Applying Ethical Guidelines in Nursing Research on People with mental illness

Abstract

This article describes how ethical guidelines have been applied while interviewing psychiatric patients who were recovering from mental illness, especially from psychosis, to allow nurses to understand these patients' experiences. Because psychiatric patients are vulnerable, their participation in research involves ethical dilemmas, such as voluntary consent, legal capacity to consent, freedom of choice, and sufficient knowledge and comprehension. The first part of this article describes the most important ethical guidelines concerning human research. These have been published by different organizations, departments, committees and commissions for the purpose of protecting human rights and dignity whenever research participants are vulnerable persons or their capacity to consent is limited. At present, however, no special regulations govern research involving adults who have been diagnosed with a condition characterized by mental impairment. Furthermore, a relatively small body of research has documented the effects of various disorders (e.g. psychiatric conditions) on decision-making capacity per se. One basic moral and policy question is whether these individuals should ever be involved in research. The second part of this article concentrates on how the investigator made sure that participating patients had understood their role in this particular piece of nursing research. During the interviews the investigator noticed that some ethical dilemmas required further study and debate because of the lack of consensus on the proposed regulatory provisions on research involving institutionalized persons and their ability to make an informed and voluntary decision.

Occupational Stress, Coping Strategies, and Quality of Life among Nurses in General and Psychiatric Setting in Jeddah City—KSA

“…These include the fact that stressed workers are more likely to be unhealthy, poorly motivated, less productive and less safe at work. Also, high level of occupational stress reduces the quality of nursing care [12], and can threaten patients' lives and security [7].…”

‘That was helpful … no one has talked to me about that before’: Research participation as a therapeutic activity

“…Paradoxically, it is often a focus on protecting participants from harm and cushioning vulnerable people that violates important ethical principles of autonomy and justice, whereby people might be withdrawn from research studies, not included, or their viewpoints rendered irrelevant (Rogers 2004). There are strong arguments to allow competent individuals to participant in research which poses risks (Edwards et al 2004), and there have been consistent challenges to the assumptions underpinning paternalistic decisions in relation to research participation (Appelbaum et al 1999;Koivisto et al 2001;Stanley et al 1981;Tee & Lathlean 2004). Competent individuals ought to be able to choose to participate after weighing potential benefits and harms, and it is beholden on the researcher to express these in comprehensible terms.…”

Ethnography and the ethics of undertaking research in different mental healthcare settings

“…It is usual to regard people experiencing mental health problems as being 'vulnerable' research participants (Koivisto et al 2001, SEHD 2006. Indeed, the National Research Ethics Service online application form and guidance notes place all adults with mental illness under this category (NPSA 2007).…”