Introduction
Ethics is a field that is essentially relevant to all the aspects of the delivery of health care. All the health researchers and medical professionals need formal training in principles and theories of health care ethics. This set of beliefs, moral principles, and values should be used as a guide for all the medical practitioners in making imperative choices about the medical care. By thinking carefully about ethical aspects of the health care decisions, these researchers and medical practitioners make choices, which are good, fare, right, and just.
The four principles that define ethical duties, which health care specialists owe to the patients, are justice that is to be fair, beneficence that is, to help a patient advance his or her own good, nonmaleficence that is to do no harm, and autonomy, which requires patients right to decide on their own be honored (Ashcroft 2007). Every patient has certain rights. A number of them are actually guaranteed by the federal law like patients right to receive copies of their medical records. It is interesting to note that various states have extra laws that protect the patients. Nuremberg code and Belmont Report are important ethical guidelines and principles for research involving the human subjects. This essay therefore focuses on the significance of these two emphasizing why the events, which led to their formation are important and how they affect the ethical issues that actually surround the clinical trials in the present day.
Although Hippocratic Oath is still in existence, the most crucial result of Doctors Trial was in fact the creation of Permissible Medical Experiments or simply the Nuremberg Code. This fundamental code in real sense places emphasis on the patients and provides both requirements and guidelines for human experimentation. The basic purpose of this code was essentially to offer an obligation to benefit patients. In point of fact, this was a noteworthy change from Hippocratic Oath that placed emphasis on the determination of patients’ care by the doctors and not vice versa (Freyhofer 2004). In addition, this code focuses on the experimentation, not only the doctor-patient relationship. In the medical ethics history, Nuremberg Code is among the most fundamental documents. It actually provides a new and clear comprehension of what is required in the human experimentation in the expectations that Holocaust atrocities will never occur another time.
This code includes important principles like informed consent and the absence of coercion, beneficence towards the experiment participants, and scientific experiments that are properly formulated. The human subject voluntary consent is completely vital as this code requires. In addition, it dictates that experiment must yield fruitful results hence this benefits the entire society. The code also protects the participants by preventing the unnecessary mental and physical injuries and sufferings during the experiment. Additionally, a participant has the right to withdraw from the experiment. It also requires the researcher to be an expert and have the necessary qualifications hence this is important in ensuring that patients are not harmed or injured in the course of the experiment (Rozenberg 2003).
On the other hand, Belmont report was prepared in 1979 by the National Commission for Protection of Human Subjects of Biomedical and Behavioral Research. This report tries to summarize basic ethical principles that were identified by this commission. Therefore, it is essentially a statement of the basic ethical guidelines and principles, which should assist in solving the ethical problems surrounding conduct of research with the human participants. It is fascinating to note that this essential report contains 3 core principles, which define health care professional ethical duties. These are the principles of justice, beneficence, and autonomy or respect for persons (Sims 2010).
Under the justice principle, the report dictates that the risks and benefits of research should be fairly distributed. This means that there should be fair procedures and results in selection of the research participants hence this is crucial as it ensures that risks and benefits are shared equally. The beneficence principle requires that the human participants must not be exposed to any harm at all. Furthermore, it requires the research to minimize possible risks and maximize possible benefits. For that reason, this principle needs the scope and nature of benefits and risks be assessed systematically. This helps to protect the participants from possible harms during the research.
The principle of autonomy requires individuals to be treated like autonomous agents. In addition, those individuals who have diminished autonomy are actually entitled to protection. Thus, participants should be given an opportunity to select what intend to or will not intend to happen to them (Sims 2010). This is simply informed consent where the consent process should have 3 elements which are information, comprehension, and lastly voluntary participation.
The events that led to the formation of these two are very important. The two documents were formulated as a result of special populations’ abuses during experiments hence these events are important since they provided a plan that was used to create research guidelines and restraints of today’s human participants and particularly for the present day special populations groups. Nuremberg Code was formulated about 66 years ago by the American judges prosecuting Nazi doctors who were accused of conducting torturous and murderous human experiments in concentration camps (Freyhofer 2004). Therefore, this served like a blueprint for the modern day principles, which ensure subjects’ rights in the medical research. On the other hand, Belmont report was prompted by the problems that arose from the infamous Tuskegee Syphilis Study. Thus, this event is vital because it led to the establishment of this report, which serves like a historical document and also provides moral framework for the understanding of the regulations on the humans use in the experimental research.
The creations of these two documents, which contain ethical guidelines and principles, have various effects on the ethical issues that surround the present day clinical trials. In some instances, special populations human participants are abused hence this is unethical despite the two providing a blueprint for the present day ethical requirements for the clinical trials. These clinical trials are required to respect various principles that all help to protect the human participants in these experiments. These crucial international documents in real sense have served as primary background texts that are utilized by various modern governments, professional associations, funders, and policy makers to inform their ethical guidelines and codes of practice in relation to the research on all human subjects (Rozenberg 2003).
For that reason, the present day ethical restraints and guidelines are formulated in such a way that they protect abuses of the human participants in the clinical trials especially the special populations like prisoners, minors, and persons with disabilities. As discussed above, the events that led to formation of the two documents involved special populations’ abuses. Therefore, the four fundamental principles that is justice, autonomy, nonmaleficence, and beneficence, which define ethical duties of medical researchers and that originated from Belmont report and Nuremberg code provide guidelines and restraints that help to protecting the rights of special populations groups in the clinical trials. If these documents did not exist, the rights of these groups could not be upheld in the modern clinical tests.
References
Ashcroft, R. E. (2007). Principles of health care ethics. Chichester, West Sussex, England: John Wiley & Sons.
Freyhofer, H. H. (2004). The Nuremberg Medical Trial: The Holocaust and the origin of the Nuremberg medical code. New York: P. Lang.
Rozenberg, J. J. (2003). Bioethical and ethical issues surrounding the trials and Code of Nuremberg: Nuremberg revisited. Lewiston: Edwin Mellen Press.
Sims, Jennifer (2010). "A Brief Review of the Belmont Report". Dimensions of Critical Care Nursing 29 (4): 173–174.
