ethical principles in epidemiology

Research integrity and research fairness principles should be equally nurtured to produce high-quality impactful research—but bridging the two can lead to practical and ethical dilemmas. Except under unusual circumstances (e.g., mandated by a court of law), information obtained about individuals during an epidemiologic study should be kept confidential. Obtaining the Informed Consent of Participants, 3.7. The ethical dimensions of big data and population health research are not unlike the common ethical principles in epidemiology research and practice. In such circumstances, confidentiality safeguards and other measures should be employed to ensure that no harm can result from the research. As such, they are more restricted in scope than general ethical principles such as beneficence (which relates to the balancing of risks and benefits and the promotion of the common welfare). Staff training and periodic audits should be conducted to reinforce the importance of confidentiality safeguards. Epidemiologists have organized themselves into various national, international, and subspecialty organizations and in North America have established the American College of Epidemiology to further their professional interests in this region. The goal of these guidelines is to provide a useful account of the ethical and professional obligations of members of the American College of Epidemiology as they engage in professional activities and the application and dissemination of information to colleagues and the public. One of the most basic ethical principles of medicine and epidemiology is the moral obligation to cause no harm to participants (non-malfeasance), whether physical or psychological. The identification of disparities in health or the maldistribution of health services across groups defined by race, ethnicity, class, and many other characteristics as diverse as age, gender, sexual orientation, homelessness, and rural residence can serve as a basis for health planning and policy making and, thereby, contribute to improving the health of those who are less well-off in society. The risks of non-research public health practice activities also should be minimized. Basic Ethical Principles in Epidemiology. A consideration of the potential harms and risks of epidemiologic research also relates to the need to obtain the informed consent of participants as discussed in detail in Section 3.6. In: Coughlin SS, Beauchamp TL, eds. Conditions under which informed consent requirements may be waived, 2.7. To ensure confidentiality of information (including self-reported and biologic data), epidemiologists should gather, store and present data in such a manner as to prevent identification of study participants by third parties. To this end, epidemiologists can be employed in government positions engaged directly in either research or practice, in university research and teaching roles, in private consulting practice, or elsewhere in the private sector. Improvements in practice activities (for example, enhanced surveillance systems) also provide benefits to society. The focus is on both the obligation of researchers to disclose information about risks and potential harms and the quality of the consent of the research participant. Communicate epidemiologic information to lay and professional audiences 2.6.2 Avoidance of manipulation or coercion. The ethics of epidemiology and public health have emerged from several sources, including:3. The goal should be to communicate the core values and obligations of a professional epidemiologist (i.e., ethics guidelines) and to provide an ethical foundation so that students can deal appropriately with ethical challenges that they will face in their future practice. challenges in drug epidemiology: issues, principles and guidelines, was prepared by Craig Fry and Wayne Hall with the support of the United Nations Office on Drugs and Crime, as part of the activities conducted under GAP. One of the most basic ethical principles of medicine and epidemiology is the moral obligation to cause no harm to participants (non-malfeasance), whether physical or psychological. An individual's reasonable expectation of privacy regarding access to and use of his or her personal information should be assured. Communicating ethical requirements, PART III - DISCUSSION AND CLARIFICATION OF GUIDELINES, 3.1. On the other hand, core values in epidemiology are more general (and more basic) than ethical rules and norms within the profession such as the need to obtain the informed consent of research participants. 1254 Words5 Pages. We also relate core values to the mission of epidemiology: the pursuit of knowledge through scientific research and the improvement of public health through the application of that knowledge. Potential participants in epidemiologic research should be told the extent to which confidentiality can be protected and the intended and potential uses of data which contain personally identifying information. In this document, we are concerned with the latter. Whilst some reimbursements such as travel costs may be reasonable, paying participants to take part may not be. 92 ethical principles are consistently applied to all types of research, the core group 93 decided to prepare a Supplement to the 2002 document that would address the special 94 features of epidemiological studies. Later in this document, in Part III, we describe and clarify these duties of epidemiologists. It is increasingly accepted, however, that a distinction should be made between the methods of epidemiology and those who are engaged in the application of these methods as a primary activity. Scientific misconduct itself can also have potentially severe consequences for public health, for health professions, and for individual researchers. ), BMJ Publishing Group 2003, Good Epidemiological Practice: IEA Guidelines for Proper Conduct in Epidemiologic Research, Weed D, McKeown R. Ethics in epidemiology and public health I. It is also necessary, however, to ensure that studies involving human research participants be submitted for review by a research ethics committee. New York: Oxford University Press, 1996. Avoiding Conflicts of Interest and Partiality, 2.10. Ethical(research(guidelines(for(sewage(epidemiology(" 5" field"of"research. 10.Criticize the communication of an epidemiologic study as reported in the An exception may be justified when epidemiologists investigate outbreaks of acute communicable diseases, evaluate programs, and conduct routine disease surveillance as part of public health practice activities. Other measures that epidemiologists should take to maintain public trust are discussed in Sections 2.9 and 3.9 (avoiding conflicts of interest), Sections 2.10 and 3.10 (confronting unacceptable conduct), and Sections 2.11.1 and 3.11 (reporting results). Search for more papers by this author 1996;184. The results of studies in progress should not be reported to the media or others if such reporting could jeopordize the scientific integrity of the study or mislead the public. View by Category Toggle navigation. Reports of epidemiologic findings should include sufficient data (in aggregate form) and sufficient information about the study methods to ensure that interpretations and conclusions made from the findings can be independently corroborated by others. It is a system of standards that governs the morality and acceptability of any medical research involving human or animal subjects. (2005). There should always be an assessment of what incentives, if any, may be offered to potential respondents for participating in the study. Standards of practice are further discussed in Section 3.8.] This document, which is indebted to past efforts to develop ethics guidelines for epidemiologists and to the commentary that has accompanied such efforts, provides the first set of ethics guidelines for the American College of Epidemiology. Research has to be funded, carried out and ultimately published, whilst researchers seek to promote their reputations and careers. Recent advances in computer technology, the development of large data sets and the ability to link different data sets which contain personal identifiers have created great concern about our ability to maintain confidentiality of information about an individual's health. It is incumbent upon epidemiologists (as members of the broader scientific community) to ensure that objectivity prevails at every step of the research process. A further obligation is the need to ensure that the potential benefits and burdens of epidemiologic research are distributed in an equitable fashion. Sponsors should recognize the necessity of ethical review and should facilitate the establishment of ethics review committees. Epidemiologists should take care to distinguish the perceived conflicts of interests of others from actual conflicting interests. Human and Ecological Risk Assessment: An International Journal: Vol. Advanced embedding details, examples, and help! This duty also applies to personal information about individuals in public health practice activities. If privacy or confidentiality must be breached, the epidemiologist should first attempt to inform participants of such required infringements. Ethics are the principles of right and wrong that are acceptable to a group of people or an individual. 2.10.1 Communicating ethical requirements. John Wiley and Sons, 2007. pp. Communicating Ethical Requirements to Colleagues, Employers, and Sponsors and Confronting Unacceptable Conduct. Ethical issues, including planning, carrying out, analysing and presenting the results of a study, are discussed. Research participants have the right to refuse to take part in a study. Basic Ethical Principles in Epidemiology 1254 Words | 5 Pages. This section draws on several papers that are all available online and referenced below. To promote public trust, especially in unempowered communities, epidemiologists should consider adopting a "participatory" approach to a research project. For veterinary epidemiology, this intervention is … In molecular epidemiology of cancer where many studies are genetic in nature and they are done among healthy people, ethical issues require special consideration. Actions. The Professional Role of Epidemiologists, 2.2. Rather, they describe the core values, duties (obligations), and virtues that should serve as the basis for the thoughtful reflection and sound judgment that such decisions call for. Basic Ethical Principles The three basic ethical principles generally accepted principles in the U.S. cultural tradition include the principles of respect for persons, beneficence, and justice. In carrying out their research, epidemiologists should abstain from conduct that may injure or jeopardize the welfare of study participants either through intentional or unintentional behaviors or actions (e.g., negligence or unjustified departure from study protocols or standards of practice) or omissions. As a general rule, research findings should be subject to independent peer review prior to publication or submission to the media. In this section we define and discuss core values, scientific and ethical precepts widely held within the profession, as well as duties and virtues in epidemiology. 4 min read . Exceptions are justified in both epidemiologic research and in public health practice only if there is an overriding moral concern such as a health emergency or a legal requirement. The ethical principles articulated almost 30 years ago in The Belmont Report, respect for persons, beneficence, and justice, inform research with human subjects and serve as the foundation for our federal regulations. American Public Health Association. Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE (K‐55), Atlanta, GA 30341, USA. Epidemiologists should demonstrate appropriate ethical conduct to colleagues by example. All sponsorship of research should also be publicly acknowledged. They ought to reflect the changing role of epidemiologists in society. These guidelines also do not provide a comprehensive account of professional duties and ethical concerns in epidemiology subspecialty areas such as molecular epidemiology, genetic epidemiology, clinical epidemiology, reproductive and perinatal epidemiology, pharmacoepidemiology, and psychosocial epidemiology. Rather, specific decisions in particular circumstances require judgments made upon reflection of the core values, obligations, and virtues described in these guidelines. Coughlin SS, Soskolne CL, Goodman KW. Voluntariness - there should be a voluntary decision or agreement on the part of a capable person. Epidemiologists should ensure that the potential benefits of studies to research participants and to society are maximized by, for example, communicating results in a timely fashion. Presentations. The contributions of some of these early and more recent thinkers are described below. Professional organizations such as the American College of Epidemiology have a role in the maintenance and encouragement of professional standards through continuing education and through the development of policy statements and guidelines. Peer review plays an important role in improving research protocols and scientific reports. by region, ethnicity, soci-economic position or gender) and in access to health care, including their causes, The impact of political, economic, socio-cultural, environmental and other external influences, Introduction to study designs - intervention studies and randomised controlled trials, Parametric and Non-parametric tests for comparing two or more groups, 1d - The Principles of Qualitative Methods, 1c - Approaches to the assessment of health care needs, utilisation and outcomes, and the evaluation of health and health care, Copyright © Public Health Action Support Team (PHAST) 20, Bioethics - a field of inquiry that originally explored problems faced in the practice of medicine and biomedical research, and now also covers clinical practice, regulatory policy, research practice, and cultural and social concerns, Philosophical ethics – theories and concepts drawn from the writings of Aristotle, Kant, Mill, Rawls, etc. Explain the importance of epidemiology for informing scientific, ethical, economic and political discussion of health issues. Donald L. Noah, DVM, MPH, DACVPM, Lincoln Memorial University; Stephanie R. Ostrowski ... Perhaps the major disadvantage is the high potential for ethical implications if an intervention with great potential benefit is intentionally withheld from the control group (eg, the historic Tuskegee Syphilis Study). Epidemiology is the study of the distribution and determinants of health and disease in human populations. An example is the virtue of benevolence. Proceedings for a WHO/ISEE International Workshop, 16-18 September, 1994, Research Triangle Park, North Carolina, USA. Epidemiology is an essential tool of public health, which largely relies on collection, collation, analysis and interpretation of data and actions based on the information gleaned from the data. Actions. Informed Consent. 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