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Why do we need ethical guidelines for medical research
Why do we need ethical guidelines for medical research ? Dany Hilmanto health research ethical committee faculty of medicine University Padjajaran
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Research activities↑ Competition in research field Desire of research environment Unfairness Dishonesty Requirement of ethical guidelines
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Why is ethical guidelines needed for medical research?
Historical justification Ethical justification
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HISTORICAL JUSTIFICATION
1767 SLATER VS BAKER VS STAPLETON 2 PHYSICIANS (SURGEONS) DISUNITED THE CALLOUS WITHOUT CONSENT Patient felt unhappy Shake to the court Expert witness physicians did unstandard procedure
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1897 Giuseppe Sanarelly Injected yellow fever to subjects patients died According to Walter Reed (1901) Research ethics need: Trial to the researcher Informed consent Limited to adult subjects
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Nazi’s doctors trial in Nuremberg Dr Josepf Mengele (angel of death) horryfying experiments Risks No beneficence Under compulsion Unfair selection Limited scientifically Nuremberg code
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Nuremberg code: Informed consent is absolutely essential Qualified researchers Favorable risk-benefit ratio Participants free to stop at any time
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1964 Declaration of Helsinski
by world medical association (WMA) 22 recommendations for human subjects research
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1932-1972 Tuskegee experiments
Pathogenesis of syphilis Black man in Tuskegee, Alabama to see natural pathogenesis of syphilis without treatment 1947: Penicilline as DOC
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1976 Belmort report Defining 3 ethical principle for research: Respect for person Beneficence Justice led to formation of Institutional Review Boards (IRB)
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Respect for persons 2 important elements: Autonomy Self determination Beneficence Maximize benefits Minimize risks Avoid harm Justice Risk and benefit equally distributed\equitable recruitment of research participant Protection of vulnerable sebjects
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Element of informed consent
Capacity to make autonomous decisions Disclosure of relevant information Understanding of this information Voluntariness of decisions Indication of agreement, e.g signature
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Thank You
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