Health care refers to the prevention and treatment of the various disease and injuries that affect our physical and mental well being. It is therefore one of the most important aspects in man’s survival. As such, nations across the world have invested heavily in their health sectors to ensure that all citizens have access to quality health care. One of the most important investments made in these sectors is research on how various diseases can best be treated.
However, there are factors that need to be considered when carrying out human research. This is because there have been cases in the past whereby the remedies to various diseases have proven to be life threatening. As such, health care is affected by many other issues which if overlooked, may lead to ineffective health care delivery to those who need it. This paper will explore the importance of ethical standards in research. In this regard, a case analysis of whether vaccines because autism will be used to further our understanding on the relationship that exists between ethics and research.
Ethics is defined as a system of moral principles through which social conduct is judged as either “right” or “wrong”. As relating to human research, ethics are moral principles which determine what acceptable practices are when dealing with human subjects. In our current health care system, there are numerous practices which are a direct consequence of faulty research methods that are visibly unethical. Examples include prescription drugs having serious side effects, application of medical theories that negatively affect members of society and medical practices that are not in the best interest of the vast majority and can therefore be judged as wrong and malevolent.
Do vaccines cause autism?
Autism by definition is a medical term that is used to describe children and adults who experience difficulties in socializing, communicating (verbal and non-verbal), and language acquisition (Tager-Flusberg, Paul and Lord, 2005). The authors describe autism as a neurological disorder that stems from the brain’s inability to carry out some functions in a normal manner. The causes of Autism as well as the reasons why it affects lingual and communication skills are not entirely known.
However, some researchers have in the recent past documented that some vaccines containing mercury do cause autism. Despite this revelation, majority of the vaccines are still being sold in various parts of the world. Not only is this a risky practice, but it is also unethical. In light of this, it would be a worthwhile endeavor to explore the conflict that exists between research and ethics in the medical sector. In other words, we are going to evaluate the extent to which ethical standards are important guidelines for human research.
According to Higgs (2010), there has been a close relationship between mandatory childhood vaccines and autism. In his article, the author highlights various cases as well as statistical evidence that prove that some vaccines have in the past fifty years been the primary cause of autism amongst many children. For example, Higgs (2010) states that in as much as moralists and other medical practitioners claim that vaccines do not cause autism, there is documented evidence that reveals that neurotoxins incorporated into the vaccines have significantly contributed to the autism spectrum disorders prevalence in the past two decades.
To support his argument, Higgs (2010) takes the reader back to 1930 when Eli Lilly & co. received a patent for a mercury-based substance called thimerosal. The substance was and is still used as a preservative for most childhood vaccines. Attempts to get the substance tested for its effects on human beings fell on deaf ears. According to the congressional report of 2003, the company relied on substandard tests which were not properly carried out, to determine that thimerosal was safe for human consumption. Mark you, the tests were carried out in the 1920’s. The fact that the substance was later incorporated in most vaccines despite its potential dangers show unethical practices adopted during the research.
Statistically speaking, by 1989 a five year old child was expected to have received 11 vaccinations for various diseases. In regard to autism prevalence, the number of children reported to have autism spectrum disorders increased by more than 300% from a bearable figure of 1 in every 2,272 to an alarming figure of 1 in every 480 live births between 1980 and 1994 (Journal of the American Medical Association, 2001; as cited by Higgs, 2010).
Despite these shocking revelations, more vaccines have been introduced bringing them to a total of 36 vaccines which must be administered before an American child reaches age 7. As expected, reports published in 2007 indicated that the number of autism cases had increased to 1 in every 140 live births. To make matters worse, the report published in 2009 showed that 1 in every 110 live births had an autism spectrum disorder (CDC; as cited by Higgs, 2010). Such statistical revelations are pure evidence that vaccines do cause autism. The question that is left unanswered is: why, despite these truths, are potentially dangerous vaccines been administered to our children? The answer to this question can be found in the following discussion.
Conflict between Research and Ethics
As Johnstone (2008) asserts, the conflict between research and ethics has been in existence for a very long time. He further explains that this conflict is as a result of conscious awareness of apparent consequences (to a given community) that may emerge from how the research is conducted. In the medical field, this conflict is deeply rooted in the fact that practitioners portray any action that aims at enhancing good health and prolong life as a core duty.
On the other hand, they are under an ethical oath which stipulates that they should do no harm. This is the main area where the conflict emerges. To put some more emphasis on this, consider this situation: a vaccine developer realizes that the vaccine will help save multiple lives; however, he learns that people who use the vaccine are at risk of getting autism. Such a situation presents practitioners with an ethical dilemma that is often difficult to diffuse.
While handling research subjects, situations arise that require the researcher’s reaction. The decision taken may be from an ethical viewpoint or from a legal viewpoint. While at times, both of these perspectives may be in sync, there are times when they appear contradictory and as such it is the researcher’s prerogative to choose which viewpoint to lay more emphasis on. Johnstone (2008), suggests that that while some practitioners might be inclined to view legal frameworks as inconveniences in their operations, these legalities do serve the best interests of both the patient/subject and the practitioner. This is especially the case when the nurse is in a dilemma and has no other justification for his or her actions. A legally prescribed action may act as a default.
Discussion
In an ideal situation, the legal and ethical requirements of any given research are clearly spelt out. However, this is not always what happens in the field. In some cases, specific laws may be ambiguous and as such open to different interpretation by individuals. In such a case personal experience and bias will dictate what outcome will be seen. There is much variance in ethical interpretation by individual researchers, it is impossible to come up with a conclusive set of standards to be followed stipulating all the relevant laws and ethical issues. The standards which exist only act to serve as guidelines and best practices for the practitioners (Mathieson, 2006).
Professional ethics are those ethics that are stipulated by professional bodies e.g. the International Council of Nurses which endorses the international codes of ethics for nurses. They determine the expected professional behavior which should be exhibited by a nurse in his or her duties. According to the Annals of Internal Medicine (2002), the nurse’s fundamental responsibilities include promotion of health, prevention of illness, restoration of health and the alleviation of suffering. With these responsibilities comes the code for respect for all and upholding of the sacred right to life.
Analysis
Evidently, there are many ethical concerns that should be covered while undertaking a research. However, by conducting a risk/benefit analysis, a researcher is better placed to determine which actions are beneficial and which ones are detrimental.
Mathieson (2006) proposes that having the participant’s informed consent prior to the research is very important. An informed consent is always signed by the participants after the researcher explains in detail what the research is about, its benefits, potential risks, where the money will come from, how much the participants will be paid, conflicts of interest that are present or may arise, the role of management to the research, institutional association of the researchers, and most important of all, the ethical standards that will govern the research. While in some cases subjects are tricked into participating in some research, such a breakdown helps them avoid awkward situations that may arise due to being ignorant to the information.
Conclusion
This paper has in detail established the conflict between research and ethical issues in medical practice. While it has been observed that the two issues are not always in sync, it has been established that they can be reconciled at times and if not, it will be at the nurse’s discretion to choose the desirable line of action. The different personal values that come to play have also been looked at and so have the professional ethics which bind a researcher in his/her work.
The existing ethical theories that researchers adhere to have been mentioned and a brief overview on how they affect the decision making process given. To this end, factors that should be considered to ensure that researches are conducted in an ethical manner have been outlined. If followed, future research practices will not only be successful, but will at the same time exhibit high level of etiquette and professionalism.
References
Annals of Internal Medicine. (2002). Medical Professionalism in the New Millennium: A Physician Charter. Medical Journal of Australia, 177. pp. 263 – 265.
Crisp, J., Potter, P. A. and Perry, G. A. (2005). Potter & Perry’s Fundamentals of Nursing. (2nd ed). Australia: Elsevier Australia.
Higgs, S. (2010). The Poisoning of a Generation: Do Vaccines Cause Autism. Web.
Johnstone, M. (2008). Questioning nursing ethics (ethics & legal). Australian Nursing Journal, 15. p.19.
Mathieson, F. (2006). Examining the Law and Ethics Surrounding Palliative Care. Primary health care, 16(4). P.94.
Tager-Flusberg, H., & Lord, C. (2005). Language and Communication in Autism. Web.