Mind the gaps in ethical regulations of nursing research

Abstract

The introduction of and the commitment to evidence-based nursing in all care settings have led to a rapid increase of intervention and outcome-based research programs. Yet, the topics of nursing research are not only affected by interventions and outcomes but also affected by the concept of caring derived from humanistic philosophy. Considering this twofold orientation of nursing science, nuanced ethical regulations for nursing research programs are called for. In addition to the different research approaches, further arguments for ethical regulations are as follows: first, the different degrees of contextualization and the variety of participation models regarding the target groups; second, the capacities and opportunities of participants; and third, the caring relationship between nurses and research subjects. To capture these special features of nursing science, four approaches to fill the gaps in existing ethical regulations for nursing research are proposed: (a) process orientation, (b) community orientation, (c) context orientation, and (d) relation orientation.

Informed consent, vulnerability and the risks of group-specific attribution

“…Hence, qualitative research may lead to social and psychic harm because of a potential violation of privacy. 33,34 The close relationship between researchers and participants may induce feelings of coercion into participation on the clients' side and introduce a selection bias and biases regarding data collection, analysis and interpretation on the nurses' side. In order to determine the probability of additional or larger harm through research, it is necessary to balance two factors: the type of risks and the resources or faculties of people to cope with them.…”

Qualitative research ethics on the spot

“…The researchers are then intertwined in a set of differently positioned actors with different interests caught in a web of power relations. 4 Accordingly, the researcher must consider whom to include while balancing within a web of power relations consisting of actors in different positions with different interests, and the implications of such choices for the results of the research study.…”

“…[2][3][4]11 . First, the mismatch is related to the principle of doing no harm by protection of vulnerable patient groups or individuals, 5 while qualitative researchers do not necessarily understand patients' vulnerability based on predefined traits, but rather as situational.…”

“…By establishing research ethical guidelines, it was stipulated that researchers should not take ethical responsibilities entirely on themselves. 1 –4 The national committees and/or institutional review boards should give advice, guidance, and even permission to do research based on generally accepted principles and guidelines of research ethics regulated by international bodies such as the Declaration of Helsinki. The Declaration of Helsinki (1964/2013) is based on the Nuremberg Trials and includes obligations of openness and other ethical principles to provide guidance to researchers in medical research involving human subjects.…”

“…Despite the willingness of most qualitative researchers to follow the Declaration of Helsinki 5 and national or institutional ethical guidelines in research, there is a debate in the qualitative research milieu about the mismatch between such guidelines and the nature and essence of qualitative research. 2 –4,11 . First, the mismatch is related to the principle of doing no harm by protection of vulnerable patient groups or individuals, 5 while qualitative researchers do not necessarily understand patients’ vulnerability based on predefined traits, but rather as situational.…”