Ethics is a discipline that seeks to answer the questions: “what is right?” and “what is good?” That is norms for conduct that distinguish between acceptable and unacceptable behavior. Ethics is also defined as the science of morals, a treatise on morals or rules of behavior. “Ethics” is a generic term for various ways of understanding and examining the moral life and for resolving ethical problems (Beauchamp, 1994). Ethical standards are the generally accepted rules of conduct that govern society and are meant to bring about behavior change in the society.
Ethics are important in the society in that it promote good practice in research by ensuring that: research is within ethical limit; research participants are given sufficient information in order to make a fully informed decision on whether to take part; researchers have due regard for the respect of participants through protection of privacy and confidentiality and fulfilment of research funder requirements. Moreover it is an insurance requirement to be followed and adhered to. It also promote the goals of research, such as knowledge, honest, and avoidance of error. Ethics at large also promotes the values that are essential to collaborative work, such as trust, mutual respect, accountability, and fairness and helps to ensure that researchers can be held accountable to the public if they breach the ethical rules.
Ethics are actions that are correct, magically based on feelings, religiously based on values and scientifically based on observation and research of events. In ethics verses morals, ethics is a theory of behavior while morals are a practice of behavior. This indicates the distinction between what is good and what is evil in the everyday life. Both ethics and morals are the result of the society’s evolution towards “standard” behaviors. Morality in this case means those standards everyone wants everyone to follow, even if everyone else following them means having to follow them oneself. Morals encompass all forms of human behavior and action that is implicitly or explicitly aligned with values and standards.
In ethics verses religion, religion is a set of beliefs about the world or a moral code for being in the world. Rejection of the Bible and other religious authority removes all divine constraints toward honesty, purity, charity, etc. Evolution becomes the basis for the new scientific ethics and almost all religions have accommodated evolution in one form or another. Sir Arthur Keith postulated that “… the conclusion that I have come to is this: the law of Christ is incompatible with the law of evolution – as far as the law of evolution has worked hitherto. Nay, the two laws are at war with each other; the law of Christ can never prevail until the law of evolution is destroyed.”
All ethical aspects are not explicit in that there is breach of ethical rules especially in research work whereby the privacy and confidentiality of the information gathered from the subjects are not protected as expected or research work is done without an inform consent. This is also seen in scenarios where is the use of data collected for one purpose for other statistical and research purposes without explicit informed consent. In these situations people can feel wronged without being harmed by research: they may feel they have been treated as objects of measurement without respect for their individual values and sense of privacy. Ethical lapses in research can significantly harm human and animal subjects, students, and the public. Ethical guidelines are issued by the American Mathematical Society (AMS) committee council and Social Research Association (SRA) Ethics Committees.
Professional ethics are codes of behavior and values agreed on by members of a society or organization. The Codes of ethics in professional include: contracts with the society at large, obligations of health care professionals to the public, professionals are accountable for ethical standards set forth in the codes and the ethical standards of each professional group are the ethical principles. The accepted principles providing for ethical practice of medicine and research on human subjects are based on recognition of the ideals of autonomy of the person and confidentiality, beneficence (to do the right thing), concerns for human dignity & human rights, non-malefi cence (to avoid causing damage) and respect for national laws and international conventions (Wertz et al, 2003). Medical professionalism is a complex topic which includes a consideration of both individual and collective physicians, societal and patient rights and obligations. It pays attention to individual practitioner, policy development, and national and international advocacy efforts by physician organizations such as the World Medical Association and others (Blackmer, 2009).
The American Occupational Therapy Association (AOTA) Occupational Therapy Code of Ethics and Ethics Standards (2010) (“Code and Ethics Standards”) is a public statement of principles used to promote and maintain high standards of conduct within the profession. The Occupational Therapy Code of Ethics and Ethics Standards (2010) was tailored to address the most prevalent ethical concerns of the profession in education, research, and practice. The Core Values and Attitudes of Occupational Therapy Practice (AOTA, 1993) include: altruism, equality, freedom, justice, dignity, truth, and prudence.
Professionals should practice beneficence whereby they should demonstrate a concern for the well-being and safety of the recipients of their services. This includes all forms of action like altruism, love, and humanity that are intended to benefit other persons. It requires taking action by helping others, by promoting good, by preventing harm, and by removing harm. It connotes acts of mercy, kindness, and charity (Beauchamp & Childress, 2009). The personnel should practice nonmaleficence where they should intentionally refrain from actions that cause harm to other people. It requires action to incur benefit, and to avoid harm. It also includes an obligation to not impose risks of harm even if the potential risk is without malicious or harmful intent. This principle often is examined under the context of due care. If the standard of due care outweighs the benefit of treatment, then refraining from treatment provision would be ethically indicated (Beauchamp & Childress, 2009).
The principle of autonomy and confidentiality expresses that practitioners have a duty to treat the client according to the client’s desires, within the bounds of accepted standards of care and to protect the client’s confidential information. The respect for autonomy goes beyond acknowledging an individual as a mere agent and also acknowledges a “person’s right to hold views, to make choices, and to take actions based on personal values and beliefs”. The rights and responsibilities in the society should be fair equitable and appropriately distributed (Beauchamp & Childress, 2009). The principle supports the concept of achieving justice in every aspect of society rather than merely the administration of law. The individuals and groups should receive fair treatment and an impartial share of the benefits of society. The personnel should have a vested interest in addressing unjust inequities that limit opportunities for participation in society (Braveman & Bass-Haugen, 2009).
The personnel should comply with institutional rules, local, state, federal, and international laws that is procedural justice which is concerned with making and implementing decisions according to fair processes that ensure “fair treatment” (Maiese, 2004). The personnel should provide veracity which is comprehensive, accurate, and objective transmission of information when representing the profession. This is based on the virtues of truthfulness, candor, and honesty. By entering into a relationship in care or research, the recipient of service or research participant enters into a contract that includes a right to truthful information (Beauchamp & Childress, 2009). The personnel should also practice the principle of fidelity which refers to being faithful; having obligations of loyalty and the keeping of promises and commitments (Veatch & Flack, 1997).They should also treat colleagues and other professionals with respect, fairness, discretion, and integrity. The professionals should respect fidelity by meeting the client’s reasonable expectations (Purtillo, 2005).
In the Code of Professional Conduct: responsibilities, the public interest, integrity, objectivity and independence, due care and scope and nature of services are the core fundamental qualities which govern professional ethics. The professionals should have responsibilities to exercise sensitive professional and moral judgment in all their activities. They should accept the obligation to act in a way that will serve the public interest, honor the public trust, and demonstrate commitment to professionalism, broadening public confidence and performing all professional responsibilities with the highest sense of integrity.
According to Human Genome Project Information (2006), the ethical, legal and social issues looked into that arise from Genome sequencing included: fairness in the use of genetic information by insurers, employers, courts, schools, adoption agencies, and the military, among others. There should be clear guidelines on who should have access to personal genetic information, how it will be used and who owns and controls genetic information. The privacy and confidentiality of genetic information should also be observed and the ownership and who should controls genetic information should be determined. The disclosure and confidentiality issues are ethical problems appearing in medical genetics. Utmost care should be taken to protect confidentiality so as to prevent the possibility of harm from disclosure to institutional third parties. However, sometimes a genetic diagnosis in an individual may indicate genetic risks in his/her relatives and such cases; the genetic service provider should encourage the individual to ask the relatives to seek genetic counseling.
Psychological impact and stigmatization due to an individual’s genetic differences is also an ethical, legal and social issue that needs to be looked into. There are many issues that need to be addressed like how does personal genetic information affect an individual and society’s perceptions of that individual? How does genomic information affect members of minority communities? What is the psychological impact and stigmatization due to an individual’s genetic differences? The affects of genetic information on an individual and society should be addressed in order to avoid psychological trauma and stigmatization of the individuals and minor communities affected. The reproductive issues including adequate informed consent for complex and potentially controversial procedures, use of genetic information in reproductive decision-making, and reproductive rights are also ethical and legal matters that affect the survival of the human beings. The questions raised included whether healthcare personnel properly counsel the parents about the risks and limitations of genetic technology, the reliability and usefulness of fetal genetic testing and the larger societal issues raised by new reproductive technologies. Reproductive issues including use of genetic information are another important aspect in reproductive decision making, and reproductive rights (Peterson, 2001).
Clinical issues including the education of doctors and other health service providers, patients, and the general public in genetic capabilities, scientific limitations, and social risks; and implementation of standards and quality-control measures in testing procedures. The questions are raised on how will genetic tests be evaluated and regulated for accuracy, reliability, and utility? How do prepare healthcare professionals for the new genetics? How do prepare the public to make informed choices? How does a society balance current scientific limitations and social risk with long-term benefits? Wertz (2003) urged that “besides various clinical issues, we need to provide facilities to educate the doctors and other health service providers, patients, and the general public in genetic capabilities, scientific limitations, and social risks”.
Uncertainties associated with gene tests for susceptibilities and complex conditions like Alzheimer’s disease and heart disease are linked to multiple genes and gene-environment interactions. Controversies have been raised on this issue concerning testing and treatment of these subjects. The point of discussion here is should testing in these patients in situations where treatment is not available? Should parents have the right to have their minor children tested for adult-onset diseases? Are genetic tests reliable and interpretable by the medical community? This are the questions raised which needs immediate response in order to fulfill the ethical, legal and social issues in the society. Shostak (2006) stated that genetic testing is also likely to raise significant ethical, legal, and social issues for people with epilepsy, their care givers and the health care planners.
Commercialization of products including property rights and accessibility of data and materials is another ethical and legal that has raised a lot of concern in the society. The question on who owns genes and other pieces of DNA and whether the patenting DNA sequences will limit their accessibility and development into useful products has been of worry in the society. The proper use of biological material collected for genetic research need to be rigorously defined according to ethical principles agreed upon by both scientists and patients (Beauchamp, 1994). Conceptual and philosophical implications regarding human responsibility, free will versus genetic determinism, and concepts of health and disease have also raised diverse views concerning the behavior of the individuals. The questions raised are whether the people’s genes have any association with their behaviors and can they always control their behavior? The is also health and environmental issues concerning genetically modified foods and microbes whereby the questions concerning the genetically modified foods and other products are raised as to whether they are safe for human consumption or not.
Principles of ethical research in biological sciences and society rests on a set of fundamental ethical principles which are the most fundamental unit of ethical analysis since all norms and guidelines are derive from them. Ethics alone is stagnant; rather it is important to use the existing ethical framework to weigh up the risk of harm against the intended benefits of any new technology. Nonetheless, like constitutions, ethical principles and guidelines need interpretation and debate; different ethical principles can at times be in conflict. Ethics is not a formula, but a process of reflection and weighing of choices.
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