Ethics in Clinical Research and Health Education
Our society has become heavily dependent on advances in health care brought about by clinical research. Without decades of medical research and clinical trials, thousands of treatments and drugs would not be available. Presumably, almost all of our lives have been affected by this work.
Although clinical research is very valuable, there are many flaws associated with it. Perhaps one of the most serious is unethical behavior in research, which threatens codes of medical ethics. Likewise, there are many biases that have become so ingrained in research that many don’t even realize they exist.
As our society becomes more aware of the transgressions associated with medical research, it becomes imperative that we demand change. Making changes is the only way to fully ensure ethical treatment of all who seek medical help. Likewise, this is the only way to be sure that physicians are really aware of the best way to help their patients.
The ethical issues associated with various types of research have been around forever. Ethics come in many forms such as those associated with honesty and transparency both for test subjects and for those who will be affected by the results of certain studies. Others include more philosophical ethical questions such as whether animals should be used as test subjects or whether the pursuit of certain scientific hypotheses is appropriate.
In clinical research, a standard code of ethics is something that many scientists must adhere to, not only to maintain the respect of their peers, but also to maintain their license to practice medicine. Standard ethical practices in medical research include elements such as transparency of the risks associated with human trials, ensuring the integrity of research results and combating exploitation.
Although many new rules and policies have been developed as a result of violations of medical ethics, the mistakes of the past still haunt us. For example, men, women and children were each targeted for specific and dangerous trials where they were misinformed of the risks and exploited in the name of the discovery. Notorious examples include the Manhattan Project plutonium trials, the Tuskegee Institute’s Syphilis Study, the Willowbrook hepatitis experiments, and MKULTRA. Many vulnerable populations have suffered the full brunt of the damage.
There is no doubt that unethical behavior played a role in eroding the trust that many groups had throughout the medical field. Certain research biases, long rooted in our culture, have also played a role. Recovering from these major missteps will take a lot of time and effort.
Many do not realize the extent of the prejudices in some of the drugs and treatment options that exist in today’s medical world. For example, many studies of participants in medical treatment trials have found that there is a significant lack of racial and ethnic diversity. The vast majority of medical research has been conducted on participants of European descent. This means that there is very little understanding of the potential impacts or effectiveness of the treatment on people of other backgrounds before the treatment is approved for everyone.
These biases can also seep into actual medical treatment. For example, studies have indicated that women are much more likely to have their pain minimized by doctors. Doctors are more likely to think that a woman is exaggerating her pain or misdiagnosed, which can lead to ineffective treatments and fear of not being taken seriously at critical times. Minimization is intensifying for women from minority groups. All of this can lead to growing mistrust of the entire medical institution.
Make a change
Of course, solving these problems is an essential aspect of regaining confidence in many medical systems. Likewise, it is an imperative step towards providing better and more inclusive health care to all. In the long run, these changes can lead to important medical discoveries and a healthier society overall.
However, none of these changes are easy. Medical research institutions have had to come to terms with a not always glorious past and right the wrongs of the past. Often this has been done in the form of new policies and regulations on how trial patients should be treated. It is also about remaining vigilant and regularly taking precautions so that ethics are above all respected.
Clinical researchers can make a significant change by recognizing and working to eliminate bias in clinical trials. Ultimately, that means doing more trials on more patients of different ethnicities. Serious study of these differences can lead to better patient outcomes. In addition, many health officials struggle to recognize and reset their own personal biases.
Ethics in clinical research have long been a work in progress, and the past has not always been so good. Today, many scientists are working to restore the trust that has been eroded by bad ethical choices in the past. Tackling these challenges head-on and making changes to be more transparent and diverse can make a profound difference for healthcare organizations that build strong relationships with the public.