THE DISCUSSION WAS:
Choose an example of unethical research from CITI training or the readings and examine the impact of unethical research on participants, researchers, and practice. Include a critique of how international and federal regulations were changed or could be changed in order to protect research participants from vulnerable and diverse populations.
Consult the Belmont Report and the WMA Declaration of Helsinki in your examination, both of which can be found in the module resources.
BUT NOW WE HAVE TO:
Respond to two other peers who chose a different example than your own and expand on the discussion by suggesting how global research could have been improved through the application of ethical best practices.
THE PEER SAID:
Before the Belmont report and the WMA Declaration of Helsinki were developed, Stanley Milgram completed his Obedience to Authority study.
Let me start off by saying this is seriously savage and would not be allowed now that there are official protections in place for human subjects taking part in research experiments.
The obedience study took place in the early 60s and was meant to determine how likely people were to obey a figure of authority EVEN at the expense of an innocent person. There were a few variations of the study but the basic summary is that there were 3 participants in the experiment: the "experimenter" or the person in charge. They wore their white lab jacket to demonstrate that they were knowledgeable and the figure of authority. The subject is the "teacher", the "learner" is secretly in on the experiment as well but the "teacher" does not know this.
During the course of the experiment the "learner" has to answer questions. If they get it wrong the "teacher" turns switches to deliver an electric shock to the "learner". The shock voltage starts off low and increases with each incorrect answer. The "learner" pretends to be in pain- writhing, yelling, begging the "teacher" to stop. (The electric shocks are fake and the learner is actually fine but again, the "teacher" does not know this.)
The main component of the study is that the "experimenter" or authority figure is pressuring the "teacher" to keep going, even as the voltage increases and the "learner" begs them to stop. They push them to the level that the shocks can cause physical harm- not just pain. The switches were clearly labeled, slight shock, moderate shock, strong shock, very strong shock, intense shock, extremely intense shock, danger: severe shock and finally, XXX. They make sure the "teacher" understands this and they keep goading them on to continue torturing the "learner". The concept they are actually testing in the experiment is how much impact the presence of an authority figure play in the actions of the "teacher"
Issue #1: There is deceit. Of course the study would not work without the deceit but how can you get informed consent for something that the subject is not aware of? The participants thought they were part of "a scientific study on memory and learning".
This violates the principle of respect for people. This principle is all about autonomy/ self determination and the ability to decide if you want to participate or continue to participate once you have the knowledge and understanding about the experiment and the risks involved. Without having a true understanding of what the experiment is the person does not have the details necessary to make an informed decision and offer consent for participation.
Issue #2: The "teacher" is going through extreme emotional duress. They were urged to act against their own moral codes.
This violates the principle of beneficence. Per the Belmont Report, "Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do not harm and (2) maximize possible benefits and minimize possible harms." While the "learner" was not actually harmed the teacher did not know this. The teacher may not have been physically harmed but they had to listen to the cries and pleas of the learner while being badgered by the "experimenter" to continue the activity that is causing them significant emotional duress.
This experiment did not attempt to minimize possible harm. In fact the whole point was to determine how uncomfortable the "teacher" would have to be to stop. They made every attempt to persuade the "teacher" to continue even when they demonstrated discomfort and negative emotional reactions. This would not be allowed under the guidance of the Belmont Report.
Issue #3: Withdraw of consent/ refusal to continue participation. The "teacher" was made to feel like they could not stop by the "experimenter". Even when they offered objections they were not easily allowed to end the experiment.
This violates the respect for persons related to the idea of "voluntariness". Consent can only be obtained when the subject has decided to willingly participate and continue to participate without pressure or without duress.
Milgram chose his subjects via an advertisement in the paper so the volunteers were signing up without undue pressure- but for an experiment to test memory. Once they were taking part in the experiment, it was not easy to stop. The best comparison I can come up with is another vulnerable group: the use of prisoners as experiment subjects. Per the Belmont Report, "prison(ers) may be subtly coerced or unduly influenced to engage in research activities for which they would not otherwise volunteer."
The Belmont Report stresses the various additional protections for children, those with lack of autonomy (including prisoners): consent is not valid unless it is comes from understanding and willingness to participate. While only adults were eligible to participate, the ideas of protection, self determination, autonomy and the principles of beneficence and respect were definitely not part of Milgram’s experiment.
Thanks for reading!
Best,
Chelsea
Reference:
Eckman, B. K. (1977). Research: Stanley Milgram’s “OBEDIENCE” studies, etc: A Review of General Semantics, 34(1), 88–99.
Department of Health, Education, and Welfare. (1977) THE BELMONT REPORT: Ethical Principles and Guidelines for the Protection of Human Subjects of Research
Required Resources:
Textbook: Essentials of Nursing Research: Appraising Evidence for Nursing Practice, Chapter 4
This chapter discusses ethics in research: its origins, its principles, and procedures to guide you in evaluating research for its consideration of ethical principles.
Website: http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html
The Belmont Report is the foundation of the ethical principles and guidelines for research involving human subjects. Review it for assistance with the activities for this module, including the discussion and CITI training.
Website: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
The WMA is an organization that develops and promotes international standards of Medical Science and Medical Ethics for people around the world. Review it for assistance discussing international research guidelines.
PLEASE MAKE SURE TO DO EVERY PART OF THIS DISCUSSION PLEASE. NEEDED BY SUNDAY AFTERNOON.
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