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Assignment:
Ethics and Evidence-Based Research
Write a 1250-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Part 1: Describe why ethical safeguards designed for clinical research may not be feasible or appropriate for evidence-based practice or evidence-based practice implementation projects.
Part 2: Review the sectioned headed, Two Ethical Exemplars in Chapter 22 of the textbook (Melnyk and Fineout-Overholt, 2015, pages 518-519). Discuss three main ethical controversies related to implementing Evidence-Based Quality Improvement (EBQI) Initiatives. Describe how these controversies relate to the four core ethical principles.
Part 3: Identify which ethical principles may be in conflict with the concept of “patients having an ethical responsibility in improving healthcare.” Discuss how these conflicts may be resolved.
Assignment Expectations:
Length: 1250 – 1500 wordsStructure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.Format: Save your assignment as a Microsoft Word document (.doc or .docx) or PDF document (.pdf)File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)
M7 Assignment UMBO – 1, 2, 3, 4M7 Assignment PLG – 1, 2, 6M7 Assignment CLO – 2, 3, 8
Expert Solution Preview
Introduction: In this essay, we will discuss various aspects of ethics and evidence-based research in the context of medical practice. We will address the feasibility and appropriateness of using ethical safeguards designed for clinical research in evidence-based practice or implementation projects. Additionally, we will explore the main ethical controversies related to implementing Evidence-Based Quality Improvement (EBQI) initiatives and their relationship to the four core ethical principles. Lastly, we will examine the conflict between ethical principles and the concept of “patients having an ethical responsibility in improving healthcare” and propose potential resolutions for these conflicts.
Part 1: Ethical Safeguards in Clinical Research and Evidence-Based Practice
The ethical safeguards designed for clinical research may not always be feasible or appropriate for evidence-based practice or evidence-based practice implementation projects. Clinical research typically involves strict protocols and rigorous control over variables, aiming to generate generalizable knowledge and ensure participant safety. On the other hand, evidence-based practice focuses on applying the best available evidence to inform patient care decisions. This difference in objectives necessitates a reconsideration of ethical safeguards.
In clinical research, obtaining informed consent is a crucial ethical safeguard to protect participants’ autonomy and well-being. However, in evidence-based practice implementation projects, the emphasis may shift to the broader patient population rather than individual patients. In such cases, obtaining individual consent for every intervention or implementation may be impractical or even hinder the progress of the project. Instead, alternative methods such as group consent or consent waivers may be considered, given that the interventions are evidence-based and have shown positive outcomes.
Furthermore, clinical research often involves randomization and control groups, which may be ethically problematic in evidence-based practice implementation. Randomizing patients to control groups may prevent some patients from receiving potentially beneficial interventions. Applying randomized controlled trials (RCTs) in real-world clinical settings can be challenging, as they may disrupt the continuity of care and impose undue burdens on healthcare providers. Therefore, alternative study designs, such as quasi-experimental or observational studies, may be more suitable for evidence-based practice implementation, as they allow for greater flexibility in real-world settings.
Part 2: Ethical Controversies in Implementing EBQI Initiatives
The implementation of Evidence-Based Quality Improvement (EBQI) initiatives can raise several ethical controversies related to the four core ethical principles: autonomy, beneficence, non-maleficence, and justice.
One main ethical controversy inherent to implementing EBQI initiatives is related to autonomy, as it involves making decisions for patients based on aggregated evidence rather than individual preferences. This raises concerns about violating patient autonomy and infringing on their rights to participate in decision-making. Additionally, implementing evidence-based interventions may require healthcare professionals to deviate from their usual practice, potentially compromising their professional autonomy.
Another ethical controversy is related to beneficence, as the use of evidence-based interventions may be driven by cost-effectiveness or resource allocation considerations, rather than solely focusing on improving patient outcomes. This raises questions about whether the implementation of evidence-based interventions is truly driven by the best interests of individual patients or by considerations of broader health system efficacy and financial sustainability.
The third ethical controversy is related to non-maleficence, as evidence-based interventions may sometimes involve potential risks or adverse effects. Implementing interventions with known risks in real-world settings may pose challenges in balancing potential benefits with risks, especially considering that patients may have varying levels of tolerance for risk. Ethical debates may arise concerning when the potential benefits outweigh the potential harms and whether the risks are fully disclosed to patients.
Part 3: Ethical Principles and Patients’ Ethical Responsibility in Improving Healthcare
The concept of “patients having an ethical responsibility in improving healthcare” raises conflicts with certain ethical principles, particularly autonomy and justice. Patients’ ethical responsibility implies that they not only have rights but also obligations in healthcare, such as adherence to treatment plans, adopting healthy lifestyles, and actively participating in shared decision-making. However, imposing such responsibilities may undermine patients’ autonomy and right to make choices about their own healthcare.
Patients’ ethical responsibility may be in conflict with the principle of autonomy because it assumes that patients should conform to certain behaviors or treatment plans, regardless of their own preferences or values. This conflict can be resolved by promoting patient education and empowerment, allowing patients to make informed decisions based on their values while also understanding the potential consequences of their choices. Shared decision-making models, which involve collaborative discussions between patients and healthcare providers, can strike a balance between patients’ autonomy and their ethical responsibility in improving healthcare.
Additionally, the concept of patients’ ethical responsibility may raise concerns about justice. It may disproportionately burden patients from disadvantaged socioeconomic backgrounds or marginalize individuals with limited resources or support systems. Resolving this conflict requires healthcare systems to address the social determinants of health and ensure equitable access to resources and opportunities necessary for patients to fulfill their ethical responsibilities.
Conclusion:
Ethical safeguards designed for clinical research may not always be feasible or appropriate for evidence-based practice or implementation projects. Ethical controversies can arise in implementing EBQI initiatives, particularly regarding autonomy, beneficence, non-maleficence, and justice. The conflict between patients’ ethical responsibility and certain ethical principles, namely autonomy and justice, can be resolved through patient education, shared decision-making, and addressing underlying social determinants of health. Striking a balance between ethical considerations and evidence-based practice is crucial to ensure patient-centered care and the promotion of ethical values in healthcare.
