Ethical considerations in doing ACB research. By Eunice Machuhi

Health research involving humans may produce benefits that positively affect the welfare of society as a whole, even though most of this research offers little or no direct benefit to participants involved.

According to Dr Charles Dabone (a part-time professor at the University of Ottawa and chair of the Committee of Knowledge to Action at CADHO), the Canadian Institutes of Health Research has organized this type of research under four main themes which are biomedical, clinical, health services and social, cultural, environmental and population health.

His presentation drawn from the data on ‘’Ethics in research: A science lifecycle approach’’ by the Canadian Institutes of Health Research (CIHR) states that biomedical research is conducted with the goal of understanding normal and abnormal human functioning at the molecular, cellular, organ system and whole-body levels.

This includes development of tools and techniques to be applied for this purpose, developing new therapies or devices that improve health or the quality of life of individuals, up to the point where they are tested on human subjects.

The data also notes that clinical research is conducted with the goal of improving the diagnosis and treatment of diseases and injuries as well as improving the health and quality of life of individuals as they pass through normal life stages. This type of research usually encompasses research on, or for the treatment of patients.

• The goal of health services research is to improve the efficiency and effectiveness of health professionals and the health care system through changes to practice and policy. This type of research is a multi-disciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviours affect access to health care, the quality and cost of health care for the health and well-being of the population.
• Further, the data states the objective of social, cultural, environmental and population health research is to improve the health of the population or of defined sub-populations through a better understanding of the ways in which social determinants affect health status.

He noted that there are risks involved when undertaking these types of research that can involve harm to participants and others. Harm in this case is described as ‘anything that has a negative effect on the welfare of participants, and the nature of the harm may be social, behavioural, psychological, physical or economic.’

Dr Dabone was addressing participants during the fifth discussion series of the OHTN chair webinar series. Part of his presentation was also based on the 2018 Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans-TCPS 2. 

Best practices mandate that ethical considerations about health research involving humans need to be factored. Dr Dabone noted that ethical analysis should encompass the interests and participation of society as a whole in the research endeavour around the four themes- biomedical, clinical, health services and social, cultural, environmental, and population health research.

• One factor to consider when conducting research is consent that is given voluntarily, informed, as an ongoing process, on incidental findings, precede collection of, or on access to research data.

Best practices also mandate that when applying fairness and equity as a factor, researchers are expected to be inclusive in selecting participants, as this is deemed appropriate. Indeed, inappropriate exclusion could involve participants such as women, children, elderly, participants who lack decision making capacity that could lead them not benefit from research findings. In addition to dissemination of research results, it is important to consider equitable distribution of research benefits.

The third consideration involves privacy, confidentiality, and security.

 Additionally, conflict of interest is also an important factor to consider when conducting research. Conflict of interest arise when activities or situations place an individual or institution in a real, potential or perceived conflict between the duties or responsibilities related to research, and personal, institutional or other interests.

These interests include business, commercial or financial interests pertaining to the institution and/or the individual, their family members, friends, former, current or prospective professional associates. Or conflict with an ethics board member.