In addition to the institutional review process, a num- ber of codes and regulations have been implemented to ensure ethical conduct in research. The two historical documents are the Nuremberg Code and the Declara- tion of Helsinki, which were developed in response to unethical acts, such as the Nazi experiments. These experiments occurred in the 1930s and 1940s and included experiments with untested drugs, sterilization, and euthanasia on prisoners of war. These experiments were unethical as they caused grievous harm to the sub- jects and denied the opportunity to refuse participation (Polit and Beck, 2012).
Another famous incident of unethical research that prompted the need to oversee the conduct of research is the famous Tuskegee syphilis study. This study, which was initiated by the U.S. Public Health Service, contin- ued for 40 years. The study was conducted to determine the natural course of syphilis in African-American men.
Many participants were not adequately informed about the purpose and procedures of the study. The subjects periodically were examined but did not receive treat- ment for syphilis, even after penicillin was determined to be effective. The study was not stopped until 1972, when published reports of the study sparked public out- rage (Centers for Disease Control and Prevention, 2011).
Bad Blood (Jones, 1993), a comprehensive documentary account of the Tuskegee syphilis study, clearly relates the study’s adverse effects on research participation by Afri- can Americans and on race relations in the United States.
As late as the 1960s, another famous study that vio- lated human rights took place. The Jewish Chronic Dis- ease Hospital in New York was the setting for a study to determine patients’ rejection of liver cancer cells. Twenty- two patients were injected with liver cancer cells without being informed that they were taking part in the research.
In addition, the physician directing the study did not have institutional approval for a study that had the potential to cause the subjects harm or even death (Murphy, 2004).
In institutions in which IRB approval is not required for non-federally funded programs, the researcher should seek external advice regarding ethical consid- erations. When IRB approval is an option, researchers should seek it because IRB approval demonstrates sci- entific rigor to the audience when the research is dis- seminated either through presentation or publication.
S U M M A R Y
Educators must prepare health care professionals to have an appreciation of research and to participate in research design implementation and evaluation at the level of their preparation. Practicing nurses of various educational levels actively must seek, develop, and adopt EBP proto- cols while encouraging affiliated institutions to support this effort. Health care administrators must facilitate an environment that fosters intellectual curiosity and sup- ports research efforts. Collaborative arrangements between health care agencies and universities must be developed for such activities as student projects, continuing education,
development of clinical practice guidelines, and research endeavors. Consumers must be educated about the value of health care research, and policymakers must be informed of pertinent findings so that results can be translated into health policy.
Additional resources are available online at:
http://evolve.elsevier.com/Cherry/
103 CHAPTER 6 Nursing Research and Evidence-Based Practice
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