Case Summary
Dr. Sandra Selleck is recruiting elderly Alzheimer’s patients to participate in a multicenter, randomized, controlled clinical trial funded by the Alzheimer’s Society to evaluate the novel medication tetrahydroaminoacridine (THA). Dr. Selleck requested authorization from Ann Wilson, the manager of St. Mary’s Nursing Home, to enter the facility and seek out suitable research participants (Thomas & Waluchow, 1998). Ann Wilson objected, stating that she was worried about the elderly people she was caring for and that they should not be used as “guinea pigs” for research (Thomas & Waluchow, 1998). Ann Wilson refused to budge despite Dr. Selleck’s arguments that the research ethics boards had approved the trial of the other two investigators and her hospital.
Case Analysis
Overview of the Ethical Conflict
Ann Wilson and Dr. Sandra Selleck have a conflict in this case. Ann Wilson, the director of St. Mary’s Nursing Home, opposes using elderly parents as test subjects in a clinical experiment. Dr. Selleck supports the clinical investigation and wishes to enlist residents of St. Mary’s nursing home as potential research participants (Thomas & Waluchow, 1998). The health of the elderly residents of St. Mary’s Nursing Home and the viability of Dr. Selleck’s suggested clinical experiment are in jeopardy.
Potential Outcomes and Their Implications for Research Participation
Ann Wilson agreeing to the proposed clinical research under specific restrictions or Dr. Selleck finding alternate sources for recruiting older persons are the two most likely outcomes in this situation. If Ann Wilson can guarantee that the elderly participants would not be taken advantage of or exposed to any risks, she might agree to the clinical trial (Thomas & Waluchow, 1998). Alternatively, Dr. Selleck could look for other nursing homes or assisted living institutions to recruit older people.
Benefits and Risks for Elderly Residents in the Proposed Clinical Trial
Ann Wilson’s consent to the proposed clinical trial will enable the senior residents of St. Mary’s Nursing Home to experience an improvement in their health thanks to the new medication. However, if the terms are not strictly followed, there is a chance that kids may be exposed to dangers and may even become targets of abuse.
Dr. Selleck can obtain the required sample size and proceed with the clinical experiment if she finds alternative avenues for recruiting seniors (Thomas & Waluchow, 1998). Nevertheless, the older adults at this nursing home will not benefit from the new medication. The residents of the nursing home could benefit from a new treatment that promises to significantly slow the advancement rate of Alzheimer’s disease if Ann Wilson agrees to the planned clinical trial. However, if they are exposed to dangers or are victims of exploitation, some older persons may suffer injury (Vaughn, 2023).
Ann Wilson’s refusal to participate could also impact the interests and concerns of organizations such as the Alzheimer’s Society, the Hospital’s Research Ethics Board, and other research institutes involved in the clinical trial (Thomas & Waluchow, 1998). The importance of autonomy might be protected if Ann Wilson agrees to the clinical trial, as older people will be free to choose whether or not to participate in it. However, because older people may be exposed to potential threats, the value of their assets may be compromised (Thomas & Waluchow, 1999). Additionally, because Ann Wilson cannot independently decide whether the therapeutic research should move forward, the benefit of lawfulness may be compromised.
The value of information might be upheld if Dr. Selleck discovers alternative recruiting sources, as the senior residents of St. Mary’s Nursing Home may be able to learn more about the new medication’s potential side effects. However, the older residents of St. Mary’s Nursing Home might be unable to take advantage of the potentially beneficial treatment, which could violate the ideal of equal consideration of interests (Vaughn, 2023). Furthermore, since the clinical trial may not be able to deliver the information and results required to guide the development of new medicines, the rights and interests of future generations may be compromised.
Both approaches have potential benefits and drawbacks, and they both uphold and violate certain principles. The approach proposed by Ann Wilson respects the ideal of autonomy but violates the values of damage and legality. The method proposed by Dr. Selleck respects the value of information but violates the principles of equitable consideration for all parties and respect for the rights of future generations (Vaughn, 2023). The senior residents of St. Mary’s Nursing Home may benefit from Ann Wilson’s solution regarding results and impact by giving them access to a potentially beneficial treatment. Still, they may also be exposed to potential hazards.
Recommended Course of Action and Justification
The best course of action is for Ann Wilson to agree to the suggested clinical trial, subject to specific restrictions. If Ann Wilson can ensure that the elderly participants are protected from exploitation and any potential risks, she may consent to the clinical trial. The older individuals will be given the freedom to decide whether or not to participate in the trial, upholding the ideal of autonomy.
The senior residents of St. Mary’s Nursing Home would benefit from it, as it would provide them with access to a treatment that might be helpful while reducing the trial’s risks (Vaughn, 2023). The fundamental criticism of this solution is that it violates the principles of harm and legality. However, this can be resolved by ensuring that no potential risks are presented to older people and that the clinical trial complies with medical research rules and laws.
References
Thomas, J. E., & Waluchow, W. J. (1998). Well and good: A case study approach to biomedical ethics (3rd ed). Broadview Press.
Vaughn, L. (2023). Bioethics: Principles, issues, and cases (5th ed.). Oxford University Press.