pediatr (Barc) 2023:S2341-2879(23)00133-3. [PMID: 37349245 DOI: 10.1016/j.anpede.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/31/2023] [Indexed: 06/24/2023] Open
Abstract
The editorial process of scientific journals is complex but essential for the dissemination of scientific knowledge. The quality of the process depends on the authors, editors and reviewers, who must have the necessary experience and knowledge to ensure the quality of the published articles. One of the most significant challenges scientific journals face today is the peer review of manuscripts. Editors are responsible for coordinating and overseeing the entire editorial process, from manuscript submission to final publication, and ensuring that articles meet ethical and scientific integrity standards. Editors are also in charge of selecting appropriate reviewers. However, the latter is becoming difficult due to the increasing refusal of expert reviewers to participate in the editorial process. The reasons for it are diverse, but the lack of recognition for review work and reviewer fatigue in the most sought-after reviewers are among the most important. Some of the measures that could be taken to alleviate the problem concern the possibility of professionalizing peer review.
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Affiliation(s)
- Cristina Candal-Pedreira
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Julia Rey-Brandariz
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Mónica Pérez-Ríos
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Alberto Ruano-Ravina
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
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Alvarez M, Hotton EJ, Harding S, Ives J, Crofts JF, Wade J. Women's and midwives' views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study. Pilot Feasibility Stud 2023; 9:98. [PMID: 37322539 DOI: 10.1186/s40814-023-01330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during labour, with research midwives expected to present, discuss and answer questions whilst maintaining equipoise. However, little is known about these interactions. An integrated qualitative study (IQS) was used to investigate information provision for women invited to participate in the Assist II feasibility study investigating the OdonAssist™-a novel device for use in assisted vaginal birth with an aim to generate a framework of good practice for information provision. METHODS Transcripts of in-depth interviews with women participants (n = 25), with recruiting midwives (n = 6) and recruitment discussions between midwives and women (n = 21), accepting or declining participation, were coded and interpreted using thematic analysis and content analysis to investigate what was helpful to women and what could be improved. RESULTS Recruiting women to intrapartum research is complicated by factors that impact on women's understanding and decision-making. Three key themes were derived from the data: (i) a woman-centred recruitment process, (ii) optimising the recruitment discussion and (iii) making a decision for two. CONCLUSION Despite evidence from the literature that women would like information provision and the research discussion to take place in the antenatal period, intrapartum studies still vary in the recruitment processes they offer women. Particularly concerning is that some women are given information for the first time whilst in labour, when they are known to feel particularly vulnerable, and contextual factors may influence decision-making; therefore, we propose a framework for good practice for information provision for research involving interventions initiated in the intrapartum period as a woman centred, and acceptable model of recruitment, which addresses the concerns of women and midwives and facilitates fair inclusion into intrapartum trials. TRIAL REGISTRATION ISRCTN. This qualitative research was undertaken as part of the ASSIST II Trial (trial registration number: ISRCTN38829082. Prospectively registered on 26/06/2019).
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Affiliation(s)
- Mary Alvarez
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK.
- Bristol Medical School, Bristol University, BS8 2PS, Bristol, UK.
| | - Emily J Hotton
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
- Translational Health Sciences, Bristol University, Bristol, UK
| | - Sam Harding
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
- Research and Innovation, Learning and Research Building, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
| | - Jonathan Ives
- Bristol Medical School, Bristol University, BS8 2PS, Bristol, UK
- Centre for Ethics in Medicine, Bristol University, Bristol, UK
| | - Joanna F Crofts
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
| | - Julia Wade
- Bristol Medical School, Bristol University, BS8 2PS, Bristol, UK
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Wanka A, Urbaniak A. [Participatory approaches in age(ing) research : Definitions, fields of application and challenges in different research stages]. Z Gerontol Geriatr 2023:10.1007/s00391-023-02209-9. [PMID: 37322267 DOI: 10.1007/s00391-023-02209-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023]
Abstract
There is much to be gained from participatory research: it can increase the closeness of research to everyday life, the acceptance of the resulting practical implications and holds the potential to fundamentally democratize scientific knowledge production. It is not surprising that this is not without irritation on the part of academic researchers and their institutional environment as well as on the part of nonacademically trained co-researchers. Based on an inspection of the relevant literature this article outlines the different understanding and definitions of participatory age(ing) research, its current fields of application, and utilization in different phases of the research process. Subsequently, the challenges that participatory approaches in age(ing) research can pose in these different fields and phases are discussed and possible solutions are outlined.
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Affiliation(s)
- Anna Wanka
- Goethe Universität Frankfurt am Main, W.-Adorno-Platz 1, 60323, Frankfurt am Main, Deutschland.
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Bak MAR, Ploem MC, Tan HL, Blom MT, Willems DL. Towards trust-based governance of health data research. Med Health Care Philos 2023; 26:185-200. [PMID: 36633724 PMCID: PMC9835739 DOI: 10.1007/s11019-022-10134-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 05/13/2023]
Abstract
Developments in medical big data analytics may bring societal benefits but are also challenging privacy and other ethical values. At the same time, an overly restrictive data protection regime can form a serious threat to valuable observational studies. Discussions about whether data privacy or data solidarity should be the foundational value of research policies, have remained unresolved. We add to this debate with an empirically informed ethical analysis. First, experiences with the implementation of the General Data Protection Regulation (GDPR) within a European research consortium demonstrate a gap between the aims of the regulation and its effects in practice. Namely, strictly formalised data protection requirements may cause routinisation among researchers instead of substantive ethical reflection, and may crowd out trust between actors in the health data research ecosystem; while harmonisation across Europe and data sharing between countries is hampered by different interpretations of the law, which partly stem from different views about ethical values. Then, building on these observations, we use theory to argue that the concept of trust provides an escape from the privacy-solidarity debate. Lastly, the paper details three aspects of trust that can help to create a responsible research environment and to mitigate the encountered challenges: trust as multi-agent concept; trust as a rational and democratic value; and trust as method for priority setting. Mutual cooperation in research-among researchers and with data subjects-is grounded in trust, which should be more explicitly recognised in the governance of health data research.
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Affiliation(s)
- Marieke A R Bak
- Department of Ethics, Law and Humanities, Amsterdam UMC (Location AMC), University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
| | - M Corrette Ploem
- Department of Ethics, Law and Humanities, Amsterdam UMC (Location AMC), University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Hanno L Tan
- Department of Cardiology, Amsterdam UMC (Location AMC), University of Amsterdam, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - M T Blom
- Department of Cardiology, Amsterdam UMC (Location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Dick L Willems
- Department of Ethics, Law and Humanities, Amsterdam UMC (Location AMC), University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
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Molina JL, Tubaro P, Casilli A, Santos-Ortega A. Research Ethics in the Age of Digital Platforms. Sci Eng Ethics 2023; 29:17. [PMID: 37185917 PMCID: PMC10127972 DOI: 10.1007/s11948-023-00437-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
Scientific research is growingly increasingly reliant on "microwork" or "crowdsourcing" provided by digital platforms to collect new data. Digital platforms connect clients and workers, charging a fee for an algorithmically managed workflow based on Terms of Service agreements. Although these platforms offer a way to make a living or complement other sources of income, microworkers lack fundamental labor rights and basic safe working conditions, especially in the Global South. We ask how researchers and research institutions address the ethical issues involved in considering microworkers as "human participants." We argue that current scientific research fails to treat microworkers in the same way as in-person human participants, producing de facto a double morality: one applied to people with rights acknowledged by states and international bodies (e.g., the Helsinki Declaration), the other to guest workers of digital autocracies who have almost no rights at all. We illustrate our argument by drawing on 57 interviews conducted with microworkers in Spanish-speaking countries.
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Affiliation(s)
- José Luis Molina
- GRAFO-Department of social and Cultural Anthropology, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Paola Tubaro
- Laboratoire Interdisciplinaire Des Sciences du Numérique (LISN), Centre National de La Recherche Scientifique (CNRS), Université Paris-Saclay, Inria, France
| | - Antonio Casilli
- School of Telecommunications, Institut Polytechnique de Paris, Telecom Paris, France
| | - Antonio Santos-Ortega
- Department of Sociology and Social Anthropology, Universitat de València, Valencia, Spain
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Linville CL, Cairns AC, Garcia T, Bridges B, Herington J, Laverty JT, Tanona S. How Do Scientists Perceive the Relationship Between Ethics and Science? A Pilot Study of Scientists' Appeals to Values. Sci Eng Ethics 2023; 29:15. [PMID: 37097519 PMCID: PMC10129971 DOI: 10.1007/s11948-023-00429-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 01/21/2023] [Indexed: 06/19/2023]
Abstract
Efforts to promote responsible conduct of research (RCR) should take into consideration how scientists already conceptualize the relationship between ethics and science. In this study, we investigated how scientists relate ethics and science by analyzing the values expressed in interviews with fifteen science faculty members at a large midwestern university. We identified the values the scientists appealed to when discussing research ethics, how explicitly they related their values to ethics, and the relationships between the values they appealed to. We found that the scientists in our study appealed to epistemic and ethical values with about the same frequency, and much more often than any other type of value. We also found that they explicitly associated epistemic values with ethical values. Participants were more likely to describe epistemic and ethical values as supporting each other, rather than trading off with each other. This suggests that many scientists already have a sophisticated understanding of the relationship between ethics and science, which may be an important resource for RCR training interventions.
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Affiliation(s)
- Caleb L Linville
- Department of Philosophy, Kansas State University, 1116 Mid Campus Dr North 201 Dickens Hall Manhattan, 66506-0803, KS, Manhattan, United States
| | - Aidan C Cairns
- Physics Education Research, Department of Physics, Kansas State University, Manhattan, United States
| | - Tyler Garcia
- Physics Education Research, Department of Physics, Kansas State University, Manhattan, United States
| | - Bill Bridges
- Physics Education Research, Department of Physics, Kansas State University, Manhattan, United States
| | - Jonathan Herington
- Department of Philosophy, Kansas State University, 1116 Mid Campus Dr North 201 Dickens Hall Manhattan, 66506-0803, KS, Manhattan, United States
- Department of Philosophy, University of Rochester, Rochester, United States
| | - James T Laverty
- Physics Education Research, Department of Physics, Kansas State University, Manhattan, United States
| | - Scott Tanona
- Department of Philosophy, Kansas State University, 1116 Mid Campus Dr North 201 Dickens Hall Manhattan, 66506-0803, KS, Manhattan, United States.
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Padmapriya ST, Parthasarathy S. Ethical Data Collection for Medical Image Analysis: a Structured Approach. Asian Bioeth Rev 2023:1-14. [PMID: 37361687 PMCID: PMC10088772 DOI: 10.1007/s41649-023-00250-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 06/28/2023] Open
Abstract
Due to advancements in technology such as data science and artificial intelligence, healthcare research has gained momentum and is generating new findings and predictions on abnormalities leading to the diagnosis of diseases or disorders in human beings. On one hand, the extensive application of data science to healthcare research is progressing faster, while on the other hand, the ethical concerns and adjoining risks and legal hurdles those data scientists may face in the future slow down the progression of healthcare research. Simply put, the application of data science to ethically guided healthcare research appears to be a dream come true. Hence, in this paper, we discuss the current practices, challenges, and limitations of the data collection process during medical image analysis (MIA) conducted as part of healthcare research and propose an ethical data collection framework to guide data scientists to address the possible ethical concerns before commencing data analytics over a medical dataset.
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Affiliation(s)
- S. T. Padmapriya
- Department of Applied Mathematics and Computational Science, Thiagarajar College of Engineering, Madurai, India
| | - Sudhaman Parthasarathy
- Department of Applied Mathematics and Computational Science, Thiagarajar College of Engineering, Madurai, India
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Smith AP, Taiclet L, Ebadi H, Levy L, Weber M, Caruso EM, Pouratian N, Feinsinger A. "They were already inside my head to begin with": Trust, Translational Misconception, and Intraoperative Brain Research. AJOB Empir Bioeth 2023; 14:111-124. [PMID: 36137012 PMCID: PMC10030379 DOI: 10.1080/23294515.2022.2123869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Background: Patients undergoing invasive neurosurgical procedures offer researchers unique opportunities to study the brain. Deep brain stimulation patients, for example, may participate in research during the surgical implantation of the stimulator device. Although this research raises many ethical concerns, little attention has been paid to basic studies, which offer no therapeutic benefits, and the value of patient-participant perspectives.Methods: Semi-structured interviews were conducted with fourteen individuals across two studies who participated in basic intraoperative research during their deep brain stimulator surgery. Interviews explored interpretations of risks and benefits, enrollment motivations, and experiences of participating in awake brain research. Reflexive thematic analysis was conducted.Results: Seven themes were identified from participant narratives, including robust attitudes of trust, high valuations of basic science research, impacts of the surgical context, and mixed experiences of participation.Conclusion: We argue that these narratives raise the potential for a translational misconception and motivate intraoperative re-consent procedures.
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Affiliation(s)
- Ally Peabody Smith
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Lauren Taiclet
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Hamasa Ebadi
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, United States
| | - Liliana Levy
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Megan Weber
- Anderson School of Management, University of California, Los Angeles, United States
| | - Eugene M. Caruso
- Anderson School of Management, University of California, Los Angeles, United States
| | - Nader Pouratian
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, United States
| | - Ashley Feinsinger
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
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Dal-Ré R. Waivers of informed consent in research with competent participants and the Declaration of Helsinki. Eur J Clin Pharmacol 2023; 79:575-578. [PMID: 36884061 PMCID: PMC9993354 DOI: 10.1007/s00228-023-03472-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Rafael Dal-Ré
- Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Avda Reyes Católicos 2, 28040, Madrid, Spain.
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Lathan HS, Kwan A, Takats C, Tanner JP, Wormer R, Romero D, Jones HE. Ethical considerations and methodological uses of Facebook data in public health research: A systematic review. Soc Sci Med 2023; 322:115807. [PMID: 36889221 DOI: 10.1016/j.socscimed.2023.115807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/10/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE Since 2016, around seven in 10 adults in the United States (U.S.) actively use Facebook. While much Facebook data is publicly available for research, many users may not understand how their data are being used. We sought to examine to what extent research ethical practices were employed and the research methods being used with Facebook data in public health research. METHODS We conducted a systematic review (PROSPERO registration CRD42020148170) of social media-based public health research focused on Facebook published in peer-reviewed journals in English between January 1, 2006 and October 31, 2019. We extracted data on ethical practices, methodology, and data analytic approaches. For studies that included verbatim user content, we attempted to locate users/posts within a timed 10-min period. RESULTS Sixty-one studies met eligibility criteria. Just under half (48%, n = 29) sought IRB approval and six (10%) sought and obtained informed consent from Facebook users. Users' written content appeared in 39 (64%) papers, of which 36 presented verbatim quotes. We were able to locate users/posts within 10 min for half (50%, n = 18) of the 36 studies containing verbatim content. Identifiable posts included content about sensitive health topics. We identified six categories of analytic approaches to using these data: network analysis, utility (i.e., usefulness of Facebook as a tool for surveillance, public health dissemination, or attitudes), associational studies of users' behavior and health outcomes, predictive model development, and two types of content analysis (thematic analysis and sentiment analysis). Associational studies were the most likely to seek IRB review (5/6, 83%), while those of utility (0/4, 0%) and prediction (1/4, 25%) were the least likely to do so. CONCLUSIONS Stronger guidance on research ethics for using Facebook data, especially the use of personal identifiers, is needed.
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Affiliation(s)
- Hannah Stuart Lathan
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Amy Kwan
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Courtney Takats
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Joshua P Tanner
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Rachel Wormer
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Diana Romero
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| | - Heidi E Jones
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA; City University of New York Institute for Implementation Science in Population Health (ISPH), New York, NY, USA.
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50
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Al P, Hey S, Weijer C, Gillies K, McCleary N, Yee ML, Inglis J, Presseau J, Brehaut J. Changing patient preferences toward better trial recruitment: an ethical analysis. Trials 2023; 24:233. [PMID: 36973759 PMCID: PMC10044713 DOI: 10.1186/s13063-023-07258-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
While randomized controlled trials are essential to health research, many of these trials fail to recruit enough participants. Approaching recruitment through the lens of behavioral science can help trialists to understand influences on the decision to participate and use them to increase recruitment. Although this approach is promising, the use of behavioral influences during recruitment is in tension with the ethical principle of respect for persons, as at least some of these influences could be used to manipulate potential participants. In this paper, we examine this tension by discussing two types of behavioral influences: one example involves physician recommendations, and the other involves framing of information to exploit cognitive biases. We argue that despite the apparent tension with ethical principles, influencing trial participants through behavior change strategies can be ethically acceptable. However, we argue that trialists have a positive obligation to analyze their recruitment strategies for behavioral influences and disclose these upfront to the research ethics committee. But we also acknowledge that since neither trialists nor ethics committees are presently well equipped to perform these analyses, additional resources and guidance are needed. We close by outlining a path toward the development of such guidance.
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Affiliation(s)
- Pepijn Al
- Rotman Institute of Philosophy, Western University, London, ON, Canada.
| | - Spencer Hey
- Prism Analytic Technologies, Cambridge, MA, USA
| | - Charles Weijer
- Departments of Medicine, Epidemiology & Biostatistics, and Philosophy, Western University, London, ON, Canada
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Nicola McCleary
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Juliette Inglis
- Patient partner, Montreal, QC, Canada
- Patient partner, Edmonton, AB, Canada
| | - Justin Presseau
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jamie Brehaut
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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