Ethical Challenges and Evolving Practices in Research on Ethics in Health Research
Bibliographic record
Abstract
Introduction 'Research ethics' are moral principles guiding research, from its inception through to completion and publication of results and beyond. (1) Ethical review offers guidelines concerning the rights, dignity and safety of human subjects, and plays a critical role in governance, the formalized system set in place to maintain and monitor the integrity of the research enterprise. (2) Although ethical issues in health research are well documented, empirical evidence based on the experiences of those involved in research, is limited. Such knowledge could enhance understanding of the research process and research ethics and underpin an evidence-based system of human subject protection. (3) The current oversight system does not systemically assess performance and outcomes in health research. (4) As noted by the Institute of Medicine a systems-based approach to protecting research participants is needed, but absence of sufficient data regarding human research activities significantly impedes the examination of system performance. (5) In this paper we identify some of the ethical challenges that both researchers and reviewers face when conducting or reviewing human subject health research. We also describe evolving practices for conducting research on ethical aspects of health research and show how empirical evidence which explores the perspectives of those involved in research can improve research governance. An evidence-based foundation for research ethics is particularly timely in the context of structural, organizational and political changes which continue to reverberate through the research community. The traditional model of researcher--subject relationship scrutinized by a local REB has been replaced by an increasingly complex model in a dynamic landscape of large-scale multidisciplinary, multi-investigator, multi-site and often global projects. Such developments introduce complications to health research. For example, multidisciplinary projects require negotiation between investigators and institutions about issues on which there may be disagreement (e.g. the securing of informed consent and defining minimal risk). Further complications may arise in multi-site or international studies where traditional notions of autonomy in the consent process may be a source of disagreement between individualistic and community based models. There have also been significant funding changes. For instance, there has been a huge increase in the number of drug and device trials being undertaken in the private sector that are often conducted or coordinated by contract research organizations. (6) Moreover, the increasing adoption of participatory action research has, in some cases, transformed the once passive human subject to an active research participant, with significant implications for the priorization of core values informing ethical review as well as research practice. (7) Approaches to Research on Ethical Aspects of Health Research Given the emerging complexities of research and the paucity of systematic evidence on the utility of ethics review and governance, a fresh, evidence--based approach is timely. Exploring the research process from multiple perspectives within the health research community (i.e. clinical and social science researchers, REB members, sponsors and policy makers) alongside subject perspectives would add valuable insight to the health research and ethics process. Systematic scrutiny of diverse standpoints allows comparisons to be made, and similarities and differences to be identified, revealing key challenges for ethical oversight of health research involving humans. This could yield new awareness of significant differences in risk predictions by REBs (private and public), researchers, and research subjects, (8) or varied views on the provision of information dissemination in clinical trials. (9) Canada could play a leading role in developing a research agenda that would contribute to a systematic body of evidence on research ethics. …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.492 | 0.400 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.009 |
| Science and technology studies | 0.018 | 0.172 |
| Scholarly communication | 0.062 | 0.048 |
| Open science | 0.010 | 0.027 |
| Research integrity | 0.037 | 0.046 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".