Nursing Ethics and Clinical Trials

Clinical trials are essential to furthering the treatment of diseases. Many patients view participation in them as a “last-ditch” effort. They feel like they have exhausted all options.

This is one of the myths about clinical trials. They aren’t reserved until everything else is exhausted. Always feel free to ask your healthcare provider if there are any trials that you may qualify for.

Here is where things can get a little tricky. Suppose that you are a nurse working in the hospital and have a patient that you think should be introduced to trials. This is a large, teaching hospital that frequently recruits from among the inpatient population. Is it your job to bring up the topic? There are three key considerations to keep in mind:

  1. Among all else, it is imperative to know what the facility policies are regarding situations like these.
  2. Every hospital is supposed to have an Ethics Committee and they should be easily accessible for questions.
  3. There is no straight answer to this example and no two answers will ever be the same. Each nurse may view this topic completely differently

In addition to clinical trials, current ethical hot topics in nursing include assisting in abortions, flu-shot requirements for nurses and end-of-life issues. Nurses should be familiar with the ethics of the nursing profession, but also be comfortable with their own ethical code. Nurses who can find agreement between personal and professional ethics will be most successful at maintaining their integrity and moral character. Nurses who are comfortable with their morals and let ethics guide their decisions will be well equipped to provide patient care. [http://www.nursing-theory.org]

Nurses should be familiar with the ethics of the nursing profession, but also be comfortable with their own ethical code.

Jean Watson’s Theory of Human Caring makes seven assumptions:

  1. Caring can be effectively demonstrated and practiced only interpersonally. Caring consists of carative factors that result in the satisfaction of certain human needs. 

  2. Effective caring promotes health and individual or family growth. 

  3. Caring responses accept the patient as he or she is now, as well as what he or she may become. 

  4. A caring environment is one that offers the development of potential while allowing the patient to choose the best action for him or herself at a given point in time.

  5. A science of caring is complementary to the science of curing.

  6. The practice of caring is central to nursing.

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You are probably wondering why I shared this. Look at the fifth assumption closer; “allowing the patient to choose the best action for him or herself at a given point in time.” The patient has a large degree of autonomy and that needs to be acknowledged. Ultimately any participation in a clinical trial is up to the patient.

Generally it is a physician bringing up the topic, but in my eyes, I wouldn’t be afraid to broach the subject. Casually mentioning that there are always a multitude of trials for conditions, isn’t going to end your career. Trust your gut, but most of all…care for your patient.

If you are a nurse who is working as part of a clinical trial, then you have additional demands. Your first priority is always going to be the patient, but there is also the importance of maintaining a boundary between the clinical study. Your responsibility is to collect the data, administer medications and adhere to the specific role that is delineated in the clinical study protocol.

Clinical trials from the nursing aspect are so much more than just an opportunity for learning about a disease and treatment for patients. Multiple ethical standards apply, no matter what the role is. These must always be adhered to along with the regulations from your State Board of Nursing.

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Kim is a registered nurse, a Breakthrough Crew ambassador, and a patient advocate focusing on the in-care patient experience. She blogs at AutonomicRN.com and tweets at @AutonomicRN.