A Comparative Evaluation of Ethics in Clinical Research and EBP

This essay provides a comprehensive evaluation of ethics in clinical research, contrasting it with evidence-based practice (EBP). It explores the origins of ethical considerations, emphasizing the importance of ethical guidelines in clinical trials and the role of ethics in EBP. The essay delves into the ethical principles of beneficence, nonmaleficence, autonomy, and justice, and their application within the context of Evidence-Based Quality Improvement (EBQI) initiatives. It examines the potential conflicts between patient responsibility and ethical principles, particularly regarding the implementation of EBQI. The essay highlights the importance of informed consent and addresses the need for ongoing education of researchers and doctors on ethical considerations, concluding that ethical guidelines are recommendations rather than laws and need continuous improvements.

EVALUATION OF ETHICS IN CLINICAL RESEARCH
AND EVIDENCE-BASED RESEARCH

Introduction
Ethics in clinical research is contrasted against ethics in evidence-based practice
(Freshwater, 2013). The word "ethics" is derived from a Greek word ethos, that implies character
or customs. The term ethical behaviour implies good or moral philosophy. Ethics is a systematic
review of values that determines what is right and what is wrong. Ethics can be regarded as a
professional value and is regarded as an eternal philosophical expression. In clinical research, it
is expected that all must be ethical in all aspects of life. Ethics should be followed by doctors,
dentists, nurses, lawyers, trainers, businessmen, etc. Researchers are also in the research.
Research is a multilateral activity. The Merriam-Webster Dictionary defines the research as a
way to explore or work on the site, investigate case studies or analyze activities. The study was
designed and implemented on the basis of literature or experience.
Clinical Research ethical guidelines cannot be applied for evidence-based practice
Ethics in clinical research is focused upon the identification and implementation of the
acceptable condition towards the exposure of certain individuals to risks and the burdens. In a
clinical study, people, unlike animals, atoms or asteroids, are involved in the study (London,
Kimmelman & Carlisle, 2012). The domain of clinical research focuses on improving people's
health and well-being, by generally identifying better methods of treating or preventing disease.
Clinical research ethics focuses primarily on identifying and implementing acceptable conditions
so that some people generally benefit from risks and burdens in society. The ethical guidelines
for clinical research were first formulated after examining the inhuman behavior of the
participants in the study. Ethical guidelines around the world have been formulated with
2

participants only after human behavior has been discovered during the study. During the pre-war
period, most of the studies were conducted alone or in patients (Tharyan, 2009). During World
War II, countries were increasingly interested in science and research, leading to more extensive
and systematic clinical research on patients, especially soldiers. Most of the studies have been
used in assembly work, especially in prison, despite their consent and well-being.
Evidence-based practice (EBP) is the best proof of creation regarding the decision on
Patient Care. It seems difficult to imagine that such practices can cause ethical problems. The
discussion on these topics focuses on the theory of evidence. Critics suggest that the EBP is
based upon a narrow definition of evidence. EBP is based on Aristotle's theoretical description of
the domain of ethics.
EVP is contrasted against clinical research as EVP does not include some types of
knowledge. Principles of EVP is focused upon theoretical evidence and not upon conducting
clinical trials. In clinical research, clinical trials have to be performed to evaluate the feasibility
of a study conducted. Clinical research includes activities that include direct contact with human
subjects or material of human origin by the investigator (Melnyk & Fineout-Overholt, 2011). It is
focused upon generating knowledge on which practice can be based. Hence, clinical research has
more ethical manifestations, while EVP has less ethical considerations. Ethics applied in EVP
cannot be used for clinical research as clinical research has greater applicability as compared to
EVP.
Evidence-Based Quality Improvement (EBQI) Initiatives controversies
3

The Evidence-Based Quality Development Initiative (EBQI) focuses on improving the
quality and outcomes of PPE. EBQI contains system demonstrations based on measurements to
instantly improve the treatment with specific adjustments. The three main ethical aspects are the
EBQI, is consistent at improving patient outcome. Secondary strategies to improve the quality of
results may seem inefficient and waste scarce resources. The same activities considered highly
qualified with applicable benefits. The EBQI is perceived as all patients receiving the same
evidence-based interventions for their routine care. As it focuses on improvising patient care
within certain settings. It aims at encompassing internal data for the practitioner towards guiding
their further practice and to make changes accordingly. This leads to the question regarding
whether EBQIs needs similar standards of consent from patients as clinical research. In the case
of traditional and standardized practice, implementing EBP might not be ethical. EBQI has been
considered to be a crucial part of the ongoing management of clinical care delivery (EBP).
The four most important ethical principles are beneficence, nonmaleficence, autonomy,
and justice. The essential principles of health benefits and health benefits include the importance
of benefits to the patient. Nonmaleficence includes the importance of not compromising the
patient when practicing medical practice. Autonomy recognizes that the patient has the right to
act. According to the principle of justice, resources should be distributed among people and
without prejudice. Depending upon the core ethical principles, the foundation for quality
improvements has emerged. The dimensions include safety, equity, efficiency, effectiveness,
patient-centered care, and timeliness.
In case EBQI is required, the ethical consequences will emerge. If EBQI does not
guarantee the principle of justice and autonomy, we can ignore them. This is especially true if the
patient is not allowed. If you do not try to improvise quality with EBQI, the principles of
4

imperfection and charity can be misleading. Risks identified with EBQI is extremely low and
often the risks might be greater in case the EBQI are not accommodated. Research is focused on
implementing evidence for practice.
Ethical principles may conflict with the concept of "patients with reasonable
responsibility to improve treatment".
In daily clinical practice, professional healthcare professionals use double points of
recommendation on patient responsibility. On the other hand, patients are encouraged to take
responsibility for changing the lifestyle that can improve their health. On the other hand, if
patients do not meet these recommendations, they are not responsible for this error. The obvious
difference is the difference between tasks and activities. The level of dual accountability has
proved to be epistemologically, appropriately recommended and healing is useful. However, the
patient's responsibility is not correct. In order to prioritize accountability, the physician should
give patients an obligation to lay down ethical standards outside patients. Therefore, these
proposals should be rejected. The concept of patients having an ethical responsibility towards
improvising healthcare in its own terms, violates the ethical principles of beneficence. These
conflicts might be resolved.
Research might often carry certain risks for patients. The principle of beneficence,
autonomy, nonmaleficence, and justice is sufficient for individual patients. In accordance with
these principles, patients and health professionals do not require the effect of their decisions and
activities on others. While the principles of fairness and the list of other principles generally
5

determine aspects of whether there are very clear resources (such as organizations) or policy-
level decisions. The account of moral encompasses moral responsibility.
Various scholars argue as to why some people are particularly responsible for patients.
But it cannot be applied for all patients. All people involved in health decisions should be of high
quality and should support doctors and health professionals. According to Gauthier, kindness
recognizes moral responsibility and then uses the principles of ethics in health decisions. David
Resnik focuses on the ethics of patients in clinical cases. Patients are encouraged to follow
certain medical procedures, but to provide information about what behavior is inconsistent. The
ethical basis is not the creation of the patient's involvement.
In daily clinical practice, professional healthcare professionals use double points of
recommendation on patient responsibility. On the other hand, patients are encouraged to take
responsibility for changing the lifestyle that can improve their health. On the other hand, if
patients do not meet these recommendations, they are not responsible for this error. The obvious
difference is the difference between tasks and activities. The level of dual accountability has
proved to be epistemologically, appropriately recommended and healing is useful. However, the
patient's responsibility is not correct. In order to prioritize accountability, the physician should
give patients an obligation to lay down ethical standards outside patients. Hence, these proposals
should be rejected. Moreover, the ethical conflicts can be avoided. If the researcher or doctor
informs the patient regarding the study procedure and obtains consent thereof, then such ethical
conflicts can be avoided.
Conclusion
6

To conclude, it can be said that although there are present several ethical guidelines for
clinical trials, they are not adequately controlled. In fact, ethical guidelines are only
recommendations and not laws. Some countries such as the United States and other countries of
the world has included it as a part of the proper implementation of these guidelines. The other
aspect is the education of doctors and researchers across various facilities. Doctors are specially
trained to be good doctors, but they are never taught fundamentally in ethical clinical trials. A
doctoral thesis or thesis is a valuable opportunity to educate tomorrow's researchers on the
elements of clinical research in ethics. Students must also participate in a simple observation
study.
7

References
Freshwater, M. F. (2013). Ethics and evidence based research: Is there a conflict?. Indian journal
of plastic surgery: official publication of the Association of Plastic Surgeons of
India, 46(1), 6. doi: 10.4103/0970-0358.113699. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745124/
London, A. J., Kimmelman, J., & Carlisle, B. (2012). Rethinking research ethics: the case of
postmarketing trials. Science, 336(6081), 544-545. doi: 10.1126/science.1216086.
Retrieved from http://science.sciencemag.org/content/336/6081/544.short
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins. Retrieved from
https://books.google.co.in/books?hl=en&lr=&id=hHn7ESF1DJoC&oi=fnd&pg=PT15&dq=Melnyk,
+B.+M.+%26+Fineout-Overholt,+E.+(2015).+Evidence-based+practice+in+nursing+
%26+healthcare:+A+guide+to+best+practice+(3rd+ed.)+Philadelphia,+PA:
+Wolters+Kluwer+Health&ots=HmKyngk-
21&sig=cHXEyzs3BVLDIChRSsibTw7pQSs#v=onepage&q&f=false
Tharyan, P. (2009). Prospective registration of clinical trials in India: strategies, achievements &
challenges. Journal of Evidence
‐Based Medicine, 2(1), 19-28. doi: 10.1111/j.1756-
5391.2009.01015.x. Retrieved from
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1756-5391.2009.01015.x
8