NUR 513 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?
NUR 513 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?
Nursing research, like all aspects of nursing, is governed by the American Nurses Association’s (ANA) code of ethics for nurses. These include autonomy, beneficence, justice, and non-maleficence (Gaines, 2021). In relation to research, the nurse researcher is ethically bound to assure that patients involved in research are given full autonomy. This includes attaining informed consent so that patients maintain full decision-making power regarding their care. Ethical issues can arise in this process for a number of reasons. To ensure that the patient has been fully and successfully informed, the researcher must have an understanding of all the factors that can influence comprehension and understanding of the information being provided, specifically the risks and benefits involved in participating in a study. The patient’s culturally and religiously influenced beliefs, their ability to understand information, any mental, physiological, or environmental factors that affect information processing, acceptance or denial of current illness state, loss of hope or the desire to please the provider or others can all influence the patient’s true comprehension of the risks and benefits of participating in a study as presented to them (DeNisco, 2019). Without assuring that a patient has truly understood what they are agreeing to, their autonomy and self-determination is at risk.
The second ethical principal of beneficence should be integral to the research question being studied. The goal of evidence-based practice (EBP) is to improve patient care and therefore the change in care being suggested should aim to benefit patients. If the nurse researcher is unsure of the benefit to patients, they must intervene and halt research until beneficence can be insured.
Justice means providing care that is fair and equal to all recipients. In relation to research, this means that no one should be excluded from the potential benefit of new and better care, nor should any group be unequally represented in research populations, thereby taking on undue risk. The nurse researcher is responsible for making sure that research is equally and equitably applied to all populations.
The ethical principal of non-maleficence directs nurses to do no harm. This principal comes into play when developing a research question. If there is an expected negative outcome involved in the practice being researched, the researcher must not proceed with the study.
In summary, the ethical code for nurses must guide all nursing research to assure that patient’s well-being, safety and autonomy are protected. The development and continuation of improved nursing knowledge and practice is important, but only as long as we are careful to protect patients along the way.
DeNisco, S. M., & Barker, A. M. (Eds.). (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning.
Gaines, K. (2021, July 22). What is the nursing code of ethics. Nurse.org. https://nurse.org/education/nursing-code-of-ethics/
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When conducting research that involves human recipients, there are three basic ethical principles that should be applied: respect for the subjects, beneficence, and justice (White, 2020). For the first ethical principle, respect, nurses advocate for the patient’s autonomy. We must disclose the possible risks and benefits associated with the application of the research. Additionally, we are ethically obligated to avoid persuading patients into participating. Further, informed consent must be received prior to initiating the research process. We must also respect the privacy and confidentiality of our patients who are participating in the research. Patients must be informed of what information will be shared and who the information will be shared with. Next, beneficence refers to doing good and avoiding harm. When conducting research, we must keep our patient’s safety as the top priority. All members of the research team must have the moral obligation to only proceed with the research process if it is believed to positively impact the recipient. The final ethical principle, justice, indicates that all recipients have the right to unbiased treatment. As nurses, we must advocate for our patients regardless of financial status, insurance, gender, age, etc. It is crucial to apply all three of these principles into standard practice when conducting and applying the research process.
White, M.G. (2020). Why human subjects research protection is important. Ochsner Journal, 20(1), 16-33. https://doi.org/10.31486/toj.20.5012
The major ethical issues in conducting research are informed consent, beneficence- do not harm, respect for anonymity and confidentiality, and respect for privacy. Informed consent explains the potential risks or side effects and the expected benefits of their participation(DeNisco & Barker, 2016). Nonmaleficence is the ethical principle that prevents healthcare providers from administering ineffective care or acting with malice. A researcher must consider all possible consequences of the research and balance the risks with proportionate benefits. Protocols are essential to minimize the need for obtaining and storing identifiable information about the participants in the research study. If the researcher is not able to promise anonymity, confidentiality should be addressed, which is the management of private information by the researcher in order to protect the subject’s identity. One of the last ethical issues discussed is respect for privacy. Privacy involves knowing how, when, and to what extent their information will be shared outside the study. All possible measures have to be taken to protect subjects from potential physical,psychological or social damage during the research or after the circulation of the results(Fouka & Mantzorou, 2015).
The role of the advanced registered nurse in research is to be a strong patient advocate. It includes being a patient representative, maintaining the patient’s rights, and protecting the patient’s interests from the start to the completion of the research. As with anything in healthcare, the patient’s safety remains the priority. The patient’s full disclosure and information during the research study are equally important.
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: essential knowledge for the
profession. Burlington, MA: Jones & Bartlett Learning
Fouka, G., & Mantzorou, M. (2015, March 13). What are the major ethical issues in conducting research? is there a conflict between research ethics and the nature of nursing? Retrieved February 7, 2020, from http://www.hsj.gr/medicine/what-are-the-major-ethical-issues-in-conducting-research-is-there-a-conflict-betwee n-the-research-ethics-and-the-nature-of-nursing.php?aid=3485
APA ensures proper paper formatting and organization of assignments. APA ensures that ideas and research information is presented invariably. The presented guides have helped me write the assignments. Creating accurate references and citations in APA is quite a task. One question that is a bit confusing is the APA referencing for websites. In some cases, we use sources from reputable websites such as ANA, AACN, and WHO. The confusion is on whether to italicize the website’s title or not. Also, can the header be omitted in APA 7? Another question that I would like clarification on is on block citations on quoted content. Besides, citing quoted text often requires the indication of page numbers. What happens when the content has no page numbers, for instance, in the case of e-books and websites?
When I have APA questions, my go-to resource includes GCU APA resource guides, in the students’ resource center. I also use the internet to clarify some of the questions. Some helpful resources on the internet include Purdue OWL. With all these resources, I anticipate demonstrating excellent referencing and citation skills for my last assignment since I will have all my pending questions answered. As a professional, accurately and communicating research findings and ideas is crucial. I also look forward to applying the APA knowledge outside my class assignments to facilitate research organization and clear communication. APA style provides clarity on complex topics by ensuring a good flow. APA encourages a direct exposition of our research and ensures and emphasizes the original ideas being presented.
Ethics in nursing focused on the overall well-being of the patient but in research ethics, the principal idea is respect for persons. In clinical research, the nurse-patient relationship becomes the nurse-research participant relationship. Two major ethical issues that came with clinical research are the inability to provide a known or probable good/do no harm and conflicted allegiances and/or dual professional obligations.
The inability to provide a known or probable good/do no harm has many core components. Feelings of powerlessness when the situation arises patient needs therapeutic treatments such as drugs or equipment, the research nurse is not able to provide and cannot continue the same drugs or equipment after the research ended because insurance was not covering those drugs. So, they feel they are in the middle and cannot help their patients in this situation. Clinical research nurses also expressed concern over internal conflicts they experienced in terms of worrying about whether enrolling a subject in a study could potentially be harmful (Larkin et al 2019). Also, situations like participants having difficulty understanding the purpose of the research and the uncertainty of the outcome make nurses uncomfortable and challenging. The second major issue centered around personal identity (being a nurse first) with the professional obligations inherent to that role (patient advocacy) and conflicted allegiance with certain elements of conducting the research. There can be a conflict between research responsibility and nursing responsibility.
Unresolved ethical challenges can lead to moral distress, distancing, and other negative consequences. This can negatively impact the research participants. So, it is especially important to resolve the challenges research nurses experience (Larkin et al 2019).
Larkin, M. E., Beardslee, B., Cagliero, E., Griffith, C. A., Milaszewski, K., Mugford, M. T., … & Witte, E. R. (2019). Ethical challenges experienced by clinical research nurses: A qualitative study. Nursing Ethics, 26(1), 172-184. https://doi.org/10.1177/0969733017693441.
Nursing is a guided profession with ethics. Ethics govern healthcare professional actions, decisions, and their relationships with external and internal stakeholders. Ethics in nursing focused on the overall well-being of the patient but in research ethics, the principal idea is respect for persons. Therefore, healthcare professionals are expected to uphold ethics when attending to patients. Healthcare providers with ethics forms nurse-patient relationship (Stokes & Palmer, 2020). The connection is important in treatment and recovery processes. Besides, in clinical research, the nurse-patient relationship becomes the nurse-research participant relationship. However, maintaining a perfect nurse-patient relationship may be challenging due to ethical issues. Clinic research nurses understand the value of their relationship with patients. Unfortunately, internal conflicts may interfere with nurse-patient relationship. Personal differences may trigger tension and internal conflict that may hinder suitable rapport between patients and nurses (Kim & Park, 2019). Unresolved ethical challenges can lead to moral distress, distancing, and other negative consequences. Therefore, addressing these ethical issues in the infancy stages is important.
Kim, W. J., & Park, J. H. (2019). The effects of debate-based ethics education on the moral sensitivity and judgment of nursing students: A quasi-experimental study. Nurse Education Today, 83, 104200. https://doi.org/10.1016/j.nedt.2019.08.018
Stokes, F., & Palmer, A. (2020). Artificial intelligence and robotics in nursing: ethics of caring as a guide to dividing tasks between AI and humans. Nursing Philosophy, 21(4), e12306. https://doi.org/10.1111/nup.12306
of nurses. The scholarship of nursing ethics has also viewed the practice of nursing as an act of service to the wider community and has involved deliberation of the responsibilities of nurses in relation to the welfare of society as a whole. Nurses are faced with ethical questions every day in their practice. Almost every nursing action and situation involves ethics. To raise a question about ethics is to ask about the good in nursing practice (Kohlen & McCarthy, 2020).
In conducting research, some of the major ethical issues that we come across are informed consent, privacy and confidentiality, unethical use of social media and electronic health records, and if one is asked to participate in actions that contradicts one’s values. We need to ensure that participants are adequately informed of their options for care, treatment, and procedures. The privacy and confidentiality of patient information especially with the increased use of technology, social media, and electronic health records. Another major ethical concern is when a nurse is asked to perform actions that contradict their values. It is difficult to maintain self-integrity and respect in this kind of situation (DeNisco, 2021).
At the beginning of the study, researchers ask themselves: will this project be worthwhile? Who will benefit from it? What are the potential risks for the participants? What are our roles and responsibilities as researchers? Who are we accountable to and what are we accountable for? These questions will align with the role of the Advanced Practice Nurses (APN) roles in conducting research as it relates to patient advocacy and ensuring that the purpose of the research is to benefit the patient and society in general. (Roth & Unger, 2018)
Roth, W. & Unger H., (2018) Current perspectives on research ethics in qualitative research. Forum Qualitative Social Research, 19(3), 33. http://dx.doi.org/10.17169/fqs-19.3.3155
DeNisco, S. (Ed). (2021). Advanced practice nursing: Essential knowledge for the profession (4th Ed.). Jones and Bartlett Learning
Kohlen, H., & McCarthy, J. (Eds.). (2020). Nursing ethics : Feminist perspectives. Springer International Publishing.
In healthcare industry Ethical values are essential for all practitioners .Ethical values are universal rules of conduct that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued. Ethics are moral principles that regulates how the person or a group will behave or conduct themselves. The focus pertains to the right and wrong of actions and encompasses the decision-making process of determining the ultimate consequences of those actions. Each person has their own set of personal ethics and morals. In healthcare ethics are important due to the facts that workers must recognize healthcare dilemmas, make good judgments and decisions based on their values while complying with the guidelines that govern them. To practice competently with integrity, nurses, like all healthcare professionals, must have regulation and guidance within the profession.Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care.
Banks S, All-mark P, Barnes M, Barr H, Bryant L, Cow-burn M, et al. Inter-professional ethics: A developing field? Notes from the Ethics & Social Welfare Conference, Sheffield, UK, May 2010. Ethics and Social Welfare. 2010;4(3):280–294.
Hadda LM, Geiger RA. Nursing Ethical Considerations. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
I concur with you that nursing ethics is a field of scholarship that pays attention to the ethical dimensions of the professional work of nurses. The field provides guidelines that govern nursing practice. Therefore, healthcare providers are expected to be custodians of nursing ethics. Authority and agencies have introduced policies aimed at maintaining nursing ethics (Okumoto et al., 2022). The scholarship of nursing ethics viewed the practice of nursing as an act of service to the wider community and has involved deliberation of the responsibilities of nurses in relation to the welfare of society as a whole. As healthcare workers serve, they are expected to uphold certain standards. Ethics defines professionalism among nurses. Professionalism is assumed to be competence among most patients. However, nurses encounter ethical issues that may trigger violation of ethics (Zhang et al., 2019). In conducting research, some of the major ethical issues that we come across are informed consent, privacy and confidentiality. Poor handling of these ethical issues may interfere with the quality of healthcare services.
Okumoto, A., Yoneyama, S., Miyata, C., & Kinoshita, A. (2022). The relationship between hospital ethical climate and continuing education in nursing ethics. PloS one, 17(7), e0269034. https://doi.org/10.1371/journal.pone.0269034
Zhang, F., Zhao, L., Zeng, Y., Xu, K., & Wen, X. (2019). A comparison of inquiry-oriented teaching and lecture-based approach in nursing ethics education. Nurse education today, 79, 86-91. https://doi.org/10.1016/j.nedt.2019.05.006