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Found 60 results
  1. Content Article
    In the midst of huge winter pressures, NHS principles on care in “temporary escalation spaces” threaten to take leave from reality. In September 2024 NHS England published Principles for providing safe and good quality care in temporary escalation spaces—in short, a guide to the ethics of corridor care. In this BMJ opinion piece, Julian Sheather and Matt Phillips take a closer look at the principles outlined in the report. Related reading on the hub: Response to RCN report: On the frontline of the UK’s corridor care crisis A nurse's response to the NHSE guidance on their principles for providing safe and good quality care in temporary escalation spaces
  2. Content Article
    Dan Cohen is an international consultant in patient safety and clinical risk management, and a Trustee for Patient Safety Learning. In this blog, Dan discusses the four principles of medical ethics, specifically focusing on how each applies to providing safe patient care. Our moral imperative Having spent more than 50 years as a doctor, I have come to appreciate that everything in my, and our, professional life comes back to the basics of why we entered the healthcare professions in the first place. We genuinely wanted to help people, to keep them healthy and to return them to their maximum healthy state when they became ill. We wanted to serve our patients by being helpful. This has been our moral imperative and our beacon. This moral imperative is the reason we get up every day and go about our jobs, often working under stressful circumstances confounded by environmental stressors, liabilities related to human factors and process inefficiencies. All of these factors have an impact on our effectiveness in clinical settings, with stress and burnout also trickling over into our personal lives. Providing healthcare is challenging, especially when so much of our work environment is seemingly out of our control. Yet we keep coming back for more because we really care. Healthcare professionals may be viewed as special and unique people by many in society, sometimes even put on a pedestal. But really, they are mostly ordinary women and men, drawn by an important calling with highly specific and serious responsibilities. What we do is special and unique! Healthcare professionals try to provide the highest quality care, focusing on optimal clinical outcomes while avoiding mistakes, errors and harm to patients. We also acknowledge that what matters most to patients influences our approach to their care. How we satisfy our moral imperative is governed substantially by adhering to the medical ethics; i.e., the behaviours, actions and deeds that are held within the moral imperative. Behaviours that do not align with the moral imperative are considered unethical. The principles of medical ethics The principles of medical ethics have been best characterised by four foundational pillars, first elucidated by Tom L. Beauchamp and James F. Childress in 1979 in their seminal book, Principles of Biomedical Ethics.[1] These principles remain as relevant today as they were when first described. I will discuss briefly these foundational pillars, specifically focusing on how each applies to providing safe patient care. Principle 1: Respect for patient autonomy Providing healthcare should be a collaborative process with professionals and patients working together to achieve the best outcomes. Therefore, patients’ needs, wants and expectations should be foremost. Optimal outcomes, especially in outpatient care, cannot be achieved without patient engagement, as the patients are generally the implementers of care, certainly after they leave their doctors’ surgeries. Patients are entitled to be informed about the risks and benefits of interventions that may cause them harm, surgical interventions most notably, and this requires discussions and sharing of information to ensure patients are appropriately involved in decision making. The practice of obtaining signed patient consent for surgical procedures acknowledges this. However, consent is often obtained in a 'slap-dash' way by having patients sign forms that may be incomplete or incompletely understood by patients. The informed consent process, as it has been operationalised, may satisfy legal requirements but is often flawed as it may not generally include a thoughtful doctor to patient discussion of risks and benefits. Respect for patient autonomy absolutely requires adherence to the principle of candour in healthcare. If mistakes are made in providing care, patients deserve to have these mistakes discussed with them in a timely fashion. This generally means shortly after the mistake has been discovered and is especially crucial with mistakes that have caused harm or may cause delayed harm. Until patients release us from our responsibilities as their care provider, we must remain committed to satisfying their healthcare needs. This cannot be accomplished if we are not honest and candid when discussing what has happened. There is now good evidence that candid discussions decrease the frequency of medical negligence claims and lawsuits and the size of healthcare injury claims paid.[2] [3] Caring for patients means respecting them and sharing information with them, whether that's for the better or worse. Principle 2: Beneficence Healthcare professionals are required to provide care that is intended to be beneficial to patients. It may seem counterintuitive to say this, but what this really means is that the care provided should be evidence-based and comply with the highest standards designed to achieve best outcomes. There are certainly instances where evidence is lacking or controversial or where doctors and/or professional groups may disagree regarding the best care and how to achieve best outcomes. Yet each healthcare professional must aspire to provide the best possible care, even in the face of uncertainty. And if there is uncertainty, then that uncertainty also should be discussed with our patients. This principle requires that healthcare professionals be willing to discuss "alternative approaches" to standard healthcare therapeutics if patients bring these options into the discussion, including the use of acupuncture, homeopathic and/or herbal products, and other approaches that patients may wish to consider. After all, patient autonomy must be respected, so professionals, regardless of their own opinions regarding these interventions, must be willing to listen and provide relevant information in a compassionate way. It is important to point out to patients when some of these alternative approaches may be harmful in certain situations. For example, certain herbal treatments may pose risks for patients taking oral anticoagulants. Healthcare professionals must share their concerns about what risks are known and mention when risks are not known. I have come across this dilemma in my own practice and I would be honest and say something like: “I cannot say with confidence that what you wish to do will be safe or unsafe, because I simply do not know the answer, although I will look into this more thoroughly. However, if I cannot find evidence of safety, then I cannot fully support you using 'XYZ' because I will be concerned that it may be harmful. The choice is always yours, and I respect your decision even if it is not one that I would make myself". Principle 3: Nonmaleficence This principle, which some have interpreted simply as "do no harm" is actually more complex than that. By their very nature, some of our recommendations cannot always avoid harm. So, by extension "do no harm” really means to avoid unnecessary harm to the extent that this is possible. For example, for a patient undergoing surgery, the surgeon will use a scalpel to perform the surgery. Hence the surgeon must actually harm the patient in order to perform the surgery, and that harm could lead to further harm (e.g., bleeding, infection, etc.) that was never the intention of the intervention. In the same way, chemotherapy to treat cancer may carry substantial risks of harm because of medication side effects that cannot always be avoided. This is the reason that informed consent must address the risks and benefits of the treatment, and professionals must make sure their patients fully understand these risks and benefits. Nonmaleficence means to avoid unnecessary harm whenever possible. Principle 4: Justice Sadly, even in our caring professions, not all of our patients are treated fairly and equitably. The principle of justice requires that all patients be treated without reference to their genetic, biological, social and economic backgrounds, gender or gender identity, and political views. The impacts of prejudices and biases against individuals of differing ethnicities, skin colours, social classes, political views, and coincidental health and lifestyle issues have adversely influenced both access to healthcare services and the quality and timeliness of healthcare services provided, possibly resulting in adverse healthcare outcomes.[4] [5] [6] For example, individuals with obesity and smoking related comorbidities and illnesses are often viewed as "responsible" for their health challenges and subject to biases, whereas recreational middle distance runners are rarely viewed negatively for their anterior cruciate ligament (ACL) injuries or joint osteoarthritis. Healthcare professionals thus have a moral obligation to acknowledge this vulnerability in themselves and to never let these biases or prejudices interfere with our provision of care. Our prejudices may well harm patients and/or prevent them from achieving optimal healthcare outcomes. This is particularly an issue when professionals are working under stress and task saturation, when we tend to take shortcuts in diagnosis and may rush to solutions or be less sympathetic and compassionate to those who are "not like us". Disparities in care are dangerous variables when providing safe, high-quality healthcare for everyone. Summary The principles of biomedical ethics apply directly to the fundamental moral imperative to provide the highest quality care while avoiding mistakes, errors and harm to patients. We must ensure that what matters most to patients influences our approach to their care and, thus, to adherence to this moral imperative. The foundational pillars of medical ethics also require professionals to be honest with patients when things go wrong and to focus on sustaining the relationships between patients and their care providers. Therefore, healthcare professionals are advised that before walking into their clinics, surgeries, hospitals, etc., they should stop and pause momentarily to reflect upon who they are as professionals, the moral imperative they work under and the professional behaviours that must align with the moral imperative. We must recognise the challenges of working in a complex environment and be especially careful. Stress degrades behaviour for all of us and, from time to time, I have been as much at fault as anyone. It’s called being human. Be part of the solution, not part of the problem. References Beauchamp TL, Childress JF. Principles of Biomedical Ethics, 8th Ed. Oxford University Press, USA, 2019. Kachalia A, Kaufman SR, Boothman R, et al. Liability claims and costs before and after implementation of a medical error disclosure program. Annals of Internal Medicine 2010; 153(4): 213–21. Kachalia A, Sands K, Van Niel M, et al. Effects Of A Communication-And-Resolution Program On Hospitals’ Malpractice Claims And Costs. Health Affairs 2018; 32(11): 1836–44. Lavizzo-Mourey RJ, Besser RE, Williams DR. A Half-Century of Progress in Health: The National Academy of Medicine at 50: Understanding and Mitigating Health Inequities — Past, Current, and Future Directions. N Engl J Med 2021; 384:1681–4. Sabin JA. Tackling Implicit Bias in Health Care. N Engl J Med 2022; 387:105–7. Fernandez A, Chin MH. Keep Your Eyes on the Prize – Focusing on Health Care Equity. N Engl J Med 2024; 390:1733–6. Further reading on the hub from Dan: Clarity and the Art of Communication for Patient Safety Late night reflections on patient safety: commentaries from the frontline (2014) Diagnostic errors and delays: why quality investigations are key Patient Safety Spotlight Interview with Dr Dan Cohen, Patient Safety Learning Trustee Structures, processes and outcomes for better or worse: Personal responsibility in patient safe care What does all this safety stuff have to do with me? How one professional’s arrogance led to new insights Interview with Dr Dan Cohen on human performance
  3. Content Article
    In this interview, we speak to Barbara Molony-Oates, public involvement manager at the Health Research Authority about why it's important to involve patients and members of the public in health research. Barbara tells us about the Shared Commitment to Public Involvement, a partnership of research organisations working together to promote, support and improve public involvement in health and social care research. She describes how the Shared Commitment was developed and how it is helping researchers involve individuals and communities who have never before considered taking part in research.
  4. Content Article
    The rapid uptake of digital healthcare channels offers huge benefits, but evidence also suggests a close correlation between digital exclusion and social disadvantage. People with protected characteristics under the Equality Act are among those least likely to have access to the internet and the skills needed to use it. Experts from across health and care came together to contribute to "Access Denied", a new whitepaper on digital health inequalities. This whitepaper sets out recommendations to ensure that those innovating in digital healthcare can do so in a way which addresses healthcare inequalities. Recommendations The report makes the following recommendations for designers and developers of digital tools, and the NHS organisations who select and implement them: Work with digital innovations that meet the highest standards for accessibility and usability; Test digital products and services thoroughly with a cross section of patients, providers and commissioners; Use data to optimise and improve delivery to improve outcomes and minimise exclusion over time. Understand how different people may need specific channels of delivery at different times or for different services; Ensure you capture data so you can measure and compare outcomes and experience by channel. Don’t plan care pathways for the majority – ensure it is optimised for those from minority backgrounds too; Consider the support needed to move people to digital pathways; Ensure equality impact assessments for transforming care pathways pay attention to digital exclusion as a potential risk of inequality. It is also calling for designers, developers and the NHS to work together on the following areas: We need to develop frameworks, similar to those seen for information governance and clinical safety, which would set out guidance for mitigating against health inequalities that could become adopted and embedded by design; Ethical considerations must be built into the clinical safety case of the tool and data used to inform or train algorithms must be thoroughly examined for bias.
  5. News Article
    Women are being misled and manipulated about abortion by some crisis pregnancy advice centres in the UK, according to evidence from a BBC Panorama investigation. The centres operate outside the NHS and tend to be registered charities. Most say they don't refer women for abortions, but offer support and counselling for unplanned pregnancies. But the BBC's investigation reveals more than a third of these services give misleading medical information or unethical advice, and sometimes both. Pregnancy counselling is available through the NHS and regulated abortion providers, but searching online, Panorama identified 57 crisis pregnancy advice centres advertising. The BBC decided to investigate after hearing from women who had been to these centres. One said she had been "traumatised" and that the centre had tried to "manipulate" her into not having an abortion. Some 21 centres gave misleading medical information and/or unethical advice about abortion Seven centres said having a termination could lead to "post-abortion syndrome" - a mental health condition likened to post traumatic stress disorder, which is not recognised by the NHS. Eight centres linked abortion to infertility and problems carrying future pregnancies to term. Five centres linked abortion to an increased risk of breast cancer. Leading medic in the field of obstetrics, and director of an abortion provider, Dr Jonathan Lord, said women needed an "informed choice" which required "good quality unbiased information". Read full story Source: BBC News, 27 February 2023
  6. News Article
    A US government watchdog called for greater federal oversight of ethics boards that sign off on scientific studies, finding that for-profit companies have taken an outsize role in approving certain research and questioning whether financial motivations could put human subjects at risk. Federal regulations require that certain research on human subjects — including those testing the safety of new drugs — first get approval from a registered institutional research board. These boards, which are made up of at least five members and can include researchers and academics, are designed to make sure that a study poses as little risk as possible and that participants have enough information to give consent. While the majority of these boards are affiliated with universities, a small number have no affiliation with institutions conducting research. But according to a new report from the U.S. Government Accountability Office (GAO), these independent boards now account for the largest share of reviews of studies involving new drugs and biologics. The GAO found that federal agencies overseeing the ethics panels inspect relatively few of them and lack ways to evaluate how well they protect people participating in research. Read full story (paywalled) Source: The Washington Post, 16 February 2023
  7. Content Article
    Healthcare sector strikes are a relatively recent phenomenon, becoming notable only in the last half of the twentieth century. In this article, Spanish medical ethics expert Gonzalo Herranz, from the Bioethics Department at the University of Navarra, examines the ethical issues and legal implications associated with healthcare worker strikes, as well as looking at the moral duty to try and prevent strikes.
  8. Content Article
    On 13 January 2018, a group of healthcare simulationists from around the world gathered at a summit held in Los Angeles, California to collaborate on a unifying code of ethics for healthcare simulation professionals. There are six aspirational values that are described in the Code of Ethics: Integrity Transparency Mutual respect Professionalism Accountability Results orientation
  9. Content Article
    This innovative, practical guide introduces researchers to the use of the video reflexive ethnography in health and health services research. This methodology has enjoyed increasing popularity among researchers internationally and has been inspired by developments across a range of disciplines: ethnography, visual and applied anthropology, medical sociology, health services research, medical and nursing education, adult education, community development, and qualitative research ethics.
  10. Event
    until
    As the adoption of artificial intelligence (AI) in health and care continues to progress rapidly, it's essential that clinicians ensure this technology is used for the benefit of patients and to assist us in providing equitable and high-quality care both now and in the future. However, it's also crucial that we are aware of the potential risks and unintended consequences of using AI. This month, the RSM will delve into the development of machine learning (ML) and AI and their applications to healthcare. It will also debate the need for ethical guidelines and regulation in this field. By attending this event, you will understand: What is machine learning and artificial intelligence. How AI is being currently applied to healthcare and the potential future uses. How data drives AI and the potential bias within the data. The way ML and AI can lead to errors and harm. The ethical issues surrounding the use of AI in healthcare. The need for regulations and governance, both in healthcare and the broader society. Register
  11. Content Article
    The epidemic of workplace violence has prompted the use of harsh responses that include “behaviour contracts” (sometimes called “behavioural agreements”) by US healthcare organisations. The authors of this JAMA article look at how this approach can undermine a hospital’s commitment to providing evidence-based, patient-centred care and highlight other approaches to dealing with patient aggression and violence in healthcare settings.
  12. Content Article
    The rapid growth of interest in and use of large language models (LLMs) across various industries is raising some crucial and profound ethical concerns, especially in the field of healthcare. This Lancet article highlights ethical concerns from the perspectives of users, developers and regulators. It focuses on data privacy and rights of use, data provenance, intellectual property contamination, broad applications and plasticity of LLMs. The authors argue that a comprehensive framework and mitigating strategies will be vital to ensure LLMs are responsibly integrated into medical practice, ensuring alignment with ethical principles and safeguarding against potential societal risks.
  13. Event
    This course will offer an overview of the law relating to medical treatment decisions, both children and adults, and both for patients able to make a decision for themselves, and where best interests decisions must be made for those who cannot, and how to tell the difference. We will also look at how, and when, it may be necessary to involve the court to resolve disputes and – better – how to avoid disputes altogether. Decisions about medical treatment can be about life and death, such as withdrawal of treatment or (not) providing CPR. Or about quality of life, liberty and independence, which can be just as important. But the legal (and ethical) framework around these decisions is often misunderstood, leading to distress and disputes at the very worst of times, as we have seen in a few very high-profile cases. It can also cause uncertainty and doubt in clinicians, where the law is misunderstood as a stick to beat them with, rather than a shield to protect their reasonable decision-making. We will cover whether a patient should always get what they want, or does “doctor know best”? When a patient cannot make a decision for themselves, who gets to decide, and how should these decisions be made? What is the role of so-called “next of kin” (and did you know that there’s actually no such thing)? Can parents insist on treatment for a child when doctors think it futile? How are disputes in this context resolved and, better yet, how are they avoided? Throughout, we will talk in particular about the importance of good communication, and managing expectations, and how to ensure that clinicians are doing the right thing for the patient, as well as avoiding getting sued. Key learning objectives: To understand and apply in practice the fundamental legal framework around decisions about medical treatment, including: Rationing and resource allocation The limits of choice and autonomy The relationship between law and ethics The importance of good communication, and how to not get sued The law on consent Mental capacity and best interests decision for adults Decisions about children – Gillick competence, parental responsibility and disputes Restraint and deprivation of liberty Going to court Register
  14. News Article
    The government of Mexico City handed out nearly 200 000 “ivermectin based kits” last year to people who had tested positive for Covid-19, without telling them they were subjects in an experiment on the drug’s effectiveness. The results of that experiment were then written up by public officials in an article placed on popular US preprint server SocArXiv. It became one of site’s most viewed articles, claiming that ivermectin had reduced hospital admissions by 52-76%. But those officials have been under fire at home since SocArXiv withdrew the paper earlier this month, calling it “either very poor quality or else deliberately false and misleading.” Opposition deputies in Mexico City’s Congress demanded hearings and said they would bring legal action against the paper’s lead author, José Merino, head of the city’s Digital Agency for Public Innovation. Explaining the decision to withdraw the article—the first to be taken down by SocArXiv—the site’s steering committee wrote that it had responded “to a community groundswell beseeching us to act” in order “to prevent the paper from causing additional harm.” The committee wrote, “The paper is spreading misinformation, promoting an unproved medical treatment in the midst of a global pandemic. The paper is part of, and justification for, a government programme that unethically dispenses (or did dispense) unproven medication apparently without proper consent or appropriate ethical protections.” Read full story Source: BMJ, 22 February 2022
  15. News Article
    Occupational health professionals should avoid employment and management matters related to unvaccinated NHS staff, new guidance has warned. The Faculty of Occupational Medicine guidance comes as trusts are considering their options of how to approach patient-facing staff who remain unvaccinated, including their potential redeployment or dismissal. However, HSJ understands some occupational health practitioners are concerned they may become entangled in difficult ethical issues, such as the vaccination status of individual employees, or disciplinary processes. Today’s FOM guidance said: “There is no scope for occupational health practitioners to provide an opinion on medical exemptions, whether to confirm or refute them… “Redeployment, dismissal and other employment consequences of vaccine refusal by a worker, within the scope of the proposed regulations, are entirely employment and management matters, and not an area in which occupational health should be involved.” FOM president Steve Nimmo said: “When the programme is implemented, occupational health professionals should be mindful of ethical and consent issues, and be careful not to be associated with any disciplinary process.” Read full story (paywalled) Source: HSJ, 7 January 2022
  16. Content Article
    This book examines the concept of medical narcissism and how error disclosure to patients and families is often compromised by the health professional’s need to preserve his or her self-esteem at the cost of honouring the patient’s right to the unvarnished truth about what has happened. This ground-breaking book explores common psychological reactions of healthcare professionals to the commission of a serious harm-causing error and the variety of obstacles that can compromise ethically sound, truthful disclosure.
  17. Content Article
    Many devices in current use were marketed before the US Food and Drug Administration (FDA) began regulating devices in 1976. Thus, manufacturers of these devices were not required to demonstrate safety and effectiveness, which presents both clinical and ethical problem for patients, especially for women, as some of the most dangerous devices—such as implanted contraceptive devices— are used only in women. This article from Madris Kinard and Rita F. Redberg investigates whether and to what extent devices for women receive less rigorous scrutiny than devices for men. This article also suggests how the FDA Center for Devices and Radiological Health could more effectively ensure safety and effectiveness of devices that were marketed prior to 1976.
  18. Content Article
    In 2015 the Supreme Court judgement in the case of Montgomery v Lanarkshire Health Board created a significant change to the law in regard to gaining informed, or valid, consent. The case concerned Nadine Montgomery, a pregnant lady of small stature with diabetes who delivered her son vaginally in 2001. Her son experienced a hypoxic insult as a result of shoulder dystocia and consequently suffered cerebral palsy with severe disabilities. She successfully argued that had she been informed of the risk of shoulder dystocia she would have opted to have an elective caesarean section. This is part of NHS Education for Scotland's Advanced Practice Toolkit repository for credible and supportive resources.
  19. Content Article
    Two professionals who treated Jack Adcock before his death were convicted of gross negligence manslaughter, receiving 24-month suspended sentences. His nurse, Isabel Amaro, was erased from the nursing register; but after reviews in the High Court and Court of Appeal, his doctor, Hadiza Bawa-Garba, was merely suspended. Nathan Hodson explores the proposition that nurses are at greater risk of erasure than doctors after gross negligence manslaughter through a close reading of the guidance for medical and nursing tribunals informed by analysis from the High Court and Court of Appeal in the Bawa-Garba cases. 
  20. Content Article
    Catherine Villanueva Gardner, Professor of Women’s and Gender Studies and Philosophy at the University of Massachusetts Dartmouth, looks at the material effects on women with Long Covid.
  21. Content Article
    This guidance from the General Medical Council sets out the how doctors should raise and act on concerns about patient care, dignity and safety.  The guidance covers the following areas: Part 1: Raising a concern Duty to raise concerns Overcoming obstacles to reporting Steps to raise a concern Part 2: Acting on a concern Investigating concerns Help and advice
  22. Content Article
    This Clinical Audit Guide has been written to help community and hospital pharmacists prepare for and conduct clinical audits. To view this guidance you need to be a Royal Pharmaceutical Society member.
  23. Content Article
    This manual by the Healthcare Quality Improvement Partnership provides an overview of the basic clinical audit process for non-clinician members of a clinical audit team. Topics include: What is Clinical Audit? How to Set Objectives How to Select an Audit Sample Clinical Audit Confidentiality and Ethics Comparing Performance Against Criteria and Standards Writing an Audit Report Implementing Change and Action Plans
  24. Content Article
    This guide by the University Hospitals Bristol clinical audit team provides a brief summary of what clinical audit is, and what it isn't. It outlines the main stages of clinical audit and describes how it can be used, how to engage patients in the process and which staff members should be involved.
  25. Content Article
    Ethics in medical science have been borne out of practices that occurred during the second world war, with the Nuremberg code being set up to prevent unethical experimentation on humans from being carried out.  This was further supported by the Declaration of Helsinki that strengthened the protection of participants within medical research by setting out the stipulations that informed consent should be obtained before research. It ensured that data should be kept confidential so that medical research that ultimately requires input from human participants would be able to be carried out with minimal risk to the individual.  Lara Carballo continues the 'Why investigate' blog series with a cautionary tale of why within Human Factors it is necessary to ensure that ethics are in place before embarking on research. Once upon a time there was a little boy. Let’s call him Albert. Little Albert had grown up in the hospitals until one day, when he was just 9 months of age, he was taken by a couple who gave him lots of interesting and friendly objects to play with. One by one, Albert was shown bunnies, puppies and little white rats amongst other fascinating objects. He was intrigued by these soft play things and enjoyed exploring the shapes and textures that were new to the enquiring infant. One day as he was about to play with his favourite rat, Houdini (poetic licence employed here), there came from behind him a loud and frightening crash like the sound of metal being struck. The shock made him cry but he soon calmed as the noise died away. He settled to play with Houdini again. But once more, as he reached to pick him up from the cold wooden floor, the child was alarmed by the same loud clang. This happened again and again until eventually whenever Houdini was placed near to him, he began to cry with fear. His beloved pet and ally had now become an object of terror. The worst thing about this tale, is that it isn’t a tale at all. Instead, it is part of a regrettable body of research carried out by a very real couple of psychologists, John Watson and Rosalie Rayner, who wished to establish how phobias were formed. This study is very much set in a specific time before formalised codes of practice and ethics were formed. It is work that would thankfully not be possible to carry out in current times. In accordance with current UK ethics, such as the British Psychological Society’s ethical code (BPS 2018), this study would have been able to have been prevented on several grounds. The BPS guidelines require four principles to be followed: respect competence responsibility integrity. Amongst these principles, there are at least four issues that would be able to protect future participants in research from ever being treated in the way which befell Little Albert. Researchers now are required to: respect participants’ dignity not share identifiable personal details remain aware of the wellbeing of the participant ensure that they do not abuse their potentially perceived position of power. Watson and Rayner did none of these things. They certainly did not treat Little Albert in such a way that his dignity remained intact. In addition, they carried out research on a child (for which a whole extra section of ethical guidelines exists). However, this child is now known to have been ill from the outset and they caused additional emotional harm that was never able to be erased. This highlights the abuse of a position of power, and the very fact that researchers now are able to narrow down the true identity of Little Albert brings into question the details that were added to their original report. This unfortunately true not-so-fairy-tale is an example of why we need an ethical framework when designing research. In some ways now, it feels like second nature; it’s surely logical to treat others with respect? Sadly these guidelines were unable to help Little Albert, but because of him and others like him, we have learnt and listened. His sad demise will serve to protect those that come after him. Read the other blogs in this series Why investigate? Part 1 Why investigate? Part 2: Where do facts come from (mummy)? Who should investigate? Part 3 Human factors – the scientific study of man in her built environment. Part 4 When to investigate? Part 5. How or Why. Part 6 Why investigate? Part 7 – The questions and answers Why investigate? Part 8 – Why an ‘It’s an error trap conclusion’ is an error trap Why investigate? Part 9 – Making wrong decisions when we think they are the right decisions Why investigate? Part 10. Fatigue – Enter the Sandman Why investigate? Part 11: We have a situation
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