Ethical Issues in Randomized Control Trials

Ethical Issues in Randomized Control Trials PROBLEM 1 A research team is conducting a Randomized Control Trial of a new drug to treat the common symptom of the Ebola virus (fever) over the past six (6) months. The experimental group consisted of female Ebola patients aged between 30 and 50 years to whom the new drug was administered. The control group consisted of male Ebola patients aged between 70 and 80 years. To this control group placebo, a substance that resembles medicine superficially and is believed by the patient to be medicine but that has no medicinal value was administered. Discuss ethical issues associated with this research design? Ebola virus disease also as (EVD) is a highly infectious and contaminating disease which has recently killed thousands especially in West African. This disease is a severe and most often fatal illness in humans. The Research design used Randomized Control Trial, however it does not state how it was able calculate the RCT sample size. The years in age of women and men are listed but we do not know how many participants the experiment had. This research conducted random sampling, was the randomization truly â€Å"random,† or are there really are two populations being studied here. It is very difficult to come up with two randomized age groups of men and women. As stated above Ebola is a very dangerous disease and one of the ethical issues in research is that vulnerable groups should not be used unless benefits outweigh the damages, the age group of men between 70-80yrs fall in that category as elderly. This research design would have been giving this vulnerable group a placebo m edicines (dumpy) to this group over a period of 6 months. How many individuals would have been lost to this fatal killer disease? The declaration of Helsinki states that in any medical study, every patient including those of a control group, if any should be assured of the best proven diagnostic and therapeutic method. The controlled group where not assumed of this, placebo control trials are justified when it comes to testing a new product like hair removing creams which has no permanent damage, with severe illness this cannot be acceptable .illness that are fatal and highly contagious when with a placebo control is not justifiable with Ebola because without any medical intervention they will die. The study design also shows large evidence of both allocation and performance bias, in a sense the women that were selection to the intervention group were specifically chosen to be in the intervention group, due to the fact that they will perform better, by facilitating quick and desirab le recovery compared to the elderly men whom their bodies cannot respond with the same efficiency. Lastly some of these elderly men are Husbands, Dads, Granddads, brothers of other people countless family will suffer endlessly over 6 months, whilst their relative is not getting any help at all. What modifications would you suggest on the research design in future? There is never a single way to follow when it comes to research, however they are research design which are more suitable and permit the evidence obtained to answer the initial question as explicitly as possible. In future I would use I would use Time series design. This is due to the fact that Time series design allows each participant to receive an intervention over a period of time and results are measured before and after any intervention. Hence reducing the fatality that are associated with Ebola but also making it less contagious if the medication is being effective. Another change I would introduce is to remove the placebo medication, one cannot be comparing a drug efficiency to a dumpy Placebo, and if it is a new medication then it will have to be compared to other similar drugs to assess its effectiveness instead of nothing, whilst humans are dying and others getting contaminated within that 6 months. Another change would be for the research not to use vulnerable elderly as the control group, hence using adolescent and young adult sample population, since they would give a clearer indication to the efficiency of the new drug. Lastly I would calculate a large enough sample size to increase the findings internal and external validity. Due to Ebola being fatal a sample size would help, by clarifying the total fatalities experience but most important the number of patients cured. PROBLEM 2 One of the leading causes of fast spread of HIV and AIDS in Africa is poverty particularly income poverty that forces unmarried women and girls to indulge in prostitution. In January2005, the IMF/World Bank designed a 10-year micro-finance targeting 1000 prostitutes. The aim of the project was to see a significant drop in the number of women or girls who indulge in this malpractice. To be registered as a beneficiary, interested women and girls were required submitted an application and pay a processing fee of MK500. A total of 2500 applications were received at the close of the deadline. To identify project beneficiaries, it was decided that a lottery be conducted and that all applicants be invited to witness the draw. After selecting the beneficiaries (i.e., treated group), a random draw was also conducted to select non-beneficiaries (i.e., control group). Discuss ethical issues associated with this research design? Acquired immune deficiency syndrome (AIDS). AIDS develops from infection with HIV (human immunodeficiency Virus), which attacks the immune system and disables a person’s defenses against other diseases, including infections and certain cancers. This research used Random selection to find the 1000 participants it wanted to induct into the micro-finance program .Firstly the time frame of the project, the project was meant to run for 10 years and considering that this will have been an observation study design a lot of things can happen within the 10 years, which will affect the internal Validity of the findings. Secondly this Research design asked participants to pay for the application ,a sum of K500 which would total up to K1,250,000 million for the 2500 applicants. Research ethics prohibits payments that can potentially cause pressure, bribes and economic social disadvantages. Therefore many individuals who really need the help would have been excluded, subsequently them havi ng inability to source out the K500.It is also unethical asking money from a poverty group who happens to practice prostitution, they will engage in this malpractice to raise that K500, leading to the project not trying to stop prostitution but encouraging it on the other hand. Research designs have to respect the privacy and confidentiality of participants at all times. Conducting a Lottery where everyone is invited and dividing the treatment and control groups of prostitutes in front of a congregation hampers privacy and confidentiality ethics, this sort of exposure can result into the applicants looked down upon by community members. What modifications would you suggest on the research design in future? When it comes to payments, Research ethics promotes that participants should be suitably compensated for any expenses, compensated for effort, time or lost income, and acknowledged for their contribution.in total this research raised K1,250,000 million. The suitability of this money is not justifiable since IMF bank will actually be spending huge amounts monthly to sustain this project. I would remove this application fee so that its open to every suitable candidate without having financial hinders. The applicants were unmarried women and girls, I think that the focus should have been different since these are different age groups. The women can be put on the micro-financing plan whist the girls can be given a different option to continue on with education and the money directed towards their fees. To expand on that it would be better to teach the participants to fish rather than give them fish every time for 10 years, since when the project stops they will go back and continue with their malpractices (prostitution) .However if you can teach some of the women income generating activities and education for the girls then they will be able to become dependent and stop the prostitution altogether. This is known as transformative participatory monitoring and evaluation. Another change that I would install is the time span of the projects 10 years is a lot of time, I would change the Research design to Randomized Control Trial with Crossover design. This would allow all 2500 participants to partake, thus not having any control groups, but time sequence when they would be receiving the money, hence follow ups can be conducted to what the individuals are capable of with and without benefits. Futuristic speaking, I would change the design of the selecting process of the 2 groups, a Lottery selection were everyone is invited would be cancelled and conduct an expert panel to assess economic, social and health status of the applicants. Decisions would be made and benefici aries awarded to the real needy ones. REFERENCES Kazdin, A.E. (2010).Single-Case Research Designs: Methods for Clinical and Applied Settings, 2nd edition. New York: Oxford University Press. Millum,J Grady C. (2013) The ethics of placebo-controlled trials: methodological justifications.. Contemp Clin Trials.36(2):510-4 Rothman KJ, Michels KB: The continuing unethical use of placebo controls.N Engl J Med331:394–398,1994

Stefan’s Diaries: The Craving Chapter 7

Every muscle in my body tensed. Time seemed to stop as we stared into each other's eyes, both of us silently challenging the other to give himself away. My chest felt tight as anger coiled through my body. The last time I'd seen Damon, he'd been standing over me with a stake, just after he'd killed Callie. His cheeks had been sunken, his body gaunt from his time in captivity. Now he looked like his human self, the young man who charmed everyone from barmaids to grandmothers. Clean-shaven, dressed smartly, and playing the part of an Italian count flawlessly. Acting human. He had everyone in the room fooled. Damon raised one eyebrow at me and the twitch of a smile appeared at the corner of his mouth. To any onlooker, it would have seemed just like he was pleased to meet a new acquaintance. I knew better. Damon was enjoying his charade and waiting to see how I reacted. â€Å"Stefan Salvatore, may I introduce Count Damon DeSangue,† Lydia said. Damon gave a perfect bow, just barely bending at the waist. â€Å"DeSangue . . .† I repeated. â€Å"Count DeSangue,† Damon corrected in good humor, affecting an Italian accent. He smiled, revealing a straight set of gleaming white teeth. No, not here, I thought furiously. Not here in New York, not here among these innocent, well-meaning Sutherlands. Had Damon followed me here, or had he arrived first? He had been here long enough to attach himself to poor Lydia. And long enough to trick all of New York society. Is it possible that, in this teeming city, we both managed to become involved with the Sutherland family completely by coincidence? Damon was regarding me now, although the icy twinkle of sardonic humor was never far from his eyes, as if he guessed at what I was thinking. â€Å"Stefan, Damon – I just know you two are going to be like brothers,† Bridget gushed to me. â€Å"Well then,† Damon said, a smirk pulling the corner of his mouth. â€Å"Hello, brother! And where are you from, Stefan?† â€Å"Virginia,† I answered shortly. â€Å"Oh really? Because I was recently in New Orleans and could have sworn I met a gentleman who looked just like you. Have you been there?† Lydia leaned in closer, her eyes bright with pride. Bridget nodded eagerly at every word Damon said. Even Bram and Hilda looked entranced. I gripped my champagne glass so tightly I was surprised it didn't shatter. â€Å"No. I can't say I've ever been.† The happy tinkle of silverware from the refreshment table suddenly rose to the foreground. Hundreds of people, hundreds of blades, and one very angry, unpredictable brother before me. â€Å"Interesting,† he said. â€Å"Well, perhaps we will go back there, together. I hear they have a magnificent circus.† The orchestra began to play again, another fast-paced dance. But that was noise in the background. The ball and its participants faded away. Right now, Damon and I had our eyes locked on each other. â€Å"If you even try something,† I said low enough that only he could hear, squaring my shoulders and unconsciously tensing for a fight. â€Å"Don't think you can best me,† Damon said, rolling to the balls of his feet. The group of people we were with looked back and forth at us, clearly aware that something was going on, but unsure what exactly. â€Å"I'm feeling a bit thirsty,† I finally said aloud, not moving my eyes from his, trying to think of how to get Damon away from my new friends. â€Å"Care to join me for a drink?† â€Å"Smashing, I'd love one,† said Bram eagerly, hoping to break the tension. â€Å"Love to,† Damon said, mocking Bram's tone. â€Å"But duty – and the mazurka – calls.† He turned to Hilda and bowed. â€Å"May I?† â€Å"Oh, I'd love to, but Bram . . .† She started to hold up the dance card that hung around her wrist from a pink ribbon. Then her eyes widened, dilating, and she was staring – but no longer at the card. I looked at Damon. He was also staring, compelling her. Showing off, in front of everyone – in front of me – just how powerful he was. He was sending me a message. â€Å"Oh, he won't mind,† Hilda decided and took Damon's arm. He led her off, smiling back at me. The tips of his fangs glittered. â€Å"I wish I had his charm,† Bram said a little wistfully. â€Å"He's got all you ladies wrapped around his finger.† Lydia blushed prettily. She did not look after Hilda with a worried expression. She had the calm confidence of someone who knew exactly where her lover stood in his relation to her. Damon had no doubt compelled her to act as such. He had amassed a considerable amount of Power, very quickly. â€Å"Where exactly did you two meet?† I asked, trying to sound casual. â€Å"Oh, it was so romantic,† Bridget answered quickly. â€Å"Almost as romantic as you finding me, helpless, in the park. . . .† â€Å"Let your sister speak, Bridgey,† Bram interrupted. Lydia smiled, all of her studied politeness and mannered behavior melting away. â€Å"It really was a bit like a fairy tale. It was raining, a sudden downpour. I remember very particularly that the sun had been shining just moments earlier. Unprepared for the change of weather, Mother and I became soaked. My new hat was ruined, and all my packages were dripping wet. I swear a dozen carriages must have passed us by without stopping. And then – one of them paused, and the door opened, and there he was, extending his hand to me.† Her eyes grew soft. â€Å"He offered to give up his seat, but we got in with him. . . .† Bram made tsk-tsking noises; Lydia smiled, shrugging prettily. â€Å"I know, I know . . . ‘taking a ride with a strange man.' Very bad of us. But he was so polite, and charming . . . and we had such a lovely ride . . . and then the sun came out and we hardly noticed. . . .† My mind raced. Had Damon compelled every carriage driver in Manhattan to avoid Lydia and her mother? Was it even possible to compel that many people at once? And what about the rain? Had that been luck . . . or something else entirely? Damon wasn't capable of compelling the weather. If that were a power available to vampires, I would have heard of it from Lexi or even Katherine. Right? I studied Lydia. She wore a simple, narrow ribbon around her neck with a single pearl dangling from the front. The skin there was smooth, unblemished – and unbitten. If Damon wasn't feeding on Lydia, then what did he want from her? â€Å"Someone said something about being thirsty . . . ?† Bram said hopefully, rubbing his hands together. â€Å"I have a terrible desire for more champagne.† â€Å"Yes, thirst is a terrible thing,† I said, â€Å"but you'll have to excuse me.† Then I turned and cut my way through the merrily dancing crowd, determined to search out my brother before he had the chance to slit anyone's throat.

A Deadly Mistake Uncovered on Essay Topics on Health and Fitness and How to Avoid It

A Deadly Mistake Uncovered on Essay Topics on Health and Fitness and How to Avoid It The Pain of Essay Topics on Health and Fitness Your paper must have a totally one-sided conclusion stating your own stance is good while that of your opponent is totally bad. Of course, when you were given a very clear undertaking to write on a certain topic you won't need to wreck your brains searching for something exciting and crucial to dwell on. Maybe you presently have a generalized idea of what things to write in your mind, and the following will let you concentrate on some specific thought or perhaps change your choice. The issue is that everybody's interpretation of what makes a great society differs. Essay Topics on Health and Fitness Fundamentals Explained There are a lot of things to consider and most importantly, is the trustworthiness of the service you decide to use. Additionally, compared with the broad variety and access to fast food stores and menus, balanced food is serious ly limited. For the interest of relevance, only the recruitment part is going to be discussed. You will need to back up your viewpoint with well-researched facts and data also. Bad air quality is really a threat to our wellbeing. There are many facilities out there to assist you to stay alive and healthy. The medical industry earns millions because of the cures they hide. In our society today, there are lots of health troubles. The Basic Facts of Essay Topics on Health and Fitness The medical faculty rankings have all of the time been some extent of concern for those faculties together with the scholars. You also ought to concentrate on finding the medical school application called that has a good comprehension of the distinct medical schools across the nation. In my opinion, education may be viable measure with careful consideration of different impediments. So, both students of medical care programs along with students of any other specialty may have a task to compose an essay on health topic. The Essay Topics on Health and Fitness Cover Up An assortment of plastic surgery manipulations should turn into part of a medical insurance plan. All teens who need to undergo plastic surgery ought to be permitted to consult a health care provider. Any kinds of plastic surgery ought to be forbidden. It should be more affordable. The quantity of meat consumed should be decreased. Firstly, many quick food products provide very little if any information on the nutritional content inside them, deterring the consumers from knowing the sum of fat, sodium or cholesterol that they take in. Moreover, balanced food is often inferior to fast food in conditions of taste and prices as an issue of fact. Eating three meals each day, or even 5-6 smaller ones, is excellent for the human body and for keeping up a healthful weight. There are invariably a wide variety of opinions on the topic of technology, and here are our favourite things to consider on the subj ect. In any case, if you discover a list of topic ideas and something appears to be very lovely and simple to research, it's possibly the most popular topic that numerous students choose. The topics mentioned previously are excellent starting points that may be used to make an outstanding project on health problems. When you are attempting to produce a medical argumentative essay topic, you would like to choose one which you know a small bit about because then it will produce the research easier and you'll get a better approach to the topic. Health literacy is the procedure in which people may acquire understanding and utilize health information to increase their wellness. Travel health should be given more importance. Other folks think education will not operate. Everyone should have easy accessibility to healthcare services. You'll be fitter if you simply cycled to get the job done. Based on availability, you might be in a place to reserve an exam time for the following day or it might take up to a couple of weeks. There are hundreds and hundreds of topics to pick from and come up with when you sit and consider it. Why taking a vacation is helpful for your wellbeing. What Is So Fascinating About Essay Topics on Health and Fitness? Somebody's state of health will often influence her or his mind-set plus lots of different things that occur in their everyday life. Sitting facing the client acknowledges the practice of open communication. An individual could be somewhat overweight but have a wholesome heart and diet. If parents and kids aren't literate and cannot readily understand health info and instructions, there may be an issue in the treatment practice. Hence, it's not surprising why healthcare has a great effect on an individual's life. There are only a few quick-fix solutions on earth for handling money, work or even shedding weight. Discuss ways of monitoring who'd qualify for free therapy, and who would be expected to cover it. Others couldn't afford the most recent technology like X-ray machines. Exercise combats health troubles. Diet is at least as big of a portion of your health as exercising, that's the reason why it is so important to eat well balanced nutritious meals. Diet isn't the only thing which should be factored into a nutritious way of life. The Paleo diet can destroy your health.

Overview of the ACA Code of Ethics - 680 Words

Introduction The dynamics between the human dimensions and the professional demands of conducting a counseling practice has been the subject of a considerable amount of literature in the field. Indeed, it is a focus in counselor preparation programs. It not possible to segregate who we are as people and what we do as professionals. These two aspects of our lives are inexorably linked. The dynamics are such that the one impacts the other, while influence may be dominant in a particular direction, there is an inescapable mutuality. Further, research suggests that the individual attributes of the counselor have the most critical influence on therapeutic outcomes and have at least as much impact on client/ counselor relationship quality as the counselors techniques and theory do (Corey, 2010). A.10 d. Bartering. Counselors may barter only if the relationship is not exploitive or harmful and does not place the counselor in an unfair advantage, if the client requests it, and if such arrangements are an accepted practice among professionals in the community. Barter, as a way of providing equivalent compensation for goods or services, is an established practice in many cultures. But this is typically not the case in contexts in which counselors are credentialed and licensed to practice. At the simplest level, bartering poses the problem of establishing a fair exchange. Determination of fairness is always impacted by the perceptions of the bartering partners. A primaryShow MoreRelatedCounseling Services For A Counselor1565 Words   |  7 Pagesrelevant ACA and/or ASCA codes and the textbook. a) There are several times that a counselor might need to decline to provide counseling services. 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