NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?

What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? Discuss the role of the advanced registered nurse in advocating for patient safety and rights in conducting research.

Re: Topic 7 DQ 2

To be honest, the human species does not have a stellar track record when it comes to ethical medical research. During World War II, Nazi Germany and the German medical establishment were implicated in harsh, cruel, and immoral human research. Following WWII, the Nuremberg trials were pushed to hold people accountable for some of the most horrible acts of “research” carried out in concentration camps (Vaughn, 2017). The Nuremberg Code, which contains 10 points outlining what is considered permissible medical experimentation, is the result of these trials (Vaughn, 2017).

The Children of Willowbrook case, which began in the 1950s on Staten Island, New York, involved a mentally retarded children’s state school purposefully infecting patients with Hepatitis (Vaughn, 2017). The facility was overcrowded and understaffed, and the patients’ living conditions were appalling. This facility was in use until the 1980s.

Then there was the Tuskegee Syphilis study, which lasted from the early 1900s to 1972 in Alabama. Long-term studies on the effects of Syphilis on the human body were conducted by a small group of black men. This was done without the patients’ knowledge or consent, and it continued even after penicillin was discovered and widely used as a cure for syphilis by 1947. (CDC, 2020). These men did not receive therapy, and the study was not completed until 1972, when a journalist became aware of the situation, causing public outrage (CDC, 2020). The Tuskegee Syphilis Study resulted in the Belmont Report and the 1974 National Research Act. The Belmont Report creates a framework for research ethics based on the principles of respect, beneficence, and justice (Vaughn, 2017). Respect for the autonomy of the patient, informed consent, and the right to confidentiality Beneficience and nonmaleficence are synonyms for “doing good” and “not causing harm.” Finally, justice requires that research be conducted fairly and without exploitation, with costs shared equally by individuals and communities.

Why do we now have codes of conduct, rules, and oaths to guide us in ethical behavior relating to human research and patient care? Because ethical practice must be constantly reexamined, changed, and enforced. As an Advanced Practice Registered Nurse (APRN), it is critical to advocate for patients’ autonomy and rights. The APRN can play a major role in developing research design, frameworks and implementations so there is a duty to do so in an ethical manner. So when developing EBPs, it is important do rigorous research and closely follow the EBP process.

Also Read: NUR 513 Navigating the Online Environment Scavenger Hunt Week 1

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? References

Center for Disease Control and Prevention [CDC]. (2020). U.S. public health services syphilis study at Tuskegee: The Tuskegee timeline. https://www.cdc.gov/tuskegee/timeline.htm

Vaughn, L. (2017). Bioethics: Principles, issues, and cases (3rd). Oxford University Press.

RESPOND HERE (150 WORDS, 2 REFERENCES)

Hello,

I do agree with your finding that the process of making clinical research on human fair and just has achieved remarkable progress over the years. It is the role of the advanced practice nurse to promote the safety of the patients and ensure that the care for the patients and clinical procedures are guided by the ethical standards (Milliken, 2018). I do agree with you that the Nuremberg code of ethics to guide the clinical research was a great step forward towards achieving human dignity in scientific research. The Nuremberg code focus ten key elements of subject giving voluntary consent, the objectives of the research should be for the greater good of the society, the human experiments should be carried out after initial experiments on animals, it should avoid any injury or physical damage, the risks should not outweigh the benefits, subjects should be adequately protected, the research should be conducted by qualified scientists, subject can terminate their participation any time and willingly, incase any death, injury or disability is likely to occur then the scientist should terminate the experiment (WHO | Nuremberg code turns 60, n.d.)

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? References

WHO | Nuremberg code turns 60. (n.d.). WHO. https://www.who.int/bulletin/volumes/85/8/07-045443/en/

Milliken, A. (2018, January 31). Ethical Awareness: What It Is and Why It Matters. Ojin.nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

Re: Topic 7 DQ 2

Health research has a history of abuse, whereas participants were sacrificed for scientific gain (Doody & Noonan, 2016). These human rights violations within research spanned throughout the 20th century and made recognition of the importance of ethical nursing research to protect all involved. Good ethical nursing research implies adherence to ethical standards and studies are subject to scrutiny by an ethics board or committee, scientifically sound, researchers are supervised or have expertise, and ethical principles are adhered to throughout the process. Four common ethical principles to consider are autonomy, beneficence, non-maleficence, and justice. According to Doody and Noonan (2016), veracity, fidelity, and confidentiality must also be principles considered.

Veracity involves truth and avoids deception. Participants must understand all aspects of the study. In Los Angeles in 1989-91, over 700 minority babies as young as six months were given an experimental measles vaccine. Parents were not informed of the experiment or that the vaccine was unlicensed (Awadu, 1996). This killer vaccine led to the death of 1 of every 13.6 babies in one African experiment. Truth-telling is dishonored in at least two ways; first by lying or deliberately providing inaccurate information; and second, by omission or deliberately withholding information.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?

Participants put their trust in the researcher, who should reciprocate with two-way trust. Participants who have fidelity or a trusting relationship are more likely to stay in the studies, follow directions, and know there will be no consequences if they want to drop out at any time (Doody & Noonan, 2016). Another aspect to maintain is confidentiality. Consider taking a work-related survey in which you were asked about your boss or employer and how a breach of confidentiality would affect your responses.

By advocating for informed consent and overseeing study benefits to serve the greater society, APRNs can ensure patient safety and rights in research. Keep in mind that, in theory, all research can be harmful and should be regarded as a privilege rather than a right, especially when human lives are at stake.

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? References

Awadu, K. O. (1996, August). Outrage! How babies were used as guinea pigs in a LA county vaccine experiment. The Conscious Rasta Report, 3(6). http://www.whale.to/vaccines/awadu.html.

Doody, O., & Noonan, M. (2016). Nursing research ethics, guidance, and application in practice. British Journal of Nursing, 25(14), 803–807. https://doi.org/10.12968/bjon.2016.25.14.803

RESPOND HERE (150 WORDS, 2 REFERENCES)

I do agree with you that the history of scientific research on humans in the past century was inhuman and in violation of the dignity to human life. Human life in both the spiritual and cultural understanding is considered sacred and must be treated with uttermost dignity. The indecent and gross human rights violation of the 19^th and the 20^th century have no space in the modern world of scientific and technological research. Therefore, it is the role of all the stakeholders involved in scientific research to ensure the set standards of the ethical considerations in scientific research are closely observed at all stages of the research (Milliken, 2018).. The advanced practice nurse roles should be focused on promoting safety of the patients and quality care. They should ensure that any clinical procedure done on the patient is out of the voluntary consent of the patient. The patient has the autonomy to choose on the available alternative intervention measures. Additionally, the nurses should act in the best good for the improvement of the patient’s health. The key ethical standards of beneficence and nonmaleficence should be the guiding principles of the nurse practice in helping the patient recover to better quality of life and good health (Haddad & Geiger, 2020).

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? References

Haddad, L., & Geiger, R. (2020). Nursing Ethical Considerations. StatPearls. https://www.statpearls.com/ArticleLibrary/viewarticle/92

Milliken, A. (2018, January 31). Ethical Awareness: What It Is and Why It Matters. Ojin.nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

Re: Topic 7 DQ 2

The advanced registered nurses participate in research to improve healthcare services and help health care professionals promote patients’ outcome. For this reason, promoting professional ethical standards, integrity and compliance during research are the roles of advanced registered nurses. Some values or ethics such as the nursing ethics of caring, preventing harm, protecting dignity of the patient and the societal values about human rights, the researcher’s values about scientific inquiry may contradict the values or beliefs of the subject participating in the research (Davoodvand, Abbazadeh & Ahmadi, 2016). The issues of informed consents, respect for confidentiality, anonymity and privacy are serious ethical issues that an Advanced Practice Registered Nurse (APRN) might face when conducting research.

Informed consent is a major ethical issue that APRNs face when conducting research. Informed consent is voluntary, but it is mandatory for the APRN to provide subjects with information about the procedures and treatments, benefits and risks expected in the research prior to accepting to participating. An APRN may encounter issues with obtaining informed from older patients, critically ill and children because they are vulnerable to being forcefully misled into participating in the research. Researchers may be required to establish trustworthiness among their participants in this case (Yip, Han & Sng, 2016). Moreover, the informed consent is meant to protect subjects from assault, protect their integrity and freedom. Therefore, before the initiation of the research the APRN must inform the subjects of any physical harm or bodily injury, infringement of privacy that may occur during the clinical research (Yip, Han & Sng,2016).

Respect for participants confidentiality and anonymity is the next ethical issue. The APRNs must give participants the opportunity to release their information as they wish. Participants may withhold or release as much information based on their comfort level or level of trust. During research, ethical dilemma may arise if a researcher is required to report confidential information to the court (Yip, Han & Sng,2016).

Respect for privacy is another major ethical issue that APRNs encounter when conducting research. Researchers are not permitted to release participants information to anyone or organization without their consents. Participants will have to decide the degree at which their private information is share with others or withheld from others. The APRNs role is to protect participants privacies when conduccting research (Yip, Han & Sng,2016).

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? References

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: A qualitative study. Journal of Medical Ethics and History of Medicine, 9(5), 1-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958925/

Yip, C., Han, N.R., & Sng, B.L. (2016). Legal and ethical issues in research. Indian Journal of Anaesthesia, 60(9), 684-686. Doi: 10.4103/0019-5049.190627

RESPOND HERE (150 WORDS, 2 REFERENCES)

Hello,

I do agree with you that the advanced registered nurse practice role transcends beyond normal care for the patients, it also entails actively engaging in clinical research and coming up with advanced clinical findings aimed at promoting efficient and effective care for the patients. These nurses have the trust of the patients and are better placed in guiding the research projects aimed at promoting better clinical outcomes. However, they must adhere to the ethical standards and maintain the trust with the patients. The ethical considerations play a crucial role in the protection of human subjects in clinical research process (Wu et al., 2019). The advanced registered nurses have the responsibility ensuring confidentiality of the patient’s information. Additionally, for the patients to be involved in any research they have to give voluntary consent and have the autonomy to withdraw from the research at any point without victimization.  The patients who are underage, mentally incapacitated or older cannot be considered to offer consent and the close relatives have to be consulted in order to give the consent (Axson et al., 2019).

NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse? References

Axson, S. A., Giordano, N. A., Hermann, R. M., & Ulrich, C. M. (2019). Evaluating nurse understanding and participation in the informed consent process. Nursing Ethics, 26(4), 1050–1061. https://doi.org/10.1177/0969733017740175

Wu, Y., Howarth, M., Zhou, C., Hu, M., & Cong, W. (2019). Reporting of ethical approval and informed consent in clinical research published in leading nursing journals: a retrospective observational study. BMC Medical Ethics, 20(1). https://doi.org/10.1186/s12910-019-0431-5

When conducting research that involves human recipients, there are three basic ethical principles that should be applied: respect for the subjects, beneficence, and justice (White, 2020). For the first ethical principle, respect, nurses advocate for the patient’s autonomy. We must disclose the possible risks and benefits associated with the application of the research. Additionally, we are ethically obligated to avoid persuading patients into participating.

Further, informed consent must be received prior to initiating the research process. We must also respect the privacy and confidentiality of our patients who are participating in the research. Patients must be informed of what information will be shared and who the information will be shared with. Next, beneficence refers to doing good and avoiding harm. When conducting research, we must keep our patient’s safety as the top priority. All members of the research team must have the moral obligation to only proceed with the research process if it is believed to positively impact the recipient. The final ethical principle, justice, indicates that all recipients have the right to unbiased treatment. As nurses, we must advocate for our patients regardless of financial status, insurance, gender, age, etc. It is crucial to apply all three of these principles into standard practice when conducting and applying the research process. 

References 

White, M.G. (2020). Why human subjects research protection is important. Ochsner Journal, 20(1), 16-33. https://doi.org/10.31486/toj.20.5012 

REPLY 

The major ethical issues in conducting research are informed consent, beneficence- do not harm, respect for anonymity and confidentiality, and respect for privacy. Informed consent explains the potential risks or side effects and the expected benefits of their participation(DeNisco & Barker, 2016). Nonmaleficence is the ethical principle that prevents healthcare providers from administering ineffective care or acting with malice. A researcher must consider all possible consequences of the research and balance the risks with proportionate benefits. Protocols are essential to minimize the need for obtaining and storing identifiable information about the participants in the research study.

If the researcher is not able to promise anonymity, confidentiality should be addressed, which is the management of private information by the researcher in order to protect the subject’s identity. One of the last ethical issues discussed is respect for privacy. Privacy involves knowing how, when, and to what extent their information will be shared outside the study. All possible measures have to be taken to protect subjects from potential physical,psychological or social damage during the research or after the circulation of the results(Fouka & Mantzorou, 2015). 

          The role of the advanced registered nurse in research is to be a strong patient advocate. It includes being a patient representative, maintaining the patient’s rights, and protecting the patient’s interests from the start to the completion of the research. As with anything in healthcare, the patient’s safety remains the priority. The patient’s full disclosure and information during the research study are equally important. 

References: 

 DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: essential knowledge for the 

profession. Burlington, MA: Jones & Bartlett Learning 

 Fouka, G., & Mantzorou, M. (2015, March 13). What are the major ethical issues in conducting research? is there a conflict between research ethics and the nature of nursing? Retrieved February 7, 2020, from http://www.hsj.gr/medicine/what-are-the-major-ethical-issues-in-conducting-research-is-there-a-conflict-betwee n-the-research-ethics-and-the-nature-of-nursing.php?aid=3485   

REPLY 

ppreciated your discussion of respecting patient privacy. It is essential that patient confidential information is kept private. Respect is vital in this process as we value privacy trust is developed. Developing a trusting relationship is essential to creating an ethical practice environment. With a trusting relationship comes confidence, being able rely on others and a sense of being safe. In research, the participants must trust that their private information will remain private.  

Class, what is the relationship between trust and privacy? Why is this important within research? 

REPLY 

Nursing research, like all aspects of nursing, is governed by the American Nurses Association’s (ANA) code of ethics for nurses. These include autonomy, beneficence, justice, and non-maleficence (Gaines, 2021). In relation to research, the nurse researcher is ethically bound to assure that patients involved in research are given full autonomy. This includes attaining informed consent so that patients maintain full decision-making power regarding their care. Ethical issues can arise in this process for a number of reasons. To ensure that the patient has been fully and successfully informed, the researcher must have an understanding of all the factors that can influence comprehension and understanding of the information being provided, specifically the risks and benefits involved in participating in a study.

The patient’s culturally and religiously influenced beliefs, their ability to understand information, any mental, physiological, or environmental factors that affect information processing, acceptance or denial of current illness state, loss of hope or the desire to please the provider or others can all influence the patient’s true comprehension of the risks and benefits of participating in a study as presented to them (DeNisco, 2019). Without assuring that a patient has truly understood what they are agreeing to, their autonomy and self-determination is at risk. 

The second ethical principal of beneficence should be integral to the research question being studied. The goal of evidence-based practice (EBP) is to improve patient care and therefore the change in care being suggested should aim to benefit patients. If the nurse researcher is unsure of the benefit to patients, they must intervene and halt research until beneficence can be insured. 

Justice means providing care that is fair and equal to all recipients. In relation to research, this means that no one should be excluded from the potential benefit of new and better care, nor should any group be unequally represented in research populations, thereby taking on undue risk. The nurse researcher is responsible for making sure that research is equally and equitably applied to all populations. 

The ethical principal of non-maleficence directs nurses to do no harm. This principal comes into play when developing a research question. If there is an expected negative outcome involved in the practice being researched, the researcher must not proceed with the study. 

In summary, the ethical code for nurses must guide all nursing research to assure that patient’s well-being, safety and autonomy are protected. The development and continuation of improved nursing knowledge and practice is important, but only as long as we are careful to protect patients along the way. 

References 

DeNisco, S. M., & Barker, A. M. (Eds.). (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. 

Gaines, K. (2021, July 22). What is the nursing code of ethics. Nurse.org. https://nurse.org/education/nursing-code-of-ethics/ 

REPLY 

Ethics in nurse practice and research intends to enhance the well-being of all parties. In clinical research, the nurse-patient relationship becomes the nurse-research participant relationship. An advanced registered nurse’s research responsibility and advocacy often lead to ethical challenges. According to Yip et al. (2016), the first ethical issue is respect for persons. Nurses are expected to acknowledge autonomy in selecting research participants. Informed consent comprises disclosure, comprehension, and a detailed explanation of maintaining confidentiality. Confidentiality involves managing confidential information to protect a participant’s identity (Yip et al., 2016). The issue of beneficence is also crucial. Advanced registered nurses must ensure that they maximize the potential benefit of research activities and reduce any harm. Justice is another ethical concern. Nurses must be fair to all participants and not mistreat them.  

      Advanced registered nurses’ roles include care and advocacy. Patients are often vulnerable in a clinical setting due to a lack of information and fear caused by chronic situations. Nsiah et al. (2019) assert that advocacy enhances patients’ safety in all clinical activities. The significance of advocacy cannot be over-emphasized since most patients are at risk of making bad decisions. Nurses deliver patients from all adverse outcomes through advocacy. They ensure that patients know about appropriate research opportunities and obtain information about their rights. Nurses may also ask for the reconsideration of patients’ participation in research activities based on changes in health conditions (Nsiah et al., 2019). This also means they advocate for legal ways to obtain informed consent for special populations unable to provide consent. Moreover, they ensure that patients are informed about changes during the research process. They also ensure that the research process adheres to the initial plan and that no action compromise patients’ rights and safety.  

  References 

Nsiah, C., Siakwa, M., & Ninnoni, J. P. (2019). Registered nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124-1132. 

Yip, C., Han, N. L. R., & Sng, B. L. (2016). Legal and ethical issues in research. Indian journal of anaesthesia, 60(9), 684. 

  REPLY 

When conducting research, maintaining an excellent work ethic is part of your job. Remember that research requires a lot of daily work; protecting the patient or subjects’ dignity and protecting patient privacy in the publication of the information is part of ethical issues as we conduct research. Nurse researchers pursuing evidence to enhance their practice must cope with societal pressures, the nursing discipline, and science. But these three value systems may collide with the values of the subjects, communities, and societies, thereby creating stress and tensions, and conundrums in nursing. When conducting research, informed consent, ethics of beneficence, respect for confidentiality, and privacy are the major ethical issues.(Larkin et al., 2017) Remember that the ethics of nursing focuses on caring, preventing harm, and protecting the patients’ dignity. As patient advocates, it is our nursing responsibility to defend the rights of our patients, which may be violated as we conduct research. Therefore ethical issues and conflicting values, and our ambivalence in decision-making may present an issue.

The nursing discipline must clarify the research ethical standards, and an effective foundation should be laid to deal with human rights problems. In a research design, the first phase is sampling. There should be an explanation of why this specific group of people is the subject and why other participants were dismissed and unable to join the research. Subjects such as children, the elderly, and people with special needs require extra attention. Additional issues should be discussed, such as parental approval, or if the subject has mental incapacity, informed decisions should be given special attention. Particular subjects must be given enough information to make an informed decision about whether or not to participate. Consent should be obtained, risk injury explained, and confidentiality should be established before research. 

REFERENCE: 

 Larkin, M. E., Beardslee, B., Cagliero, E., Griffith, C. A., Milaszewski, K., Mugford, M. T., Myerson, J. M., Ni, W., Perry, D. J., Winkler, S., & Witte, E. R. (2017). Ethical challenges experienced by clinical research nurses:: A qualitative study. Nursing Ethics, 26(1), 172–184. https://doi.org/10.1177/0969733017693441 

REPLY 

Good job, I am in support of your opinion that advanced registered nurse must always remember to protect the right of her patient, comply with professional guideline and keep the therapeutic and patient centered. Defend patient’s right and interest. Assuring safety for those who cannot advocate for themselves. Ensure patient autonomy and self determination respected. It is also the role of the nurse to speak up if problems arise and go unnoticed. Know that patient advocacy extends to their support system (Lois, 2018). Advocating for patient’s will not always be easy, developing a care through assignment and negotiations can help keep the patients best interest as the focus. 

References: 

ETHICALSIESIN ADVANCED 

PRACTICE NURSINC 

ína] Rerrieved from 

https://ebrary.net/8249/education/ethical issues advanced practice nursing. 

REPLY 

For the advanced registered nurse advocating for patient safety and rights and conducting research can look like a few things. It can be protecting the confidentiality and the identity of the patients, protecting the confidentiality of participants in a research study and ensuring that patients are treated humanely and with respect during testing, research studies, and treatment/interventions. As advanced registered nurses are duties are also to advocate for the population that we serve. It means identifying areas of inequality or discrimination that certain groups may face within the health care system as well as failure to provide services to certain populations within the public. When conducting research it is important that we are looking at vulnerable populations and conducting thorough research on health issues that affect them as well as researching prevention methods to protect vulnerable populations that have a history of being neglected or abused within the healthcare system and in medicine.

When we are conducting research we want to ensure that participants of said research are aware of the purpose of the research all the elements that go into the research, how they will be protected in the research and the risk that comes along with participating in the research. It is the duty of the advanced registered nurse to ensure that the patient has all the information needed to make a well informed decision as to whether or not they would like to be part of the research and what the information will be used for and how their information will be used. Some of the major ethical issues in conducting research that impacts registered nurse can be issues with properly protecting the identity of the patients who are part of the research and failing to realize or recognize certain biases that may interfere with their research.

Larkin et al., provides an example who how a clinical research nurse may face an ethical dilemma trying respecting patient care while meeting the goals of their research requirements. Larkin stated that “A CRN may feel conflicted between the need to ensure regulatory compliance, research integrity, and adherence to the recruitment goals and enrollment criteria of a protocol, and his or her duty to protect the needs of, and remain an advocate for, the research participant” (Larkin et al., 2019, para. 1). When conflicted with such a dilemma the advanced registered nurse must always remember the oath they took to protect the integrity and safety of the patient as any unethical issue may threaten or jeopardize not only the professional reputation and credibility of the work but the patient and public’s trust. 

Reference: 

 Larkin M, Beardslee B, Cagliero E, Griffith, C., Milaszewski, K., Mugford, M., Myerson J., Ni, W., Perry, D., Winkler, S. & Witte, R. (2019). Ethical challenges experienced by clinical research nurses:: A qualitative study. Nursing Ethics. 26(1):172-184. doi:10.1177/0969733017693441 

REPLY 

Advance practice nurses globally are often involved with research with the focus of finding ways to improve patient safety and better nursing outcomes for patients and as such are faced with many ethical challenges while pursuing research. Some ethical issues that advance practice nurses or nurses in general must considered are informed consent, beneficence (doing no harm), respect for confidentiality and anonymity, respect for privacy and vulnerable groups of people. With regards informed consent, the patient must be able to make informed decisions and not be coerced to participate in research. There must be a clear explanation of the risks and benefits involved. The participant must understand the medical information given and that their decision is voluntary and that they may be able to withdraw from research at any given time without penalty. Another ethical consideration in research is patient privacy and confidentiality with the introduction of HIPPA in the United States of America it serves as a regulatory guideline for protection of individuals identifiable health information. De Nisco S. M (2021) 

Nursing is regarded as a trustworthy profession so advance practicing nurses need to remain ethical and do no harm when working with the general and vulnerable population such as children mentally challenged and the elderly and do what is the best interest of the patients when involved in any research process. 

DeNisco, S. M. (2021). Advanced practice nursing: Essential knowledge for the profession. Jones & Bartlett Learning.