The Belmont Report was created in 1978 in response to the issues that were made evident from the Tuskegee syphilis experiment, and aimed to provide a number of guidelines to ensure the safety of human subjects during biomedical research (Sims, 2010). The purpose of the report is to protect humans that are involved in medical, nursing, and scientific research by giving guiding ethical principles about how to protect these subjects. The Belmont Report has three main principles, which are “respect for persons, beneficence, and justice” (Sims, 2010, p173). There are also three main practical approaches that should be used when conducting this type of research, which will be described in detail here (Kleiman, 2008). The purpose of this paper is to outline the basic principles of the Belmont Report and give an assessment of the impact that the report has on the nursing profession. It will become evident that the report has a number of different applications and plays a role in creating fair and ethical nursing research.
The Belmont Report was primarily created as a response to the Tuskegee syphilis experiment. This experiment, now infamous, involved 600 poor, African-American sharecroppers from Alabama, nearly 400 of which were infected with syphilis (Kleiman, 2008). The aim of the study was to follow the participants through the progression of the disease to give insight into the mechanisms of the disease (Offenhartz et al., 2008). The study was terminated in 1972 for a number of reasons. The first was that the participants were tricked into participation by being given the promise of free medical care from the government, which was not given. The second was that the participants had never been told what they were being treated for, a blatant ethical issue. Finally, penicillin became available for the treatment of syphilis during the study, and participants were never given this treatment and were shielded from knowing about it by the study curators (Offenhartz et al., 2008).
These issues highlighted a need for research guidelines that offered protection to the patients. The Belmont Report addresses some of these issues. The fundamental principle of respect for persons highlights the need to ensure research subjects are making their own choices, and ensuring that informed consent with no deception is collected from each participant (Kleiman, 2008). In this sense, the participants of the syphilis experiment would have been informed about their disease and the available treatment options. The principle of beneficence highlights the need to follow the Hippocratic principle of both ensuring that no harm comes to the patience, but also to act in the patient’s best interests, which again would have protected the participants in the syphilis experiment from whom treatment was withheld at the danger of their overall health (Adams & Miles, 2013). Finally, the principle of justice means that researchers should ensure that all the procedures of the study are fair and reasonable (Adams & Miles, 2013). As shown by the syphilis experiment, there is a need to protect the participants from being enrolled into a study that offered no benefits to them as individuals.
Nurses are affected by the Belmont Report in a number of different ways. Nurses are usually the first line of contact for individuals that have chosen to participate in research, which means that they are also at the front line of ensuring that ethical standards are being met (Greaney et al., 2012). There are seven things that nurses should do to ensure that the participant is kept safe during the course of the research. The first is making sure that the study has been approved by a review board, which are agencies that are designed to ensure that the study follows the recommendations of the Belmont Report. Nurses should also make sure that informed consent is given, make sure that the participant understands the study, ensure that the patient was not tricked into participation, be aware of all the effects of the clinical trial, protect the patient’s privacy and confidentiality, and ensure that all participants get at least the standard level of recommended care for their illness (Offenhartz et al., 2008).
The Belmont Report is, therefore, crucial in the profession of nursing. Despite this, nurses also have a duty to ensure that research studies protect the individual in a number of other ways that were not covered by the report. Several criticisms of the Belmont Report point out that the recommendations made are too general to protect everyone participating in research (Offenhartz et al., 2008). In this sense, nurses have a duty to also engage with the social, ethnic, and cultural needs of the patient that may differ from the basic rules of the report. Nurses should be aware that the ethical principles of the report do not cover all of the needs of every patient, and take time to assess the ethics of a study on a wider, larger scale. By doing this, they can be better prepared to meet the standards of justice, beneficence, and respect for persons on a deeper level, and thus ensure that all patients that are not adversely affected by the research study.
Summary
The Belmont Report was issued to deal with some of the ethical issues that were highlighted by the Tuskegee syphilis study, which withheld crucial information and treatment from participants. The three main areas on which the Belmont Report focused are beneficence (ensuring that no harm comes to participants in a study), justice (ensuring that the study is non-exploitative and fair), and respect for persons (ensuring that informed consent is given and participants are aware of the nature of the study). This has an impact on nursing because nurses are often involved in frontline care for the patients in a study, and therefore must be aware of the ethical principles involved in conducting medical and scientific research on human participants. It is clear that nurses have a duty to understand the Belmont Report and its recommendations in order to protect their patients from unnecessary harm during the course of a study.
References
Adams, D. P., & Miles, T. P. (2013). The application of Belmont Report principles to policy development. Journal of Gerontological Nursing. Retrieved from http://www.healio.com/nursing/journals/jgn/2013-12-39-12/%7B42a75108-9c61-4424-9b1b-f18a60c9ce7d%7D/the-application-of-belmont-report-principles-to-policy-development?version=1
Greaney, A.-M., Sheehy, A., Heffernan, C., Murphy, J., Mhaolrúnaigh, S. N., Heffernan, E., & Brown, G. (2012). Research ethics application: a guide for the novice researcher. British Journal of Nursing, 21(1), 38.
Kleiman, S. (2008). Human centered nursing: The foundation of quality care. FA Davis.
Offenhartz, M., McClary, K., & Hastings, C. (2008). Nursing and realities of clinical research. Nursing Management, 39(11), 34–39.
Sims, J. M. (2010). A brief review of the Belmont report. Dimensions of Critical Care Nursing, 29(4), 173–174.
