In medical research, the line between ethical and unethical practice is not just a matter of moral judgment but now, more than ever, a legal imperative in Cameroon. Recent legislation governing research ethics has elevated the importance of conducting studies with the utmost integrity, making ethical lapses not only morally reprehensible but legally punishable. This shift underscores a critical issue: many students in health-related fields, including those pursuing PhDs, MD, MPH, MSc and BSc degrees, often inadvertently fall into ethical pitfalls.
Frequent ethical mistakes or violations made by students include skipping important steps like Good Clinical Practice (GCP) training, initiating data collection without proper ethical clearance, collecting untruthful data without verification and failing to obtain informed consent in a manner that respects the dignity and autonomy of participants. More so, breaches in confidentiality, such as improperly handling patient information or allowing it to be exposed outside secure environments, are alarmingly frequent. Furthermore, students often neglect to report protocol deviations, and adverse events, or adequately address ethical considerations in their research protocols.
These lapses can occur at three stages of research: during the design phase, where ethical considerations must be integrated into the conception and planning; throughout the conduct of the research, particularly in data collection and analysis; and finally, in the knowledge translation phase, where ethical reporting and dissemination of results are crucial.
This blog aims to bridge the existing gap in ethical training and awareness. We will provide a comprehensive guide to help you navigate the complexities of planning, implementing, and reporting your research ethically. As we delve into this guide, remember that ethical research is not just a regulatory requirement; it is a commitment to integrity and excellence, essential for advancing scientific and medical knowledge responsibly.
Key Ethical Considerations in Health Research
This section outlines crucial ethical considerations for medical research, paired with hypothetical scenarios. From voluntary participation to dignity and human rights, these guidelines help researchers navigate ethical challenges effectively, ensuring their work is both responsible and respectful of the communities they serve.
| Ethical Consideration | Explanation with Cameroon Examples |
| Voluntary participation and right to withdraw | Participants are free to choose to participate or leave the study without coercion or pressure. Example: Allowing participants in a Douala-based study on diabetes management to withdraw at any time without penalty. |
| Informed consent and information form | Participants know the purpose/objective, period, benefits, risks, and funding behind the study before they agree or decline to join. The informed in “informed consent” means the participant has been sufficiently informed about the study. Example: Explaining and providing detailed information and consent forms in both French and English for a maternal health study in Yaoundé. |
| Anonymity | You don’t know the identities of the participants. Personally Identifiable Information (PII) is not collected. Example: Using participant ID numbers instead of names in a mental health survey in Bali. |
| Confidentiality and Privacy | You know who the participants are but keep that information hidden from everyone else. You anonymize personally identifiable data so that it can’t be linked to other data by anyone else. Example: Storing sensitive patient data from an HIV/AIDS study in secure, password-protected databases and cupboards in the clinic. |
| Potential for Minimum Harm (Non-Maleficence) | Physical, social, psychological, and all other types of harm are kept to an absolute minimum. Example: Carefully monitoring and addressing any distress caused during a study on post-traumatic stress disorder in conflict-affected areas of Cameroon. |
| Potential for Maximum Good (Beneficence) | The maximization of benefits to the participants. Example: Ensuring that a nutrition intervention in rural Cameroon provides tangible health benefits to the community. |
| Justice and Equity | All participants should have equal access to participation irrespective of their differences. Example: Including diverse ethnic groups or tribes in a national health survey to ensure representativeness. |
| Dignity and Human Rights | Respect for the individual by treating them as autonomous agents, and ensuring that persons with diminished autonomy are entitled to protection. Example: Special care in research involving vulnerable populations like children, mentally ill or the elderly in Cameroon. |
| Transparency in Reporting | Ensuring your work is free of research misconduct, and you accurately represent your results through publications in scientific journals and presentations in conferences. Example: Transparently publishing both positive and negative outcomes of a malaria vaccine trial conducted in the Littoral region. |
Importance of ensuring ethical standards
In the pursuit of scientific knowledge and medical advancements, the importance of maintaining high ethical standards cannot be overstated. Ethical research practices are fundamental to the integrity of any study, particularly in the field of health research. This is not just about adhering to a set of rules; it’s about respecting the dignity and rights of participants, ensuring the validity of research findings, and maintaining public trust in scientific inquiry. These standards are not just procedural formalities; they are essential elements that:
- Protect the rights of research participants: Ethical standards ensure that the dignity, rights, and welfare of participants are respected and safeguarded throughout the research process. This is particularly crucial in health research, where studies often involve vulnerable populations or sensitive topics.
- Enhance research validity (scientific and social value of results): Adhering to ethical guidelines enhances the credibility and reliability of research findings. Ethical research practices lead to valid and unbiased data, which are fundamental for drawing accurate conclusions that can inform public health policies or medical treatments.
- Maintain scientific or academic integrity: Upholding ethical standards is key to preserving the integrity of the scientific process. This involves conducting research in a responsible and honest manner, free from fabrication, falsification, or plagiarism.
- Reduce the occurrence of frauds (research misconduct) and accidents: Ethical guidelines help in minimizing instances of research misconduct and preventable accidents, thereby safeguarding the interests of both the participants and the research community.
- Better understand the concept of the study: Ethical considerations aid in clarifying the study’s objectives and methodologies, ensuring that the research is conducted with a clear and focused purpose.
- Improve the study procedure from data collection to reporting: Ethical standards streamline the entire research process, from data collection to the dissemination of results, ensuring that each step is conducted with precision and responsibility.
- Improve the confidentiality process: By emphasizing the importance of confidentiality, ethical standards ensure that sensitive information is handled with the utmost care, respecting the privacy of participants.
- Produce right SOPs used in safety aspects: Developing and following the right Standard Operating Procedures (sops) for safety ensures that all aspects of the research are conducted in a safe and controlled environment.
- Disseminate results and make them accessible: Ethical research involves not only the generation of knowledge but also its dissemination in a manner that is accessible and beneficial to the wider community.
Common mistakes made by students and how to avoid them
This section aims to highlight common mistakes made by students in health research and provides practical, actionable advice on how to avoid them. By understanding these common errors and learning how to circumvent them, students can enhance the quality of their research and ensure it meets ethical and academic standards.
| Common Mistakes | Measures to Avoid Them |
| Skipping Good Clinical Practice (GCP) Training | Prioritize and complete GCP training to understand the ethical and scientific quality standards for designing, conducting, and reporting medical research studies. You can take TREEE, NIDA, GHN or CITI GCP certifications which are free online. |
| Data Collection Without Ethical Clearance | Always obtain ethical clearance before starting data collection. Plan and submit your research proposal to the ethics committee in advance. |
| Inadequate Informed Consent Process | Ensure informed consent is obtained in a manner that respects participant autonomy. Use clear, simple language and allow time for questions. |
| Breach in Confidentiality | Implement strict confidentiality protocols. De-identify data and secure all sensitive information both physically and electronically. DO NOT collect patient name, address and phone number on questionnaires and take them home. |
| Neglecting to Report Protocol Deviations or Adverse Events | Establish a system for reporting and documenting any deviations from the protocol or adverse events promptly and transparently. |
| Poor Handling of Ethical Considerations in Research Protocols | Thoroughly address all ethical considerations in your research protocol. Seek guidance from supervisors or ethics committees as needed. |
| Time Wastage and Psychological Distress | Pre-test questionnaires and streamline research processes to minimize time wastage and participant distress. |
| Plagiarism | Always credit original sources. Use plagiarism detection tools and understand citation rules. |
| Fabrication of Data | Uphold data integrity. Describe the handling of incomplete data in your methodology and avoid any form of data manipulation. |
Additional Tips:
- Regular Consultations: Engage with mentors or supervisors regularly for guidance and feedback.
- Ethical Awareness: Stay informed about the latest ethical guidelines and standards in your field.
- Collaborative Learning: Share experiences and learn from peers to enhance your research approach.
- Continuous Learning: Attend workshops and seminars on research ethics and methodology.
Conclusion
By incorporating the different measures explained in this blog, students can navigate the complexities of health research more effectively, ensuring their work not only contributes to scientific knowledge but also upholds the highest ethical standards. This approach of conducting thesis ethically from the conception of the protocol to the dissemination of the findings is particularly vital in the context of health research in Cameroon, where ethical considerations are intertwined with diverse cultural and social dynamics.
References
- Bhandari, P. (2022, December 02). Ethical Considerations in Research | Types & Examples. Scribbr. Retrieved February 22, 2023, from Scribbr
- E-learning platforms in Research Ethics and GCP such as the Global Health Network (GHN), Collaborative Institutional Training Initiative (CITI) and Training and Resources in Research Ethics Evaluation (TRREE).
- Drolet, Marie-Josée, Eugénie Rose-Derouin, Julie-Claude Leblanc, Mélanie Ruest, and Bryn Williams-Jones. “Ethical Issues in Research: Perceptions of Researchers, Research Ethics Board Members and Research Ethics Experts.” Journal of Academic Ethics 21, no. 2 (2023): 269–92. DOI.
- Swisher LL, Arsalanian LE, Davis CM. The realm-individual-process-situation (RIPS) model of ethical decision-making. HPA Resource. 2005;5(3):3–8.
- Drolet, M. J., & Ruest, M. (accepted). Quels sont les enjeux éthiques soulevés par la recherche scientifique? In M. Lalancette & J. Luckerhoff (dir). Initiation au travail intellectuel et à la recherche. Québec: Presses de l’Université du Québec, 18 p.
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