Ethical Aspects of Epidemiological Research

These two quotes are about values and expectations, about perceived responsibilities, about community benefits and individual rights in medical care and research, and reflect thereby compellingly the tensions, the paradoxes, the different views and ethical aspects concerning biomedical research (Coughlin 2000). Epidemiology is part of the arena of biomedical research and is particularly focussed on determinants of disease occurrences in populations. Ethics is the systematic analysis of values and norms (Weed and Coughlin 1999; Weed and McKeown 2001). Usually ethical reasoning and conduct are not issues that are at the top of a epidemiologist’s menu chart (Beauchamp et al. 1991). In previous chapters of this handbook we have seen that most epidemiological methods are non-interventional, e.g. observational by design, meaning that conventional ethical aspects of experiments with human beings (e.g. protocol review, randomisation, placebos, informed consent, etc.) are not applicable as such. Many ethical committees have been struggling with the review of protocols of non-interventional studies because of the rationale and design of the study being directed at not influencing the ‘natural’ disease course of patients, but at determining statistical inferences between various exposures (e.g. environment, drug treatment, medical practice) and effects in the population in a non-experimental fashion.

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