Welcome to Chapter 3: Ethics in Nursing Research

Nursing research exists to improve the health and well-being of individuals, families, communities, and populations. However, conducting meaningful research requires more than asking good questions or choosing the right research design—it requires a commitment to conducting research ethically.

Ethics is the foundation upon which trustworthy nursing research is built. Every decision made by a researcher has the potential to affect the people and communities who generously contribute their time, experiences, and knowledge. Ethical nursing research therefore extends far beyond obtaining approval from a Research Ethics Board (REB). It involves continually considering respect, fairness, beneficence, cultural safety, and accountability throughout every stage of the research process, from identifying a research question to sharing findings and translating knowledge into practice.

Historically, unethical research practices have caused significant harm and have shaped the ethical standards used around the world today. These historical lessons remind us why informed consent, privacy, confidentiality, justice, and protecting vulnerable populations remain central to nursing research.

This chapter also intentionally explores ethical research involving First Nations, Inuit, and Métis Peoples. The placement of Indigenous research principles within this chapter is deliberate. Indigenous communities have experienced a long history of exclusion, exploitation, and research conducted on communities rather than with communities. Understanding this history helps nurse researchers appreciate why respectful partnerships, relationship-building, reciprocity, Indigenous data sovereignty, and community leadership are essential components of ethical research today.

Although Indigenous perspectives are highlighted in this chapter through an ethical lens, they are also woven throughout this textbook and the broader nursing research process. Ethical nursing research requires recognizing diverse ways of knowing, valuing multiple perspectives, and ensuring that research contributes positively to the communities it intends to serve.

As you continue developing your own research ideas throughout this textbook, remember that ethical thinking is not simply one step in the research process, it is a responsibility that accompanies every decision a nurse researcher makes.

Examples of Unethical Research Practices

Research has led to many life‑changing discoveries, improving health, living conditions, and our understanding of social issues. However, not all research has been conducted ethically or humanely. Some studies have exploited, harmed, and marginalized individuals and communities, revealing serious failures in responsibility and respect for human rights.

To understand today’s ethical standards, it is important to recognize the historical practices that led to their development.

In the past, some researchers carried out harmful and coercive experiments on human subjects without consent. For example, prisoners were intentionally exposed to extreme conditions such as freezing or severe heat to study injury and survival (Woodhead, 2000). In other cases, individuals were deliberately infected with diseases like tuberculosis or syphilis so researchers could observe how those illnesses progressed, even when effective treatments were available (Woodhead, 2000; BBC News Service, 2010; National Archives, 2011).

Other studies involved invasive and painful procedures performed without anesthesia, including surgical experimentation on vulnerable populations such as prisoners and enslaved women (Kristof, 1995; Ojanuga, 1993; Zellars, 2018). In addition, some researchers denied participants treatment altogether in order to document the natural course of disease as seen in the well-documented case where treatment for syphilis was withheld from African American men causing preventable suffering and death (Centers for Disease Control and Prevention [CDC], 2024).

These practices were not isolated incidents but reflected broader patterns of exploitation, particularly targeting marginalized groups who had limited ability to refuse participation. Public awareness of these abuses grew significantly after World War II, when the trials of Nazi army physicians exposed the extent of human experimentation carried out in concentration camps, where many individuals were tortured and killed in the name of research (Faden & Beauchamp, 1986). In response, the Nuremberg Code was established, outlining key principles for ethical research, including voluntary consent and the obligation to minimize harm. These principles continue to guide modern research involving human participants.

Timeline of Unethical Research Studies → Leading to Modern Guidelines 

The timeline below traces key moments in the history of unethical research alongside the development of modern ethical standards. By moving through these events chronologically, you can see how specific cases of harm, exploitation, and lack of consent prompted critical reflection and reform within the research community. As you explore, notice how each incident contributed to the creation of principles, guidelines, and regulations that now shape ethical research practices. This progression highlights an important lesson; that today’s standards did not emerge in isolation, but rather in response to real harms experienced by individuals and communities.

Respectful Language in Ethical Research

Ethical research emphasizes respect, autonomy, and meaningful participation of individuals and communities. In nursing research, language is important because it reflects how we understand and value participants.

In community-based and participatory research, the goal is not to “control” or “alter” communities, but to ensure that individuals and groups:

· are fully informed about the purpose and procedures of the research

· have the opportunity to ask questions and seek clarification

· can freely choose whether or not to participate (without coercion)

· understand how the research may relate to their rights, experiences, and interests

This approach recognizes that communities are active partners in the research process. Ethical engagement involves collaboration, transparency, and respect for community decision-making. Before informed consent can occur, consultation takes place before research decisions are finalized, and individuals or communities are informed about the plans of the research in a way that supports meaningful understanding of its purpose, procedures, and implications for their rights and interests.

Remixed from:

• Research methods in psychology (4th ed.) by Dr. Rajiv Jhangiani, Dr. Carrie Cuttler, and Dr. Dana C. Leighton, KPU. (2019). Published under a CC BY-NC-SA 4.0 license.
  • Chapter 15: Moral Foundations of Ethical Research

• Graduate Research Methods in Social Work by Dr. Matt DeCarlo, Dr. Cory Cummings, and Kate Agnelli (2021), published under a CC BY-NC-SA 4.0 license.
  • Chapter 6.0: Research ethics
• Scientific Inquiry in Social Work by Matthew DeCarlo (2018). published under a CC BY-NC-SA 4.0 license.
  • Chapter 5.1: Research on Humans

Media Attributions

• Dr. Fehr [avatar] by Katie Gregson on Canva using Canva AI image creation https://www.canva.com/ai-assistant/ is subject to the Canva Pro Content License.

References

BBC News Service. (2010, October 2). US medical tests in Guatemala ‘crime against humanity’. BBC News US & Canada. https://web.archive.org/web/20160102060840/http://www.bbc.co.uk/news/world-us-canada-11457552

Centers for Disease Control and Prevention. (2024, September 4). The untreated syphilis study at Tuskegee: Timeline. CDC.gov. https://www.cdc.gov/tuskegee/about/timeline.html

DeCarlo, M. (2018). Scientific inquiry in social work. Pressbooks. https://pressbooks.pub/scientificinquiryinsocialwork/

DeCarlo, M., Cummings, C., & Agnelli, K. (2021). Chapter 6.0.: Research Ethics. In Graduate research methods in social work. [In Social Sci LibreTexts]. https://socialsci.libretexts.org/Under_Construction/Graduate_research_methods_in_social_work_(DeCarlo_Cummings_and_Agnelli)/06%3A_Conceptualizing_your_research_project_-_Research_ethics/6.00%3A_Research_ethics

Faden, R. R., & Beauchamp, T. L. (1986). A history and theory of informed consent. Oxford, UK: Oxford University Press.

Jhangiani, R. S., Chiang, I.-A., Cuttler, C., & Leighton, D. C. (2019). Research methods in psychology (4th ed.). Kwantlen Polytechnic University. https://kpu.pressbooks.pub/psychmethods4e/

Kristof, N.D. (1995, March 17). Unmasking horror—A special report.; Japan confronting gruesome war atrocity. The New York Times. https://www.nytimes.com/1995/03/17/world/unmasking-horror-a-special-report-japan-confronting-gruesome-war-atrocity.html

National Archives and Records Administration. (2011, March 28). National Archives releases John Cutler papers online [Press release]. https://www.archives.gov/press/press-releases/2011/nr11-94.html

Ojanuga, D. (1993). The medical ethics of the “father of gynaecology,” Dr. J. Marion Sims. Journal of Medical Ethics, 19(1), 28–31. https://jme.bmj.com/content/medethics/19/1/28.full.pdf

Woodhead, L. (2000). Holocaust on trial [Film]. Nova. https://www.pbs.org/wgbh/nova/holocaust/

Zellars, R. (2018, May 31). Black subjectivity and the origins of American gynecology. Black Perspectives. African American Intellectual History Society (AAIHS). https://www.aaihs.org/black-subjectivity-and-the-origins-of-american-gynecology/