Reply to the two discussion posts below.

Reply to the two discussion posts below. Each reply should be at least 250 words. Support your assertions with at least 2 scholarly citations in APA format. Each reply must incorporate at least 1 scholarly citation in APA format. Each reply should include integration of Biblical Worldview with supporting scripture. Any sources cited must have been published within the last five years. Acceptable sources include the textbook, the Bible, peer-reviewed journal articles.
Grace V’s post:
Oct 1 2, 2022 at 11:13 AM
Discussion Board Week 8
The advancement of medicine and healthcare is reliant on research. Some history of medical research shows the dark side of human tendencies. Such as the infringement on ethical principles of beneficence, non-maleficence, autonomy, and justice. Research such as the syphilis study in Tuskegee, Nazi medical experiments, sexually transmitted infection study in Guatemala, the Willow brook State School study, and the Jewish Chronic Disease Hospital study (Gray & Grove, 2017). Another unethical research conducted by the United States government is the contaminated vaccine given to 24 prison inmates in Manila, Philippines. These events are examples of unethical studies on human subjects (Shamoo, 2022).
The history of unethical study dates back 500 years ago, by European colonizers of American Indians and the indigenous population. Multiple studies include the ingestion of radioactive isotopes, women sterilizations, and other unethical studies (Hodge, 2012). Another example is the Havasupai Tribe in Arizona where blood samples were studied without their consent (Sterling, 2011). Unethical studies continued such as the Tuskegee syphilis study that was conducted in 1932 in Alabama with 200 African American men as subjects. The purpose of the study was to evaluate the progression of syphilis. There was a lack of transparency from the researchers because some subjects were not aware of the study and were refused effective treatment even after the standard treatment of penicillin was approved. Another sexually transmitted study was conducted by Dr. John C. Cutler in Guatemala. The participants include prostitutes, prisoners, soldiers, and mentally ill patients. The patients were deliberately infected with sexually transmitted diseases. However, the study was inconclusive and the number of patients who died from the diseases or the treatments is unknown (Gray & Groves, 2017). An earlier study by Richard Pearson Strong in 1906 in Manila, Philippines tested contaminated cholera vaccine on 24 prisoners. He was found negligent for killing 13 prisoners but was not held responsible for any account (Shamoo, 2022).
One of the most commonalities between all unethical studies is the violation of self-determination, justice, non-maleficence, and beneficence. Novoa-Hecke, Bernabe & Linares (2019), coined the term “ethical dumping” where lower developed countries are at risk for unethical research that would not be readily acceptable in more developed countries. Participants from lower developed countries are more susceptible to deception due to language barriers and cultural norms. They can also be composed to coercion and would more than likely comply if given the right incentives (Gray & Grove, 2017).
Shortly after the syphilis Tuskegee Study, The U.S. Department of Health, Education, and Welfare (DHEW) established a set of regulations to avoid unethical research and protect human studies. Research must now undergo an institutional review board to ensure an ethical process is established. In addition, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research founded the Belmont Report with three ethical principles. The Belmont report addresses the principles of self-respect, beneficence, and justice.
Mathew 7:12 simply states “in everything, therefore, treat people the same way you want them to treat you, for this is the Law and the Prophets” (New American Standard Bible, 2020). Researchers and healthcare clinicians alike all have the responsibility to practice with beneficence, non-maleficence, justice, and autonomy. It is our burden to protect human rights at all costs and practice as if we are caring for our own loved ones.
References
Gray, J. R., & Grove, S. K. (2017) Burns and Grove’s the practice of nursing research:Appraisal, synthesis, and generation of evidence (9th). Elsevier.
Hodge, F. S. (2012). No meaningful apology for American Indian unethical research abuses. Ethics & Behavior, 22(6), 431-444. https://doi.org/10.1080/10508422.2012.730788
New American Standard Bible. (2020). Zondervan.
Novoa-Hecke, G., Bernabe, R., & Linares, J. (2019). Exportation of unethical practices to low and middle-income countries in biomedical research. Revista De Bioética y Derecho, 40, 167-177. https://doi.org/10.1344/rbd2017.40.19170
Shamoo, A. E. (2022). Unethical medical treatment and research in US territories. Accountability in Research, ahead-of-print(ahead-of-print), 1-14. https://doi.org/10.1080/08989621.2022.2030720
Sterling, R. L. (2011). Genetic research among the havasupai–a cautionary tale. AMA Journal of Ethics, 13(2), 113-117. https://doi.org/10.1001/virtualmentor.2011.13.2.hlaw1-1102
Bethany W’s Post
Oct 9, 2022 at 7:08 PM
Discussion Thread: Review of Ethical Principles
Unethical principles used in medical research and care of patients is a topic that is so important and critical to understanding so that we safeguard vulnerable people from methods of research or unethical medical practices in the name of research.
A resounding theme is the complete and total disregard for obtaining informed consent. Elements like the procedures involved, reasonable risk vs benefits, alternate procedures, and if there would be compensation or treatment if injury occurred. This is particularly disturbing in the case of the sterilization of American Indian women in the 1970s (Shepherd, 2021). There was no consent in many cases or even blatant lying to the patients. One woman mentioned in Shepherd’s (2021) article came in asking for her hysterectomy to be versed as she was ready to start her family. She left devastated after being told the procedure was not reversable. She insisted she was told it was reversable and would not have agreed if she had known. The ability to have children was stolen from her by a physician that did not follow ethical standards of informed consent. It was enraging reading the excuses of the physicians who completed these surgeries. What they did was a violation of their hypocritic oath and sickeningly unethical.
Another example from the same article is the U.S. Air Force’s recruitment of Alaskan Native Americans into their study about the thyroid gland in the 1950s. They did not provide the patients with a consent in clear and plan language in their native language (Hodge, 2012). Three components of informed consent are voluntarism, information, and comprehension (Gray & Grove, 2021). If there is not the ability to fully understand the consent due to this lack of information, then the patient cannot truly consent, and informed consent was not obtained. Another facet of the same study was that pregnant and lactating women and children were not excluded from recruitment. These groups of people were considered vulnerable, and this was not considered. A disregard for records keeping made it incredibly difficult to follow up with patient’s after given higher then recommended medication, thus there was not a clear way to ensure the patients did not experience harm due to their study.
Another article we were asked to read talks about consent for genetic research among the Native American people of the Havasupai tribe. They had consented for blood draws specifically for use studying diabetes. Even though they had signed a broad consent it was not disclosed that their blood was being used by other researchers studying mental health disorders, inbreeding, and alcoholism (Sterling, 2011). When the other research was published it painted the Havasupai tribe in a negative manner and violated their rights to privacy. This is a clear violation of the required element of informed consent that specifically states you must disclose it data or specimens will be shared with other researchers (Gray & Groves, 2021).
The third article we read was about doing research in low-income countries that may be prohibited in other countries for many reasons. It could be cheaper, more rapidly completed, and subjects may be more easily recruited. Easier recruitment could be due to need for medical treatment or lack of regulatory bodies ensuring patients are fully aware of all elements of research within the informed consent. Although this is not as blatant as some historical ethical violations it is almost more dangerous as researchers may be able to go without notice, regulation, or consequences for conducting sub-regulated research.
If anything, else these examples of fragrant violations of people’s right to informed consent, privacy, and protection from harm. Following the IRB process for all research prior to the start of the study should be adhered to. Adhering to the highest standards of ethical research should always be done regardless of geographical settings and collegial and criminal consequences should be enforced. This enforcement should not only serve to bring violators to justice but to serve as a deterrent for future researchers and medical personnel.
Violations of informed consent historically and in current practice is not only a violation of human rights but creates wide and potentially devastating mistrust of the medical and research community. It has the potential to cripple future research efforts that may benefit many and potentially save lives. A bible verse that speaks to truthfulness is Proverbs 12:22. The verse reads, “The Lord detests lying lips, but he delights in people who are trustworthy.” As believers we have a responsibility to be God like and to ‘detest’ lying and deceit. How can people trust researchers and medical healthcare workers if they are deceitful? God created all living things, and we must protect them as God does.
References
Gray, J.R. & Grove, S.K. (2021). Burns & Grove’s; The practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.
Hodge, F. S. (2012). No meaningful apology for american indian unethical research abuses. Ethics & Behavior, 22(6), 431-444. https://doi.org/10.1080/10508422.2012.730788
New International Bible. (2011). The NIV Bible. https://www.thenivbible.com/ (Original work published 1978).
Novoa-Heckel, G., Bernabe, R., & Linares, J. (2019). Exportation of unethical practices to low and middle income countries in biomedical research. Revista de Bioetica Derecho, 40, 167-177. https://doi.org/10.1344/rbd2017.40.19170
Shepherd, S. (2021). The enemy is the knife: Native Americans, medical genocide, and the prohibition of nonconsensual sterilizations. Michigan Journal of Race & Law, 27(1), 89-106. https://doi.org/10.36643/mjrl.27.1.enemy
Sterling, R. L. (2011). Genetic research among the havasupai–a cautionary tale. AMA Journal of Ethics, 13(2), 113-117. https://doi.org/10.1001/virtualmentor.2011.13.2.hlaw1-1102