Who the most to gain, at least

Who is to benefit from the research? One likes to think that ‘humanity’, ‘the subjects’ or ‘medical science’ are going to be the beneficiaries. A slightly more cynical analysis points to the researchers having the most to gain, at least in the short term. After all, given a successful outcome for the research project, they stand to satisfied curiosity, improve their career prospect, or to posture before their colleagues. In practice, benefits accruing to the researcher, the subject and medical science have to be carefully weighed in relation to the conduct of any project. The protection of the rights and welfare of the participating subjects is the primary consideration of scientific ethics.  Informed consent by human subjects is a necessary condition for ethically acceptable research. This means that all the risk involved in the investigation must be explained, as well as possible benefits. Honest explanation of the procedure to the subject takes considerable skill, if disclosing the design of the study (say with placebo treatment) influences expectation and performances of the subject. Also, special care need to be taken when the subject are in some way limited in understanding the risks; for example, people who are intellectually handicapped or confused under the influence of drug. Informed consent implies a freedom of choice: the subject must feel confident that refusal to participate will not prejudice their subsequent clinical treatment.  It is the researcher’s responsibility to minimize the chances of long term deleterious effects to subject. Dangers can arise from administering new treatment with unknown side effect, denying treatments of known effectiveness, or using invasive assessment techniques. The welfare of laboratory animals must not be ignored. There are nowadays enforceable constraints on the condition for using non-human subjects in research. The researcher must also minimize even short-term pain, anxiety, discomfort, or embarrassment involved in an investigation, especially if it is not part of routine therapeutic practice. This is an important issue, as some therapists and researchers take a mistakenly in ‘proprietary’ view of their patients, imagining that they should put up with some discomfort for the good of medical science. In the past, poorer patients in public wards of hospitals and long term prisoners have been the most vulnerable to questionable ethical practices.  Some research, such as that involving the assessment of sexual functioning or the investigation of human foetuses, calls for very sensitive planning. Anatomical research involving the use of human cadaver materials must be planned to ensure respectful handling and disposal. Even if the researcher does not agree, the values and taboos of groups in the community must be taken into consideration when planning the investigation. A fundamental value is that the time and effort of researchers and subjects and the resources of the community should not be wasted on a badly planned investigations will produce clinically useful results. however, some poorly designed project are doomed to failure even before the data collection begins, and lead to confusion and controversy in the professional literature. Therefore, the correct use of research methods is not only useful, but constitutes an ethical necessity.   


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