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Chapter 3 Research Framework
with the Hippocratic oath, which promises to do no harm, and therefore research
should not cause harm either intentionally or unintentionally. The question of justice,
according to the Belmont report, is about who ought to receive the benefits of
research and bear its burdens. Beauchamp and Childress (1994) further state that
justice is about fairness and treating people equally.
3.11.1 Ethical issues in undertaking research with older people
For the purpose of this study research ethics are discussed in relation to older people
in residential care. Older people are considered to be a potentially vulnerable
research population (Aselage et al., 2010). The USA National Bioethics Advisory
Commission (2001) explain that people may be vulnerable due to intrinsic rather
than situational characteristics. In other words, their intrinsic disease process such as
dementia may make them more vulnerable. Holloway and Wheller (2010) state that
older people are particularly vulnerable due to their ill health, chronic disease, and/or
fatigue, and because of this they may be unable to give fully informed consent.
Therefore additional strategies to ensure informed consent is obtained may be
needed. Hagerty-Lingler et al. (2009) propose that consent for research participation
in a residential care unit for older people should be sought not just from the resident
but also from the organisation and from the staff. Disclosures at resident level must
ensure that residents do not perceive that refusal would compromise interpersonal
relationships with staff or other residents. Disclosures at the organisation level
should incorporate the extent to which the research study will disrupt the daily
routines of residents and staff who will or will not directly participate in the research
study. Disclosures at staff level must assure staff that participation is voluntary.
Many older people living in residential care may also have dementia. This makes
obtaining informed consent from residents more challenging, yet important to
achieve. Aselage et al. (2010) discuss the importance of including residents with
dementia in the inclusion criteria for research studies in residential care settings.
They stated that “it is a widely held belief that persons with dementia should be
included rather than excluded in studies that would benefit themselves or others” (p.
11). Yet no internationally recognised guidelines exist for conducting research
studies with this population. Federal guidelines in the USA do not go beyond stating
that “additional safeguards” should be taken. Aselage et al. (2010) confirm that there