Posted: October 15th, 2022

Integration of Biblical Worldview

Integration of Biblical Worldview
Reply to the two discussion posts below. Each reply should be at least 250 words. Support your assertions with at least 2 scholarly citations in APA format. Each reply must incorporate at least 1 scholarly citation in APA format. Each reply should include integration of Biblical Worldview with supporting scripture. Any sources cited must have been published within the last five years. Acceptable sources include the textbook, the Bible, peer-reviewed journal articles.

Week 8 Discussion Board

Research is essential for the advancement of medicine and healthcare. Some medical research history reveals the dark side of human tendencies. For example, a violation of the ethical principles of beneficence, nonmaleficence, autonomy, and justice. Tuskegee syphilis study, Nazi medical experiments, Guatemala sexually transmitted infection study, Willow Brook State School study, and Jewish Chronic Disease Hospital study (Gray & Grove, 2017). Another unethical study conducted by the US government was the distribution of a contaminated vaccine to 24 prison inmates in Manila, Philippines. These are examples of unethical human subject research (Shamoo, 2022).

Unethical research dates back 500 years, to European colonizers of American Indians and indigenous populations. Ingestion of radioactive isotopes, sterilization of women, and other unethical studies are among the numerous studies (Hodge, 2012). Another case in point is the Havasupai Tribe in Arizona, where blood samples were collected without their permission (Sterling, 2011). Unethical studies like the Tuskegee syphilis study, which was conducted in 1932 in Alabama with 200 African American men as subjects, continued. The study’s goal was to assess the progression of syphilis. The researchers lacked transparency because some subjects were unaware of the study and were refused effective treatment even after standard penicillin treatment was approved. Dr. John C. Cutler conducted another sexually transmitted disease study in Guatemala. Prostitutes, prisoners, soldiers, and mentally ill patients are among those who take part. The patients were infected with sexually transmitted diseases on purpose. The study, however, was inconclusive, and the number of patients who died as a result of the diseases or treatments is unknown (Gray & Groves, 2017). An earlier study conducted in Manila, Philippines in 1906 by Richard Pearson Strong tested contaminated cholera vaccine on 24 prisoners. He was found negligent in the deaths of 13 prisoners but was not held accountable (Shamoo, 2022).

The violation of self-determination, justice, non-maleficence, and beneficence is one of the most commonalities among all unethical studies. Novoa-Hecke, Bernabe, and Linares (2019) coined the term “ethical dumping,” referring to the risk of unethical research in less developed countries that would be unacceptable in more developed countries. Language barriers and cultural norms make participants from less developed countries more vulnerable to deception. They can also be built to coerce and will most likely comply if given the right incentives (Gray & Grove, 2017).

The United States Department of Health, Education, and Welfare (DHEW) established a set of regulations to avoid unethical research and protect human studies shortly after the syphilis Tuskegee Study. To ensure an ethical process, research must now go through an institutional review board. Furthermore, the Belmont Report was founded on three ethical principles by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The principles of self-respect, beneficence, and justice are addressed in the Belmont report.

“In everything, therefore, treat people the way you want them to treat you, for this is the Law and the Prophets,” says Matthew 7:12. (New American Standard Bible, 2020). Researchers and healthcare clinicians alike must practice with beneficence, nonmaleficence, justice, and autonomy. It is our responsibility to protect human rights at all costs, as if we were caring for our own loved ones.

References

Gray, J. R., and S. K. Grove. (2017). Burns and Grove’s The Practice of Nursing Research: Appraisal, Synthesis, and Evidence Generation (9th). Elsevier.

F. S. Hodge (2012). There has been no meaningful apology for unethical research abuses against American Indians. Ethics and Behavior, vol. 22(6), pp. 431-444. https://doi.org/10.1080/10508422.2012.730788

New American Standard Version Bible (2020). Zondervan.

G. Novoa-Hecke, R. Bernabe, and J. Linares (2019). Unethical biomedical research practices are being exported to low and middle-income countries. 40, 167-177, Revista de Bioética y Derecho. https://doi.org/10.1344/rbd2017.40.19170

A. E. Shamoo (2022). Medical treatment and research that is unethical in US territories Accountability in Research, 1-14, published ahead of print. https://doi.org/10.1080/08989621.2022.2030720

R. L. Sterling (2011). A cautionary tale about genetic research among the havasupai. 113-117 in the AMA Journal of Ethics, 13(2). https://doi.org/10.1001/virtualmentor.2011.13.2.hlaw1-1102s—-
Ethical Principles Reviewed

Unethical principles used in medical research and patient care are a topic that must be understood in order to protect vulnerable people from research methods or unethical medical practices in the name of research.

The total disregard for obtaining informed consent is a recurring theme. Elements such as the procedures involved, reasonable risk vs. benefits, alternate procedures, and whether or not there would be compensation or treatment if an injury occurred are all considered. This is especially troubling in the case of American Indian women’s sterilization in the 1970s (Shepherd, 2021). In many cases, there was no consent or even outright lying to the patients. One woman mentioned in Shepherd’s (2021) article requested that her hysterectomy be reversed because she was ready to start a family. She was devastated when she learned that the procedure could not be reversed. She insisted that she had been told it was reversible and that she would not have agreed if she had known. A physician who did not follow ethical standards of informed consent stole her ability to have children. It was upsetting to read the excuses of the doctors who performed these surgeries. What they did was a blatant violation of their hypocritical oath, as well as sickeningly unethical.

Another example from the same article is the recruitment of Alaskan Native Americans into the United States Air Force’s thyroid gland research in the 1950s. They did not provide the patients with a clear and planned consent in their native language (Hodge, 2012). Voluntarism, information, and comprehension are three components of informed consent (Gray & Grove, 2021). If the patient is unable to fully comprehend the consent because of a lack of information, the patient cannot truly consent, and informed consent was not obtained. Another aspect of the same study was that pregnant and lactating women, as well as children, were not barred from participation. These groups of people were deemed vulnerable, and this was not taken into account. A lack of record keeping made it extremely difficult to follow up with patients after they were given higher than recommended medication, so there was no clear way to ensure the patients did not suffer harm as a result of their study.

Another article we were assigned to read discusses consent for genetic research among the Havasupai tribe of Native Americans. They had agreed to blood draws for the purpose of researching diabetes. Despite having signed a broad consent, they were not informed that their blood was being used by other researchers studying mental health disorders, inbreeding, and alcoholism (Sterling, 2011). When the other study was published, it painted the Havasupai tribe in a negative light and violated their privacy rights. This is a clear violation of the informed consent requirement, which specifically states that you must disclose it data or specimens will be shared with other researchers (Gray & Groves, 2021).

The third article we read discussed conducting research in low-income countries that may be illegal in other countries for a variety of reasons. It could be less expensive, completed faster, and subjects could be more easily recruited. Easier recruitment could be due to the need for medical treatment or a lack of regulatory bodies ensuring patients are fully aware of all aspects of the research as part of their informed consent. Although this is not as obvious as some historical ethical violations, it is almost as dangerous because researchers may be able to conduct sub-regulated research without being noticed, regulated, or punished.

If nothing else, these fragrant examples of violations of people’s rights to informed consent, privacy, and protection from harm. All research should adhere to the IRB process prior to the start of the study. Regardless of geographical setting, adhering to the highest ethical research standards should always be done, and both collegial and criminal consequences should be enforced. This enforcement should not only bring violators to justice, but it should also serve as a deterrent to future researchers and medical personnel.

Informed consent violations, both historically and currently, are not only a violation of human rights, but they also create widespread and potentially devastating mistrust of the medical and research communities. It has the potential to stymie future research efforts that could benefit many people and possibly save lives. Proverbs 12:22 is a bible verse about truthfulness. “The Lord despises lying lips, but he delights in trustworthy people,” the verse says. As Christians, we have a responsibility to be like God and to ‘hate’ lying and deception. How can people believe researchers and medical professionals if they are dishonest? All living things were created by God, and we must protect them as God does.

References

J.R. Gray and S.K. Grove (2021). Burns and Grove’s The Practice of Nursing Research: Appraisal, Synthesis, and Evidence Generation (9th ed.). Elsevier.

F. S. Hodge (2012). There has been no meaningful apology for unethical research practices by American Indians. Ethics and Behavior, 22(6), 431-444, doi:10.1080/10508422.2012.730788

International New Bible (2011). The New International Version Bible. https://www.thenivbible.com/ (First published in 1978.)

G. Novoa-Heckel, R. Bernabe, and J. Linares (2019). Unethical biomedical research practices are being exported to low and middle-income countries. 167-177 in Revista de Bioetica Derecho, 40. https://doi.org/10.1344/rbd2017.40.19170

S. Shepherd (2021). Native Americans, medical genocide, and the prohibition on nonconsensual sterilizations are the enemies. 89-106 in Michigan Journal of Race and Law. https://doi.org/10.36643/mjrl.27.1.enemy

R. L. Sterling (2011). A cautionary tale about genetic research among the havasupai. 113-117 in the AMA Journal of Ethics, 13(2). https://doi.org/10.1001/virtualmentor.2011.13.2.hlaw1-1102

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