Evolution of Understanding of Medical Ethics From Past to the Present Essay

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Introduction

Ethics are guidelines that govern the conduct of people working in an organizational set up. They dictate how people should handle themselves with respect to their professions. They are predefined principles that guide on what behaviors are acceptable or unacceptable in a given profession. Ethics are not all about doing things according to particular beliefs such as religious beliefs or customs. There are various forms of ethics. Meta ethics refers to the manner in which we infer meaning from things that exist around us and our understanding of them. Some forms of ethics are involved in determining whether an action is right or wrong. Such ethics are referred to as normative ethics (DeWit, 2009). Virtue ethics involve creating complete individual awareness about any given phenomena in people’s lives. Those who believe in this type of ethics attribute individuals’ bad actions to ignorance and lack of knowledge. They believe that if a person is fully knowledgeable of the right things, then that person will always do what is right. The ethics theory can be applied to real-life situations. This form of ethics is known as applied ethics. It can be applied in the formulation of policies. It can also be applied in different situations of an individual’s life for example, in a case where a lady finds herself in the circumstance of an unplanned pregnancy; she might then find herself contemplating to procure an abortion.

The objective of this research study is to analyze how human subjects are treated in several contexts. A look at the concern about the treatment of human subjects, the history of human subjects, the current treatment of human subjects and the real impact of the treatment of human subjects and research done on the treatment of human subjects will highlight the whole concept of the treatment of human subjects. Concern about the treatment of human subjects Research generally involves the use of systematic methods of data collection and the analysis of that data. The primary objective of any research is to gather more knowledge in a concerned area or topic. During a research process, various subjects may be used to provide sources of data (Mitscherlich & Mielke, 1992). Research on human subjects involves using human beings as objects of the research process. Ethics that govern different professions have been in existence for many years but in earlier times, there were no ethics applied in regard to human subjects. These exposed human subjects to various risks such as torture.

To counter the challenges faced by the mistreatment of human subjects, various institutions have developed norms that they use to help them deal with the problem. Examples of such institutions include; The National Institute of Health (NIH) and The National Science Foundation (NSF). Research ethics are then used to study those norms and provide guidelines. Research ethics will help in the promotion of research objectives. They ensure that research data is not misrepresented. They also aim at the promotion of accountability of the research, for example, the general public and the stakeholders of a research project will need to know how funds were spent in the research. Research ethics will lead to the promotion of social values for example safety issues and human rights issues. With proper employment and implementation of research ethics, researchers will know how to deal with ethical dilemmas in case such a situation occurs.

The history of human subjects

A need for permanent and preventable measures for certain kinds of illnesses led to the invention of vaccinations in the year 1700. For these vaccinations to be certified, various trials had to be undertaken. Physicians could perform the trials unto themselves or they could use their slaves. Quite often, the slaves were not aware of what was taking place and neither were they informed of the risks involved. By the year 1906, there were no rules and regulations governing how human beings were to be used as research subjects. It was then that the Pure Food and Drug Act was passed and implemented. For example, during the trial vaccines for yellow fever commonly known as Reeds Vaccines, the experiments were thoroughly scrutinized (Bronny, 1999). It was around this time that a Nazi physician carried out unethical medical experiments with the Jews (Mitscherlich, 1992).

Individuals could be picked and forced to become research subjects without their consent. ome of the experiments instilled so much pain in the human subjects creating a lot of suffering for them. Sometimes the human subjects were deceived to participate in the research or misled on what the research was all about (Chin, 2008). For example, in 1966, Henry Beecher published a paper commonly known as Beecher Paper. It outlined 22 medical surveys whereby in one of the surveys, a patient was infused with cancer cells and informed of what had happened but the fact that he had been infused with cancer cells was not revealed to the patient. In some other cases, human subjects were coerced by authorities into participating in medical research studies or experiments by offering them small incentives like monetary gifts. The confidentiality of the human subjects was not taken into consideration. Some experiments resulted in fatal outcomes like the death of human subjects. Some doctors confessed to having performed surgery on Jews’ patients of which the majority of them died (Brady&Jonsen, 1982).

In the year 1946, the Nuremberg Code was passed. It emphasized ensuring that all human subjects must give consent before participating in any research work. One example of a torturous medical experience was the Electronic Shock Treatment of 1961 commonly called the Milgram Experiment. In 1974, such inhuman and unlawful experiments were halted by the establishment of the Education and Health Review Act. In the year 2008, GlaxoSmithKline performed pneumonia vaccine trials on 8 babies and they all died (Hearn, 2011). These pneumonia trial vaccines were carried out in Argentina.

The current treatment of human subjects

Most institutions and disciplines have developed ethical rules that must be adhered to before any research takes place. Some institutions direct that they must offer permission for any funded research to take place. General ethical principles that apply to the majority of the guidelines for various institutions and disciplines include;

a. The research will not cause any harm to the subject, or put the subject at any form of risk. Some direct that the risks must be minimal. The subject must not be subjected to any form of distress. b. The subject is fully informed and aware of all that it entails participating in the research. His or her participation in the research is voluntary and his or her consent must have been sought before the research. The subject has a right to decline to participate in the research and is allowed to withdraw from participating from the research at any given time. c. The research does not deceive the subject or use any form of lies. d. The researcher fully discloses his or her identity to the subject. e. The subject’s privacy is respected by ensuring that the data of the subject is kept confidential and anonymous where necessary. The subjects can be able to access the data collected from them at any given time. This works to clear any misconceptions that could have been created in regard to the research. f. By carrying out the research, the expected benefits outweigh the possible risks. Safety precautions and monitoring is carried out throughout the research study. In case of any possible consequences that may arise during the research, it is the responsibility of the researcher to clear them well in advance. g. The researcher will employ ethical research techniques such as collecting data in a systematic way, will not be biased during research therefore will only use facts, and he or she must respect the subject, engage with the subject politely and show civility.

The real impact of ethical principles on subjects and researchers

Even after engaging all the potential measures to ensure that the subjects are safe, there could be a likelihood of unforeseen risks. For example, some of the long-term effects of GMO maize may not be known until several years to come. The subjects of this research may find themselves not affected by the current tests but may in the future eventually develop the signs and symptoms due to long-term unforeseen effects.

The subjects may find themselves emotionally and socially affected after participating as research subjects. Subjects may find themselves guilty and unworthy after engaging in some research. This may cause some psychological effects on the subjects.

Conclusion

There is a need to aggressively campaign for the value of proper treatment of human subjects. This will only be possible if some institutions will come up and act as watchdogs to ensure ethical principles are adhered to in regard to human subjects.

References

Brady, J.V., & Jonsen, A.R. (1982). “The Evolution of Regulatory Influences on Research with Human Subjects”. Human Subjects Research: A Handbook for Institutional Review Boards. New York, USA: Cengage Learning.

Bronny, R. M.(1999).Nurses in Nazi Germany. New York, USA: Princeton University Press.

Chin, P. L. (2008). Integrated theory and knowledge development in nursing (7th ed.). St. Louis, MO: Mosby.

DeWit, S.(2009). Fundamental Concepts And Skills for Nursing. Missouri: Saunders Elsevier.

Mitscherlich, A., & Mielke, F. (1992). “Epilogue: Seven Were Hanged”. The Nazi Doctors And The Nuremberg Code – Human Rights in Human Experimentation. New York: Oxford University Press.

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