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The Ethical Issues and Practical Steps for Provision of Auxiliary Care in Research
Ancillary care is an important aspect of human subject research, yet is frequently overlooked by researchers. The ethical issues involved and the practical steps to ensure that researchers meet their ancillary care obligations are discussed in this article. Additionally, it covers context-specific factors affecting the provision of ancillary care in research.
Efforts to standardise ancillary care in research
The absence of standardized guidelines for ancillary care in research is a major problem in the field of medical research. This lack of standardisation is exacerbated by the fact that context is a significant factor in the decision to participate in a medical study. For example, health care services are often inaccessible to those living in resource-constrained communities. Further, the vast majority of research ethics committees lack the relevant guidance. To combat this situation, specific guidelines should be developed for decision makers to use in their research.
We conducted a systematic search of published articles to identify relevant studies. The review included both qualitative and mixed-method studies relating to ancillary care. It also included theoretical articles examining the ethics of ancillary care. We adhered to PRISMA guidelines when synthesising published data from these studies. Nevertheless, we did not require ethical approval or informed consent for the studies because the data were already available in the public domain.
Ancillary care in research may promote individual participation in medical research. However, if participants are not receiving any form of ancillary care, they cannot be considered a benefit of research participation. Furthermore, the majority of included studies did not mention potential ethical conflicts, which suggests that the concept of ancillary care may confound benefits of research participation with clinical care, leading to ethical errors.
Ethics of ancillary care in research
The ethics of ancillary care in research is a critical area of concern, especially in resource-constrained settings. There is a clear need for better guidance and definitions, especially for developing countries. However, current discussions on this topic are limited by 3 key issues. One problem is that the focus is primarily on the relationship between the researcher and the individual participant, rather than the study’s primary unit. Another problem is that the burden of assessing the ethical value of ancillary care is placed on the principal investigator, which puts them at risk for being accused of unethical behavior. In addition, the lack of specific guidelines for decision-making in research makes the process less efficient and prone to controversies.
Ethics of ancillary care in research is a global issue. A growing body of literature outlines the importance of providing care to research participants. However, discussions have not focused on the central ethical concept of ancillary care. Increasingly, participants and communities in low-resource settings are demanding care and protection from researchers.
Practical steps to meet ancillary care obligations in research
Ancillary care is a growing area of ethical concern in medical research. However, there are no standardized guidelines for the provision of such services. Research participants’ rights are often constrained by cultural and contextual factors. This is especially true for participants from resource-constrained communities. Moreover, research ethics committees often lack the necessary guidance and resources to make informed decisions about the provision of health care in research.
To address the issue, the Council for International Organizations of Medical Sciences recently revised its ethical guidelines, acknowledging the ethical need to provide ancillary care. These changes shift the emphasis from a sole focus on the protection of study participants to including the provision of additional care. These changes are a sign of a major evolution in the ethical conduct of research. However, the terminology used by research ethics committees to explain the ethical responsibility to provide ancillary care is still too vague.
Researchers must take practical steps to meet ancillary care obligations. These obligations are derived from the health capability paradigm. Moreover, AC obligations must be made available for the participants, who may have medical conditions that are not adequately addressed by the local health care system.