A question of ethics in health research

Thursday 31 Mar 2016

An internationally recognised academic from Charles Sturt University (CSU) is stressing the importance of looking to history in defence of ethical human research.

Professor of Nursing Linda Shields, from the School of Nursing, Midwifery and Indigenous Health at CSU in Bathurst, is co-editor of Nurses and Midwives in Nazi Germany The "Euthanasia Programs".

Professor Shields recently delivered a lecture titled Why we need human research ethics committees: health professionals and the crimes of Ravensbrück and Auschwitz Concentration Camps - the first of a series of presentations highlighting the work of the University's School of Nursing, Midwifery and Indigenous Health to improve the health outcomes of rural and remote Australians.

She said, "History tells us that unethical research is not new, and we all need to know what has occurred in the past so it can't happen again."

Professor Shields highlighted the importance of modern day Human Research Ethics Committees (HREC) in any research involving humans.

 "In fact researchers cannot go ahead with research which is not approved by these committees," she said.

"It is about the protection of the individual and the public. The committees ensure that people who are invited to be part of any research are given things like informed consent, the ability to withdraw any time they like and an understanding of any risk involved in the study.

"These requirements were first codified in the early 1900s in Germany, who were the world leaders in research at the time.

"But with the rise of the Nazis, all that changed, and dreadful crimes were committed by scientists, doctors and nurses in the name of 'medical science'.

"From the Nuremberg trials of Nazi war criminals came the Nuremberg Code for Research Ethics. It remains the basis for all HRECs around the world today.

"The atrocities committed by the Nazis and health professionals in concentration camps at Auschwitz and Ravensbruck are an eternal and constant reminder of why ethics approval for research is so important to protect the well-being of people who take part in research."

The National Statement on Ethical Conduct in Research, developed by the National Health and Medical Research Council (NMHRC), states that research often involves public interaction between people that serves a public good.

"There is, therefore, a public responsibility for seeing that these interactions are ethically acceptable to the Australian community," Professor Shields said.

"There have been many instances of highly unethical research since World War Two. One of the most recent, and most notorious, was in Auckland in the 1970s when women with cervical cancer were left untreated so doctors could study the natural course of the disease.

"One of the worst things we can do is think it could never happen again.

"Australia has really good guidelines and human (and animal) research ethics committees exist in all universities and health services.

"Academic journals usually won't publish research for which no ethics approval has been granted.

"However one of the problems is that the NHMRC has no real auditing role, rather, checking on the ethics committees themselves is left to self-regulation.

"While I know of no record of an ethics committee behaving unethically, there is no independent oversight to check that it does not happen."

In late 2015, Professor Shields was inducted as a Fellow of the American Academy of Nursing in the United States.


Media contact: Fiona Halloran and Emily Malone , (02) 6933 2207

Media Note:

Professor Linda Shields is in the CSU School of Nursing, Midwifery and Indigenous Health in Bathurst. She is available for interview. Contact CSU Media.

Nurses and Midwives in Nazi Germany The "Euthanasia Programs" is published by Routledge Studies in Modern European History.

The National Statement on Ethical Conduct in Human Research was updated in May 2015. It can be found here.