Double agency in clinical research

Area of Science:

• Nursing Ethics
• Clinical Research
• Human Subject Protection

Background:

• Evidence-based practice in nursing necessitates nurses engaging in research.
• This dual role, acting as caregiver and researcher with the same individuals, presents unique ethical considerations.
• The fiduciary nature of the patient-caregiver relationship is central to these ethical concerns.

Purpose of the Study:

• To examine the ethical issues arising from nurses assuming dual roles as caregiver and researcher.
• To analyze specific challenges in recruitment, informed consent, data collection, and participant withdrawal.
• To identify strategies for preventing or minimizing problems associated with this double agency.

Main Methods:

• Literature review and ethical analysis.
• Examination of professional codes of ethics.
• Consideration of guidelines from the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans.

Main Results:

• Dual roles can lead to real and perceived conflicts of interest.
• Ethical challenges are particularly pronounced during participant recruitment and informed consent processes.
• Maintaining participant autonomy and trust is paramount when navigating these dual responsibilities.

Conclusions:

• Nurses must be vigilant in managing the ethical complexities of dual roles in research.
• Implementing robust strategies, guided by ethical codes and policies, is crucial.
• Proactive measures are essential to uphold the integrity of the patient-caregiver relationship and protect research participants.