Of all the nine norms mentioned to balance the social good, norm three is the essential norm which is “the risk of suffering or injury must be proportionate to the good to be gained.” While conducting the research, it is one of the most crucial principles because the primary purpose of the study is to find a solution to existing health problems so the risks involved in performing the investigation should be lowest and the benefits should be more. The research should not be hazardous to society or participants such as exposure to chemicals, lethal treatment experiments, or other adverse impacts. A researcher should be fully aware that the research has more positive aspects than negative aspects. Before the implication or start of the study, the researcher needs to assess all the possible risks that might be involved in the research process and the potential gains from the particular investigation. Also, the risk and benefits should be equally distributed among participants and benefits for the one group should not outweigh as compared to the other groups. Therefore, the third norm is the most important to balance the social goods.
- It is essential to test the medication on a human to determine whether the proposed medicine has an impact on the human body or the diseases in concern. Animal and humans might have similar functions but the reactions to certain treatment might be different so, the medication tests on human is essential. However, in the persuasion of scientific inquiry, the human dignity and respect should be maintained, and research should not involve any unfair treatment of humans. Also, the research subject of humans should not be treated as a means to an end. The idea of human dignity was more emphasized after the violation of dignity, rights, and interest during World War II during the Nazi’s experiments on humans. The experiments of Nazis were perplexing because of human abuse and lack of autonomy of the participant considering the benefits of the state by risking the lives of the people. A major focus in the clinical or research trials after the Nazi experiment was protecting the rights of human subjects and the risk-benefit ratio for the subjects involved and ethical approval standards have been more robust after the concentration camp of Nazi’s in world war II and more importance was given to subjects involved in the research.
Belmont report: A report issued in 1979 which is devised by the Department of Health, Education, and Welfare, Office of the Secretary consists of Ethical Principles and Guidelines for the protection of human subjects of research.
Benefit: It is one of the moral norms for the decision-making and refers to the positive effects of the treatment and will lead to improvement in the conditions of the participants. For example, one can pursue goods along with human flourishing such as human relationships and other personal goods which are essential at the minimum level.
Code of Federal Regulations (45 CFR 46): Human Subjects Research issued by the office of human subjects research in the Department of Health and Human Services of the federal government providing the basis of protection of human subjects enrolled in research.
Declaration of Helsinki: It is one of the documents which was issues by the World Medical Association in 1964 and revised in 2000 which addressed the ethical principles of the medical community regarding human experimentations.
Human Subjects: Human persons who are rolled in research involving human subjects. The use of subjects instead of participants indicates the distinction between rights and protection accorded a subject in comparison to those granted as patients.
- The scientific inquiry is pitted against the protection of individual human beings. According to the concept of consequentialism, the consequences of research would decide its rightness or wrongness. This link to norm three which is the more the benefits are, the better the research is. Also, the consequences of an inquiry should be protecting the lives and rights of human beings. There is tension between personalists and utilitarianism because personalism focus on human as a center of everything but utilitarianism is based on benefits and making a decision based on a benefits basis (Schauer, 2001). The personalists are of prime importance because they have considered humans as a center and considered their interest as the main thing. But Utilitarians discuss the benefits and consequences of the actions as prime. Utilitarians are also in conflict with deontologists because deontological ethics considers obligations and duties as a center and according to them, means do not justify ends (Mandal, Ponnambath, & Parija, 2016). However, it is essential to consider humans and their dignity as the center of the research. All the nine norms mentioned should be followed to ensure that study is being conducted ethically.
- Value-based decision-making is an important model in health that provides information to the patients or potential participants to make an informed decision about the treatments. In the case study 9G, Parkinson’s disease was under research and it was the view that if certain brain cells would be redeveloped then it would reduce Parkinson’s assault on the central nervous system. The process involved drilling holes in the brain and the controls will not have any tissues delivered. To make the decision of participation through a value-based model the first step is considering the facts, relevant information, diagnosis, and prognosis. In this case study, the patients involved already have Parkinson’s disease diagnosis. The second step is exploring the treatment options and the risk-benefit ratio so in the case of these controls the treatment was not available but it was just a view that this experiment would benefit people with Parkinson’s disease but controls would not benefit at first. The next four-step is the background check of the patients and in this case study, it was not available. The last step is to check for alternatives and in this case, the patient might opt to not be involved in the treatment. The case study presented violates one of the ethical norms which is “the risk of suffering or injury must be proportionate to the good to be gained” because the controls are at risk and the potential risk is outweighing the benefits they might attain. There is no direct benefit involved in the experiment for the controls. Also, in the selection of human subjects, it is mentioned that risk and benefits should be equally distributed and one group must not be at risk. The case study presented is not ethically sound and has fallacies which are not meet the standard requirements of the ethical protocols.