The Nuremburg trials became the first significant action against medical research without human consent (Cizik School of Nursing, 2017). Doctors exposed patients to excruciating pain by injecting subjects with salt water, freezing them to death, and inflicting fatal wounds for the purpose of study. It established the Nuremburg code became the first ever-international statement advocating for the essential need of voluntary consent of the human subjects used in trials (Cizik School of Nursing, 2017). Experiments would only occur after researchers had identified that there was no prior reason to believe that death would occur. Nuremburg trials and code educates nurses on the history of trials without consent. Nurses who still help in assisted euthanasia and delivery of death penalties to make their decisions based on knowledge acquired from past events.
The National Research Act of 1974 was passed into law paving the way for the national commission, which established the ethical principles through which medical research involving human subjects would be carried out (Daigle, 2014). The act is important because it marked the end of the Tuskegee Syphilis study involving 600African-American participants. Throughout 40 years, participants never received information about the condition they were infected with even after a cure was found (Daigle, 2014). Many participants were denied treatment and left to die. The national research act is important because it represents a point in history in which medical research not only violated medical ethics but also exposed targeted racism on the African-American community. The commission ensured that ethical issues involving human subjects without prior consent were eliminated.
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The Belmont report established a summary of principles and guidelines to govern bioethical research involving human subjects (Irbmed Part 1, 2011). It gives three basic provisions in which researchers are instructed on how to make the best ethical judgments. The three ethical principles include respect for persons, beneficence, and justice. Particularly, respect for persons is based on the concept of autonomy, where medical practitioners recognize that every person has the right to make decisions on their health (Irbmed Part 1, 2011). It also protects individuals whose autonomy is at greater risk, for example, the disabled. The Belmont report is important because it laid the foundation of medical autonomy in the modern era. It began the debate on the ethical concerns regarding children say in their participation in medical research.
Assessment of risk and benefit in bioethical research is a crucial aspect that researchers must carefully assess before proceeding with a medical trial (Irbmed Part 2, 2011). The Belmont report identifies the risk and benefit ratio as an area of concern in any research model. Research ethics committees are obligated to conduct assessments to verify if the research has validity and distinguish the risk probability. Potential risks that the participants would be exposed to must be necessary, justifiable and minimized (Irbmed Part 2, 2011). Researchers must prove that the benefits and expected outcomes outweigh the risks. The assessment of risk to benefit ratio is important because it has allowed researchers to identify favorable ratios that are important in making precise judgments.
Justice is a principle established by the IRB ensuring that there is fair distribution of the participants and fair results in the research study. Justice eliminates situations in which one population takes all the risks and burdens while another population receives all the benefits (John Hopkins Medicine, 2015). Research should not overburden hospitalized persons with further risks of participating in a medical trial. Such persons can only participate in a trail if it directly relates to their condition (John Hopkins Medicine, 2015). This principle is important because it stipulates that subjects be not only selected based on voluntary consent to a study but also under consideration of other factors such as age and health. It prevents unethical practices such as the Tuskegee trails where one race suffered all the risk.
References
Cizik School of Nursing. (2017, February 25). CARING CORRUPTED - The Killing Nurses of The Third Reich [Video].YouTube. https://www.youtube.com/watch?v=Rz8ge4aw8Ws
Daigle, D. (2014, May 4). Research Ethics involving Human Subjects [Video]. YouTube. https://www.youtube.com/watch?v=-O5gsF5oyls
Irbmed. (2011, October 11). The Belmont Report (Part One: Basic Ethical Principles) [Video]. YouTube. https://www.youtube.com/watch?v=86zWBjDaXPk
Irbmed. (2011, October 11). The Belmont Report (Part Two: Applying the Principles) [Video]. YouTube. https://www.youtube.com/watch?v=cIafASIIU70
John Hopkins Medicine. (2015, October 8). Guiding Principles of Institutional Review Boards (IRB) [Video]. YouTube. https://www.youtube.com/watch?v=iFik0of3iUM
