Principles of Medical Ethics

1. Principles of Medical Ethics • Autonomy • Nonmaleficence • Beneficence • Justice/Equity

2. Ethical Issues in Research • Informed consent • Explanation of the research: risks/benefits • Protection of the subject’s well being • Confidentiality of data • Control group issues • Ethical review/decision process • Privacy issues • Stopping participation

3. Special Ethical Issues Arise With: • Children • Mental patients • Prisoners • Poor people • Undergraduate psychology students

4. Recent ethical codes for research:The Canadian Tri-Council Ethics Code (www. nserc.ca/programs/ethics/english/policy.html#contents)The new American Psychological Association Code (www.apa.org/ethics/code2002.html)These websites are linked in my website(www.psych.yorku.ca/davidw

5. Rationale for a new ethics code? Medical ethics model based upon: Beneficence Avoidance of maleficence Respect for autonomy Equity/distributive justice Importance of informed consent (derived from the principle of autonomy) Need for a new, Canadian national model of ethics across all disciplines has never been made clear Cost/benefit analysis employed in medical research may not be appropriate for psychological research

6. Guiding Ethical Principles • Respect for human dignity • Respect for free and informed consent • Respect for vulnerable persons • Respect for privacy and confidentiality • Respect for justice and inclusiveness • Balancing harms and benefits • Minimizing harm • Maximizing benefits

7. General Issues with the new Tri-Council Code • Only the investigator-subject relationship is covered. No corresponding concern with the sponsors of research or the protection of the research endeavour (e.g., Pioneer Fund, pharmaceutical funding of medical research, Olivieri affair, Hospital for Sick Children/ U of T fiascos). • Collaborative research requires each institution’s ERB approval. • Difficulty of demonstrating psychological harm • What is “minimal risk” research?

8. Psychology’s difficulty with the Code • Deception research precludes informed consent • Alternatives (e.g., role playing) presents methodological problems as well as its own ethical dilemmas. • Paradox of ethical controversies and the importance of the findings (e.g., Milgram’s obedience research) • Difficulties of informed consent with special populations of interest to psychology (e.g., mental patients and children)

9. Psychology’s difficulty with the Code • Necessity of signed consent for interviews, questionnaire administration for academics, but not for journalists or polling organizations. • Routine statement of non-penalized withdrawal from project may not be necessary • Level of harm is not present as it is in medical research • In medical research, the subject may benefit through participation. In psychological research, the investigator is the beneficiary.