Etymology
The Belmont report took its name from the Belmont Conference Center in Elkridge, Maryland, 10 miles south ofHistory
In 1974, prompted in part by the ethical problems emerging from the Tuskegee Syphilis Study (1932–1972), the National Research Act was signed into law. This created the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1974–1978). It consisted of altogether 11 physicians, lawyers and scientists, 8 of them were men and three women, namely Kenneth John Ryan, Joseph V. Brady, Robert E. Cooke, Dorothy I. Height (the only African-American), Albert R. Jonsen, Patricia King, Karen Lebacqz, David W. Louisell, Donald W. Seldin, Eliot Stellar and Robert H. Turtle. It was divided into a series of work groups. Several people worked on issues of autonomy, others worked on issues of beneficence, or non-maleficence, or justice. The commission developed the ''Belmont Report'' over a four-year period from 1974 to 1978, including an intensive four-day period of discussions in February 1976 at the Belmont Conference Center. On September 30, 1978, the commission's report, ''Ethical Principles and Guidelines for the Protection of Human Subjects of Research'', was released. It was published in the Federal Register on April 18, 1979. The Department of Health, Education and Welfare (HEW) revised and expanded its regulations for the protection of human subjects 45 CFR part 46 in the late 1970s and early 1980s.Ethical principles
The ''Belmont Report'' explains the unifying ethical principles for using any human subjects for research which have formed the basis for the National Commission's topic-specific reports and regulations. The three ethical principles are: # Respect for persons: protecting theSummary
The summary, from the top of the Report: The Belmont report itself consists of 3 clauses: A. Boundaries between Practice and Research, B. Basic Ethical Principles, C. Applications.Boundaries Between Practice and Research
This clause establishes the differences between biomedical and behavioral research, and that the different areas of research, require different protections for human participants. Examining the differences between "practice" and "research", practice is dealing with bettering the wellbeing of an individual or group, while research is testing a theory and potentially has an unknown ending. This difference, establishes that they require different protections for human participants, and when any amount of research is occurring, it should be reviewed for the protection of those involved.Basic Ethical Principles
This clause covers, three ethical principles; ''Respect for Persons'', ''Beneficence'', and ''Justice''.Respect for Persons
This ethical principle describes individuals as autonomous agents. Stating that an autonomous agent is an individual capable of deliberation regarding their personal goals, and who is able to be guided by that deliberation. It acknowledges that while most individuals are capable of making the decision, some groups of people require more protections. Some lose their capacity forBeneficence
This principle, in short, emphasizes the maximization of benefits, and minimization of potential harms. Especially when dealing with those who require further protections, from the ''Respect for Persons'' principle. Scientific researchers are urged to consider, not just the immediate consequences, but also the long term consequences of their research.Justice
This principle deals with the distribution of benefits and burdens of research. It puts forward 5 different formulations, on how to base the distribution, 1, all given an equal share, 2, based on need, 3, based on individual effort, 4, based on societal contribution, 5, based on merit. This principle described the circumstances of the Tuskegee Syphilis Study, and explains the importance of the participants getting recognition and the possible benefits of research. It also mentions the exploitation of unwilling prisoners, as research participants, in theApplications
This clause is broken down into three parts,Informed Consent
This section is further broken down into three parts, information, comprehension, and voluntariness. Information: Ensuring that the participants, are not only given all the relevant information, but that the information is presented in an understandable and researchable way. Comprehension: The participants should be capable of understanding the information; if they aren't, the third party in-charge of their safety (part of the protections from the Basic Ethical Principles, the Beneficence section) should be given the information regarding the research, and presented it in an understandable manner. Voluntariness: Participants shouldn't be under any unjustifiable pressures to participate in research. This can include coercion, undue influence by excessive or inappropriate reward, influence by a close relative, threatening to withdraw health services, and other comparable situations. Individuals should make the decision to participate without being pressured by any unwarranted sources.Assessment of Risk and Benefits
It should be correctly assessed that the benefits should overweigh the risks.Selection of Subjects
It should be of two types that are as follows : 1) Individual justice 2) Social justice Burdens & benefits are equally shared irrespective of a person's dignity, ability, rich, poor.Application
The ''Belmont Report'' allows for the protection of participants in clinical trials and research studies. Seven things nurses, as primary caregivers for individuals participating in a study, must do to ensure the rights of the participant are met are. # Ensure the study is approved by an IRB # Get informed consent from the patient # Ensure that the patient understands the full extent of the experiment, and if not, will contact the study coordinator # Ensure the patient wasn't coerced into doing the experiment by means of threatening or bullying # Be careful of other effects of the clinical trial that were not mentioned, and report it to the proper study coordinator # Support the privacy of the patient's identity, their motivation to join or refuse the experiment. # Ensure that all patients at least get the minimal care needed for their condition Researchers must share the findings of their procedures regardless of them being good or bad results. Also in the case someone did not want to participate in research but would like treatment they cannot be turned away and must be treated with the same standard care.Upgrade since 1979
The ''Belmont Report'' both serves as a historical document and provides the moral framework for understanding regulations in the United States on the use of humans in experimental methods. In 1991, 14 other Federal departments and agencies joined HHS in adopting a uniform set of rules for the protection of human subjects, identical to subpart A of 45 CFR part 46 of the HHS regulations. This uniform set of regulations is the Federal Policy for the Protection of Human Subjects, informally known as the " Common Rule". The Office for Human Research Protections (OHRP) was also established within HHS. On January 19, 2017, the 'Revised Common Rule' was issued as a Final Rule, which came into effect on January 21, 2019, and included two changes, instituting the Belmont Report as part of the ''Protection of Human Subjects'' federal policy. Firstly, a Department/Agency head waiver clause, which previously allowed federal department or agency heads to waive parts or all of the Common Rule without restrictions, has since been restricted by the contours of the Belmont Report. The Revised Common Rule states: "Unless otherwise required by law, department or agency heads may waive the applicability of some or all of the provisions of this policy to specific research activities or classes of research activities otherwise covered by this policy, provided the alternative procedures to be followed are consistent with the principles of the Belmont Report." evised Common Rule at 45 CFR 46.101(i)Secondly, a Department/Agency head determinations clause, which previously provided Department/Agency heads with the power and discretion to decide, whether an activity qualifies as human research which is subject to the federal policy, has since required that "this judgment eterminationshall be exercised consistent with the ethical principles of the Belmont Report." evised Common Rule at 45 CFR 46.101(c)Psychology
In the field of psychology, the Belmont Report has been supplemented by theCritique
In a 2006 study by Nancy Shore, community-based participatory researchers were interviewed for their interpretation and critique of the ''Belmont Report''. Interviewees expressed concerns regarding the ''Belmont Report''s ethical principles and interpretations as being one size fits all and advocated researchers to resist the tendency to rely on those principles systematically. It argues that the ethical analysis should be extended to take into account more appropriate factors, such as cultural, gender, ethnic and geographical considerations. Debate continues over the ethics and regulations of research involving human subjects because of discrepancies over the meaning and priority of the ''Belmont Report''s basic ethical principles: respect for persons, beneficence, and justice. Notably, the ''Belmont Report'' does not specify how its three ethical principles should be weighted or prioritized. According to Albert R. Jonsen, a member of the National Commission that composed the report, the Institutional Review Board is charged with weighing these principles and deciding how they should be applied. Matters become controversial when deciding if the principles should be interpreted as more or less weighty depending upon the particular circumstances of the research in question, if the principles should be viewed as an obligation that society must undertake on behalf of its members, or if it should be viewed as giving absolute priority to respect for persons' autonomy over the general good of society.See also
* Human experimentation in the United States *References
External links