Ethics and Evidence-Based Research
Write a 1250-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Part 1: Describe why ethical safeguards designed for clinical research may not be feasible or appropriate for evidence-based practice or evidence-based practice implementation projects.
Part 2: Review the sectioned headed, Two Ethical Exemplars in Chapter 22 of the textbook (Melnyk and Fineout-Overholt, 2015, pages 518-519). Discuss three main ethical controversies related to implementing Evidence-Based Quality Improvement (EBQI) Initiatives. Describe how these controversies relate to the four core ethical principles.
Part 3: Identify which ethical principles may be in conflict with the concept of ‘patients having an ethical responsibility in improving healthcare.’ Discuss how these conflicts may be resolved
tart by reading and following these instructions:
Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
Consider the discussion and the any insights you gained from it.
Review the Assignment Rubric and the specifications below to ensure that your response aligns with all assignment expectations.
Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling, and review the rubric.
The following specifications are required for this assignment:
Length: 1250 – 1500 words; answers must thoroughly address the questions in a clear, concise manner
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an INTRODUCTION AND A CONCLUSION.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.
Ethics and Evidence-Based Research Module 7
Ethics in evidence-based research is the explicit and contentious use of current best evidence to make decisions about the conduct of research. The practice of evidence-based research ethics involves integrating expertise with the best available external evidence from systematic research. There are different ethical concerns that regard evidence-based practice including some types of knowledge which are not evidence-based practice, testing by the randomized controlled trials. Ethics in clinical research sometimes do not apply in evidence-based practice. The aim of this paper is to discuss why ethics in clinical research is sometime not appropriate in the evidence based practice, ethical controversies in ethical exemplars and the ethical principles that may be in conflict with the ethical responsibility in improving healthcare.
Why Ethical Safeguards Designed for Clinical Research May Not Be Feasible or Appropriate for Evidence-Based Practice
Clinical research has ethical safeguards which are not suitable to evidence-based practice. The ethical safeguards for clinical research lack sufficient evidence collection, and limits decision making and treatment. These limitations of clinical research cannot be applied to evidence-based research whose objective is to ensure practical solutions and effective treatment. The limitations of clinical research cannot be applied to evidence-based practice as the applications of the ethical safety guidelines will lead to ineffective treatment or poor diagnosis (Bégin, et al, 2020). Evidence based research is determined by evidence. The decisions are made based on the evidence collected. There needs to be collection of sufficient information such as the observation of human subjects which ethical guidelines for clinical research limits to a great extent the interactions between the researcher and the patients.
Evidence based practice is concerned with investigating the problem and seeking a solution. The ethical guidelines of the clinical research do not matter and if implemented will negatively affect the ability to gather and make accurate determinations of diseases and subsequent treatment plans. This is a big problem which cannot be ignored due to adverse effects on the success and effectiveness of evidence-based practice. The process of evidence-based practice is a practical process which involves the use of human subjects for diagnosis and treatment, on site investigations and the use of cases studies (Hall, 2020). The ethical guidelines for clinical research limits to a great extent the ability of the researchers to collect sufficient information on diseases or patients as there are limitations on how much information you can obtain from the patient. There are certain vital information relevant to making accurate diagnosis which are denied by the ethical safety guidelines for clinical research.
Evidence based practice has some rigorous procedures which it uses to evaluate information. Theis first sought by the use of questionnaires or case studies, the information collected is then evaluated to determine its relevance and usefulness of the information. If the information is found useful then it is implemented. The ethical guidelines for clinical research restrict obtaining data on human subjects and interferes with the process of evidence collection (Meredith, et al, 2018). The restrictions set by the ethical guidelines makes its application in evidence-based practice impossible and likely to cause inaccurate data collection. Evidence based is based on tested data and the restrictions deny the use and obtaining of critical information used in the evaluation process.
2 Ethical controversies related to implementing EBQI
From the two hospitals of Michigan and Spain, patient autonomy was the major problem cited from the study. The office of Human research protects viewed the educational intervention as a research rather than the Evidence based quality improvement. They held that the researchers should have obtained the patients consent which is required for research studies. They recommended that the study not be reviewed for its violation of patient autonomy. However, the researchers argued that the study was an evidence-based quality improvement program because it used the five-evidence procedure recommended by the centers for disease and Control CDC (Hamilton, et al, 2020). Therefore, the consent of the patients as not needed in this case because of the evidence-based research. The OHRP insisted that the study had violated the patient’s autonomy for failure to obtain their consent in the research.
The second principle violated the study is the principle of beneficence which puts a moral obligation to the researchers to act on the benefit of the patient. By failure to admit crucial information to the patients concerning the study, the researchers violated the principle of beneficence. The study was conducted without the patient’s consent. The ethical guidelines require the researchers to inform the patients about the contents of the research and the nature of the information being collected. However, the researchers argued that they had used the evidence-based guidelines, and the issue of obtaining patient consent is not applicable in the study.
The principle of non-maleficence requires the researchers to if from the patients about the study and the nature of the information they are collecting. The researchers in both researches did not fully seek the consent of the patients. The patients had to be involved in the treatment process but it did not happen and the principle of non-maleficence.
Ethical Principles May Be In Conflict With The Concept Of Patients Having An Ethical Responsibility In Improving Healthcare
The principle of autonomy which requires researchers and health professionals to seek the consent of the patient before using their personal information for quality improvement. To provide quality improvement for the patients, the health professionals require adequate and sufficient information to come up with effective diagnosis and treatment programs. Requiring the consent of the patient, might lead to the patient refusing to share vital information which will negatively affect the quality improvement process (Haddad, et al, 2018). Quality improvement is dependent on the information collected. Collection of accurate and meaningful information is imprint for quality improvement programs. Quality improvement is dependent on the collection of evidence and the using the evidence to develop treatment programs. If the patient does not consent to information, the quality of the information will be doubtful and negatively affect the treatment programs.
The principle of beneficence requires that the physician makes the decisions which are the best interest of the patient. It requires the physician to involve the patient in the decision-making process in their treatment. This makes it difficult to achieve quality improvement especially when the patients doubts the treatment plan intimated by physicians. If the physicians is suing their own expertise based on their experience and collection of data, the patient might not understand how the physicians arrived at certain decisions concerning their treatment yet the patients needs to be involved in the decision making process as per the principle of beneficence. The patient might decline an effective program because they lack understanding. It is important that a physician retains authority for the quality improvement initiative to succeed. Involving the patient might lead to the patient declining to follow up with quality improvement initiative (Suhonen, et al, 2018). Informing the patient that the quality improvement initiative is intended to improve their treatment will satisfy the requirements of the principle of beneficence. The physician is intending to introduce the quality improvement to improve the health and outcome of the patient treatment.