Case Study 2 in which an incarcerated population is surveyed for potential detrimental effects from childhood trauma presents several ethical challenges. The first consideration, respect for person, is achievable within the confines of the study. Although the participants are incarcerated, they are provided the ability to choose whether or not to participate. The participants were also required to sign a consent form although the provided information does not indicate whether or not the consent was informed consent. It is questionable, however, in that the individuals do lack autonomy due to the nature of them being incarcerated. There are concerns as to whether the participants felt coerced to participate despite having been given the opportunity to decline participation. When considering the aspect of beneficence, it would seem, without further inspection, that the researchers had no intention of doing harm and were maximizing benefits and minimizing harm; however, it is unclear from the information provided if the prisoners were offered any supportive or therapeutic services following the administration of the survey. Individuals who have experienced traumatic childhood events may potentially have PTSD from the trauma and as a consequence of having to discuss the trauma, may essentially be retraumatized by this event. There is no indication of services and follow up offered for the prisoners. While one could argue that the harm caused to an individual by having to relive a traumatic event is minimal, this is not the case. In considering justice, it does not appear that prisoners are being exploited. This study, however, does not need to be restricted to only surveying incarcerated individuals as people who have not committed violent crimes have also experienced childhood trauma. This study does not appear to inflict an immediate risk to the subject but can potentially present a risk to the researcher as the data is collected via face to face interview with a prisoner. It is not stipulated whether the prisoners were convicted of violent crimes or if they are in for “white-collar crimes.” There is no apparent risk to society. The benefit to the researcher is solely obtaining the information required to complete the study. The benefit to society is that researchers may determine a cause and effect relationship between childhood trauma and the propensity for those experiencing it to become incarcerated. There is no obvious direct benefit to the prisoners unless the study was offering follow up care and treatment to the participants.
Hi mdpelkey,
I agree with your assessment that the prisoners might lack autonomy and could possibly be coerced into participating in this study. According to the National Institutes of Health, prisoners are considered a vulnerable population, and require additional protections (National Institutes of Health, n.d.) The Code of Federal Regulations summarizes these regulations. The IRB has added responsibilities when prisoners are involved in studies. One of the additional duties that stood out to me was the one that states that a prisoner’s participation in a study should not affect his or her parole status. In other words, no decisions regarding a prisoner’s parole should be made in relation to the study, and the researchers have a duty to clearly inform the prisoner in advance that participation will not affect parole (U.S. Department of Health and Human Services, 2018). I did not even think of this when I thought of possible harm coming to a prisoner in the study. This may or may not entice prisoners to participate. While I do not think a study regarding childhood trauma inflicted on a prisoner might affect parole, I can see how it could in other cases, such as research related to drug use.
National Institutes of Health. (n.d.). Vulnerable and other populations requiring additional protections. Retrieved February 5, 2020, from https://grants.nih.gov/policy/humansubjects/policies-and-regulations/vulnerable-populations.htm#Prisoners
U.S. Department of Health and Human Services. (2018, July). Electronic code of federal regulations. Retrieved February 5, 2020, from https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=83cd09e1c0f5c6937cd9d7513160fc3f&pitd=20180719&n=pt45.1.46&r=PART&ty=HTML#se45.1.46_1305
When you state “I can see how it could in other cases, such as research related to drug use,” were you referring to the use of prisoners as test subjects for pharmaceuticals?
Similarly, another area that has been examined is the use of prisoners as living donors. As recently as 2007, lawmakers of South Carolina attempted to pass a bill that would allow incarcerated individuals the opportunity to reduce their sentence by 180 days in exchange for a kidney donation. The National Organ Transplantation Act (NOTA), prohibits “any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation” (Ross, 2018). It is arguable that time off of a sentence is “valuable consideration.” Participation in the case study type of investigational research is not nearly as invasive as participation as a living donor; however, the protections for the prisoners against coercive forces are the same.
Ross, L., & Thistlethwaite, J. (2018). Prisoners as Living Donors: A Vulnerabilities Analysis. Cambridge Quarterly of Healthcare Ethics. 27(1), 93-108.
Hi there,
I was referring to parole. The entire sentence I wrote states, “While I do not think a study regarding childhood trauma inflicted on a prisoner might affect parole, I can see how it could in other cases, such as research related to drug use.” In other words, studies regarding childhood trauma would probably have nothing to do with a prisoner’s parole. However, if a study was done regarding street drugs, I can see how this might affect parole status. For example, what if a prisoner was in jail due to the sale of illegal drugs, or the use of illegal drugs? He or she participates in a study, and more information is revealed regarding the illegal drug use of that individual. Even though this is not supposed to happen, what if that prisoner’s parole sentence was lengthened when officials of the jail find out more about what that prisoner did prior to jail? Childhood trauma is not seen as an “offense” like illegal drugs could be. On the flip side of this, a prisoner involved in a drug crime might try to use the study as a way to lessen his parole sentence by providing useful information to the researchers. According to the U.S. Department of Health and Human Services, this is not supposed to happen though (U.S. Department of Health and Human Services, 2018).
U.S. Department of Health and Human Services. (2018, July). Electronic code of federal regulations. Retrieved February 5, 2020, from https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=83cd09e1c0f5c6937cd9d7513160fc3f&pitd=20180719&n=pt45.1.46&r=PART&ty=HTML#se45.1.46_1305
Hi there. I feel as you that there was a limited amount of information supplied to us. I would like to know if follow up therapy was available to the prisoners due to potential feelings of distress, anger, guilt, or embarrassment, or even PTSD. This is a risk that must be minimized. Participants must be properly monitored, and a timely treatment plan in place (National Bioethics Advisory Commission, 2016)
National Bioethics Advisory Commission. (Feb 01, 2016). Report on ethical and policy issues in research involving human participants Volume 1 report and recommendations.
According to the Belmont report inmates are a popular study group due to their situation. You make a valid point as to weather the inmate truly had the autonomy to decline to participate in the study.
“One special instance of injustice results from the involvement of vulnerable subjects. Certain groups, such as racial minorities, the economically disadvantaged, the very sick, and the institutionalized may continually be sought as research subjects, owing to their ready availability in settings where research is conducted. Given their dependent status and their frequently compromised capacity for free consent, they should be protected against the danger of being involved in research solely for administrative convenience, or because they are easy to manipulate as a result of their illness or socioeconomic condition”.
The Belmont Report (Rep.). (1979, April 9). Retrieved https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html
OHRP (Producer).