Case Analyses (Ethics Discussion) for Participants in the Jordan RCR Program Year 1 (2015-2016)

  

1) Authorship Argument:

By:Dr. Abeer Rababa’h

Authorship is a matter of public credit and accountability for the work that has been done and it is a hot topic that we face in Jordan as scientists and researchers. As a regulation for promotion at Jordan University of Science and Technology you need a certain number of first author and co-author papers for promotion; which generates an area of argument between researchers themselves and graduate students about “Who Should Be The First Author?”.

Based on the major concepts that we learned in our intensive Responsible Conduct of Research (RCR) course, the researcher along with their collaborator should be clear and arrange the authorship list from the beginning of the proposed project. Each author on the manuscript should provide all the accepted criteria for being listed on the authorship: the scientist should participate intellectually in research hypothesis, experimental design, running the project, analyzing data, interpreting results, writing the manuscript and approve the final version to be published.  By applying these concepts of authorship, we avoid possible misunderstanding and arguments that may hinder the process of research development. Additionally, planning and accepting specific authorship criteria confirms the basic values of conducting a responsible research and settle the research environment transparency and productivity.

The structure of keeping a successful ongoing research in Jordan University of Science and Technology as an institution is highly dependent on the policy makers and funding agencies that are responsible for setting the authorship criteria clear and fair enough since they are considering authorship as a proof of productive participation that permits promotion. Finally, we should always retain the concept that the privilege of authorship is always connected with a high degree of responsibility and accountability.

 

2) The Religious Prospective During Data Collection in Jordan:

By:Dr. Mahmoud Alomari

In most societies, religion and beliefs is a sensitive issue. In Jordan, and Arab and Muslim countries, religion is particularly important. The Islamic teachings and roles intervene in all aspects of daily life, let alone during obligatory worshiping. It has recommended ways for Muslims to eat, drink, and sleep. For example, they are not allowed to eat pork, road kills, or predators. They are also asked not to consume alcohol or harmful materials (i.e. recreational drugs). Therefore, researchers should be thoughtful of these prohibited consumables during data collection from individuals in the Islamic faith.

Additionally, the daily prayers, which should be observed 5 times/day are priority for the Muslims. Thus researchers should be sensitive to these prayer times. Fasting the month of Ramadan is another obligatory practice, during which Muslims fast from sunrise to sunset. Studies involving eating and drinking should consider these hours in Ramadan. Additionally, studies involving exerting muscular effort (i.e. exercise) requiring unusual energy demands should account for these hours.

Gender interaction is another important issue, as it should be limited. For example, according to Islamic teaching, cross-gender hand-shaking is prohibited. The dress code, for men and women, is of a particular interest. Men should cover between the belly button and knees whereas women should cover the entire body except the hands and face. The dress should be unrevealing and un-transparent for both genders. Women should seek spouse permission before committing to unusual tasks (i.e. volunteering for research). Though many times, spouses don’t mind, women usually ask permission when donating blood or other biological remnants.

I think researchers should be “hypersensitive” to these and other Islamic-related issues. They should not go against, or encourage participants to go against these Islamic teachings and worships. These concerns are only few and superficially discussed. Therefore, religious scholars should be consulted before data collection in Muslim societies. Committees, that include religious scholars, are needed to account for regional special needs.

 

3) Authorship of Published Articles:

By: Mohammed Ahmed

Authorship of published articles is one of the basics that employers use to evaluate academic achievements for employment, promotion, and tenure. In academic publishing, authorship of a work is claimed by those making intellectual contributions to the completion of the research described in the work. Authorships are vulnerable to a wide range of malpractices. Unfortunately, there are many junior researchers who add the names of senior researchers as coauthors without any contribution at all, to increase their chances for publication, a practice known as gift authorship. The ethical dilemma in this can be described as why someone should be credited in my work for something that he has not been involved in?

Especially that academic publications offer researchers both financial and social benefits which means that they will be granted these benefits without the right to actually have them, which happens to be one kind of unethical practice. This malpractice will falsely represent the individual’s expertise, and give such person unfair advantages over his colleagues. Not to mention that some of the professors who demand their students to credit them in their work, or at least take their students’ work and present it at regional conferences as if it’s their own. Such malpractices should be tackled by the scientific community with strict rules and protocols to protect the rights of everyone. Recently, journals started asking corresponding authors to list the contribution of every coauthor in an effort to minimize these practices. These issues may apparently reduce this practice, but will never resolve the problem completely. In my opinion, it’s all about integrity and honesty as it carries a unique and moral overview.

 

4) Testing Carrier Status in Children

By: Maram Quttina

Human genome sequencing unraveled the ability to screen mutations that occur on the level of one base pair nucleotide change. Although this thing was a huge breakthrough; it held many ethical issues and many debates.                                                                                                                           .

Testing carrier status in children is a great issue that may expose the future of a child to be disturbing; upsetting and even horrible.

The basic ethical principle of informed consent form stated that an individual can freely and voluntarily choose to be tested without any external pressure after being informed of the benefits and risks of the study and this point guides us to the act of ”waiting” until the child becomes a grownup and has the ability to choose either to do the test or not.

Parents are separated about this issue in our culture and this may be related to the degree of their education and to the fact that genetic related diseases are “alarming”; also the fact that there is nothing that can be done about it.                                                                                         .

Testing carrier status will invade the privacy of a whole family; it is not about one individual; it is about the next generation to come.                             .                                                                       .

In my point of view we have to step back and think deeply about each situation separately because every genetic disease differs in severity, and the way we handle each one. If the potential benefits of this testing it will over weigh the harm of it and will provide a preventive way and  better medical care in the future; so it is okay to do the test . Though performing the test might help the child to adapt to the knowledge of being a carrier slowly, while receiving such information later could be more shocking. On the other hand performing such a test will affect the future reproductive prospects of a child and ruining his /her life.

5) Researchers Ethical Dilemmas:

By:Dr. Hanan Khalil

Researchers face ethical dilemmas on a daily basis. Ethical dilemma can be seen as a problem without an agreeable resolution in which the ethical- decision making process relies on the fact that different choices can be made resulting in a choice that is considered to be neither a ”right or wrong” decision.

Research ethical principles involve doing ”good” and causing no harm as well as respect to human subjects. Although these principles give the researcher the tools to base ethical decisions upon, it should also be noted that such decisions can be shaped by the values, beliefs and experiences of the researcher. On the wider perspective the cultural and societal aspects of a certain community or population may also have an impact on the ethical-decision making process.

There are many ethical dilemmas that researchers in the medical field can encounter. A good example that has been widely spread and debated nowadays is the use of embryonic stem cells in research; to date the topic still divides opinions. The ethical dilemma about this topic arises as it enforces researchers to choose between two moral principles; doing ”good” by preventing or alleviating suffering and the ”respect” to the value of human life. It becomes widely known that the embryonic stem cells can have unlimited implications in obtaining new therapeutic interventions for different un-curable diseases which means the potential of alleviating the suffering of many people in future. However, to obtain embryonic stem cell, the early embryo has to be destroyed (i.e. terminating a potential human life).

The debate regarding this issue is rooted on what defines a ”person” and whether an embryo has the status of a ”person”. For example, some people believe that the development from a fertilized egg into an embryo is a continuous process; thus a human embryo is a human being (i.e. a person) in the embryonic stage and any attempt to terminate this stage therefore is prohibited. On the other side, other people view that the embryo has not yet been implanted into the uterus and has not been associated with the physical or emotional properties of a human being and therefore should not be treated as a person.

The religious views have also influenced the discussion regarding this ethical dilemma in which different religions viewed the status of an early embryo in different ways. Whilst the Christian churches believe that embryos have the status of a human being and therefore research on embryos should not be allowed, Judaism and Islam believe that an embryo has the status of a human being only after 40 days from conception and therefore embryonic stem cell research can be permitted to allow the help of others.

In Jordan as in most other Arabic countries, Islamic believes are still the main influential factors in ethical-decision making processes for Muslim people. Thus, Islamic belief may also influence researcher’s decision making regarding embryonic stem cells in Jordan. Overall, bioethics need to be incorporated into the medical curriculum to increase the awareness of our graduates regarding such significant issues and how they can be addressed from different perspectives.

References:

1. de Vries RB et al. Ethical aspects of tissue engineering: a review. Tissue Eng Part B Rev.2008;14(4):367-75.
2. Manzar N et al. The ethical dilemma of embryonic stem cell research. Sci Eng Ethics.2013;19(1):97-106.

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6) Ethical Issues In Nutritional Epidemiology In Third World Countries

By:Dr. Rami M. Mukbel

Doing epidemiological studies on nutrition and correlating the results on the public health than generalizing the result for the whole population may cause serious ethical issues. Nowadays, reading in the literature or in the news about eating or drink specific nutrients that might help or harm you is a very big issue.  Researchers who just do surveys or are focusing on one nutrient in a study without taking in consideration other factors or variables that might influence the results and conclusion will have a big ethical issue.

For example, if we conduct a study of the influence of consuming specific animal products on an individual’s health.  A nutritionist making a survey without taking in consideration the consultation of specialists in animal production or veterinarians will have major problems in their data.

Data should consider; the source of that food, the way these animals were raised, including their type of feeding, food additives and the drugs administered to these animals that might reach the consumer without knowing it.

In addition the health status of these animals, they might contain zoonotic diseases or pathogen byproducts that might affect human health.  One big issue in third world countries is the misuse of drugs in animals by farmers without the supervision of the veterinarians. This usually causes many problems including the residual drugs that disseminate through animal products and meat, especially if they don’t respect the withdrawal time for each drug. In some cases, the drug residuals for antibiotics that sometimes are not approved to be used in humans and might cause serious problems. But even if approved, the consumption of these drugs in low doses will cause drug resistance for common pathogens resulting in multi-drug resistant strains.

Nutritional epidemiology is a very complex issue to deal with, especially if we need to apply the studies done in developed countries with very strict monitoring systems on food quality, drug use in animals and chemicals used in plants, compared to third world countries. For that, I suggest to have more research done on the food quality offered to consumers before surveying there role on their health.

 

7) Striking/Hitting School Children In Jordan By Teachers and Principals

By:Dr. Nihaya Alsheyab

Unfortunately, in Jordan the scene of striking/hitting school students is a common one especially in public schools. This unacceptable behavior is totally forbidden according to the Jordanian Ministry of Health guidelines and policies, yet it has not been enforced by some teachers and principals. Even worse, the Ministry of Education rarely takes an action against those who abuse children physically in school.

The justification behind this bad behavior, according to teachers and principals’ perception, is that this is the most effective way in punishing students for their behavior in school and sometimes can be the only way of discipline.

Students on the other hand, hate this attitude by school staff and try to strike and complain to their parents, who in turn, could be passive about it most of the time and sometimes they encourage it making teachers and principals use this behavior even more!

Few parents, however, try to complain to relevant authorities, but usually the case is not fair as principals and teachers have connections with authorities, who cover their actions.

Striking/hitting school children can lead to profound physical and psychological trauma and could make them hate school, which could affect their academic achievement and motivation to learn. This is a form of sexual abuse that should be reported directly to assigned authorities. As a researcher, it is very hard to collect data from schools and having to witness this bad behavior. This is an ethical issue that we, as researchers, encounter most of the time and do not know what to do about it.

Unless the Ministry of Education and other stakeholders in Jordan start to take serious and tough actions against those who hit children for no right, the problem will continue.

 

8) Selectivity in Data Presentation and Reporting

By:Dr. Nehad Ayoub

Researchers test hypotheses. Some results generated may not coordinate with assumptions made and tested. Indeed, explanation of such results in the context of other findings that work along with supporting a research hypothesis is challenging. Life becomes easier if these results are to be excluded from the final draft of the manuscript, or, not to be presented as part of the data generated. This raises the question of “Selective” data reporting. Is it ethical?

Some would argue that selective presentation of pieces of data may be acceptable. However, would such practice affect the impact and significance of the research work published? Would it be possible that reporting negative results or other findings that do not follow the flow of the other results indicate the potential for other interpretations and opens doors for alternative research directions? Nevertheless, is selective reporting perceived as a way of dealing with selectively with some facts while, deliberately, ignoring others. Does this make a big difference from the term “bias”? I don’t think so.

Scientists run experiments to answer questions. But, is it expected to always come with explanations for the data generated experimental settings. If transparency is a priority (which should be the case), reporting relevant findings (positive and negative) in a research is needed regardless of the fact that “Can I explain them or not”.

In line with this, scientific journals, editors, and reviewers should appreciate and understand such findings which are expected during research work, and it should not hinder the publication of well-designed and important research proposals. Alternatively, scientific editors should raise questions for other data not submitted and be able to identify the weakness of certain theories. In addition, it is crucial to emphasize the impact of selective documentation and presentation of data through special workshops that deal with academic integrity and ethical considerations among researchers.

 

9) Ethical Dilemma

 By:Dr. Mera Haddad   

Katie is a graduate student doing her PhD in optometry. She’s studying the wettability for four types of contact lenses manufactured by four different companies, one of which funded Katie’s project. Katie is also studying the relationship between the wettability of contact lenses whilst on eye and subjective comfort. She hypothesized that enhanced wettability of contact lenses could be correlated with improved comfort.

The participants had to wear the four types of lenses for one day with a one week wash-out period between different lenses. This period was essential to clear out the effect of each type of contact lenses used in the study. The wettability was assessed on the day of lens wear and subjective comfort was recorded for each subject.

Despite her supervisor’s opinion that only 10 patients were enough to draw a conclusion, Katie insisted on 20 patients so she could have stronger evidence.  She assessed the first 10 patients and then she was very short in time to assess the remaining 10 patients following the same protocol. Therefore, she decided to finish her experiment without the wash-out period between different lenses.

The results showed that the lens type that was most wet and had best reported comfort when worn in the eye was not the lens of the funding company; it was for one of the competitors. Additionally, Katie’s hypothesis about a strong relationship between wettability and comfort was achieved despite the changes she made in the protocol, i.e. omitting the washout period for the last 10 patients.

Issues Raised:

• To what extent are the research outcomes influenced by the funding source? What was the possible solution for that?
• Could Katie present her work in a conference or publish her findings?
• The correlation between wettability and comfort was an outstanding finding and a hot topic that most researchers were looking forward to reading in a published article.Could Katie publish her results without feeling guilty that the outcome might have been affected when she changed the protocol?

 

10) Ethical Issues Concerning Clinical Trials of Developing New Vaccines against Infectious Diseases on Children

By: Farah Alhashimi

The need for new, more effective, improved vaccines against infectious diseases has increased. Depending on the fact that vaccine preventable diseases become one of the most leading causes of death in the world and the lack of effective therapies for many of these diseases makes conducting clinical trials of new vaccines an essential requirement for prevention.

Most of these trials are conducted on children. It is generally agreed that exposing children to the risks of vaccine trial is unethical unless clear justifications are provided, as the compelling need for use of children to establish safety, immunogenicity, and efficiency of the trial. Also some trials cannot be done on adults since many infectious diseases are considered pediatric diseases and cause more harm in young children. In order to decrease risks, age de-acylation where phase one and two are conducted on adults first than on older children. But in some cases, like DTP vaccine, age de -acylation cannot be done, due to prior immunity in adults.

Children are vulnerable participants. Informed consent forms should be taken from their parents or from any legal representative, who should explain what is happening in the trial to their children. The consent should contain a complete description of possible risks and benefits. Getting valid consent is problematic in developing countries where people may be unfamiliar with scientific research, concepts and vocabulary, and doubled in case of children. Also the society’s cultural and/or gender norms, or the family or spousal pressure affect individual’s autonomy.  On the other hand, for economic benefits, parents may encourage enrolling their children. All efforts should be made to avoid any exploitation.

The informed consent should explain the meaning of randomization and the chance that the participant may fall in a placebo group, in this case protection against the disease cannot be ensured. Placebo controls are ethical if there is no proven vaccine for that disease or if the placebo recipients receive the true vaccine later. Placebo could be replaced by use of another vaccine that provides comparable benefits against another disease without the results of the trial.

To minimize all mental, emotional and physical harm, screening for healthy children and determining of exclusion /inclusion criteria is a critical step. Besides that, active follow-up should extend at least to the end of the trial. In case of an adverse effect, the, follow-up should be continued for an additional six months.

All pediatric trials should be subject to strong regulatory and ethical reviews in order to protect the best interests of the child participants, and should be conducted in accordance with GCP guidelines.

 

11) Informed Consent in Qualitative Research

By:Dr.Khulood Shattnawi

In research, researchers are responsible for ensuring that participants are well informed about the aims of the study that they are participating in, and that they understand the risks and the benefits that may occur during the course of the study. However, there are certain situations where valid consent is problematic and difficult to obtain from all research participants. In such situations, alternative approaches for consenting should be sought in order to maintain ethical principles in research. Examples of situations where consent is difficult to obtain are: Emergency Care research, participants who are unable to consent, future studies in already obtained tissue samples, and qualitative research such as Ethnographic Studies in which researchers observe a particular culture for certain behaviors.

In Ethnographic Research, it is difficult to obtain informed consent since it is not clear from the beginning what the participant is consenting to and where participation begins and ends (Miller and Bell, 2002). In this case, many questions arise including:

Who are the research participants?

Who needs to provide an informed consent?

What is the best way to obtain consent?

Since it is not clear for participants in Ethnographic studies what they are consenting for, a different approach for consenting would be more appropriate. Miller and Bell (2002) recommended that consent should be ongoing and should be renegotiated throughout the research process. Speziale and Carpenter (2007, p. 64) recommended that “consensual decision making” or so called “process informed consent” is more appropriate for qualitative research. Here the researcher re-evaluates the participants” willingness” to continue to be involved at different points in the research study. According to Speziale and Carpenter (2007), a “process consent offers the opportunity to change the original consent as the study emerges and change becomes necessary” (p. 64).

Being honest about the researcher’s identity is always important, as well as, what the researcher is going to do with the data collected from the research setting. When written consent may negatively impact on the quality of collection qualitative data, it becomes less necessary, and thus alternative methods of consenting should be negotiated with the IRB committee.

References:

Miller, T. and Bell, L., 2002. Consenting to what? Issues of access, gate-keeping and, informed consent. In: M.L. Mauthner, M. Birch, J. Jessop and T. Miller, eds, Ethics in Qualitative Research. London: SAGE Publication, pp. 53-69.

Speziale, H.S. and Carpenter, D.R., 2007. Qualitative research in nursing: advancing the humanistic imperative. 4 edn. Philadelphia, Pa.; London: Lippincott Williams & Wilkins

 

 12) Authorship in Research

By:Dr. Nafez Abutarboush

The most encountered unethical behavior in research involves issues relevant to authorship. Misconduct in authorship is frequently encountered specifically when a basic scientist is dealing with basic research involving patients where the need for a clinician to facilitate the work is apparently a prerequisite, for example blood sampling.

Academic clinicians over here, generally speaking, have no interest in research and they find themselves running their clinical practice with all their time and effort, without devoting sometime for pure research. Nevertheless, they need publications for their promotion. This emerges when a basic scientist is approaching them to facilitate the consenting of their patients to be enrolled in a project. They neither generate a research question nor participate in the study design; they just have been informed about the study from the principal investigator. Nevertheless, they do require strongly, being coauthors if any publication emerges from the project and sometimes, they ask for first authorship which is required for their promotion.

Dealing with this kind of behavior is very hard. The PI needs to perform research so as to continue his career and to get promoted as well. On the other hand, ethically he is convinced that those clinicians do not deserve authorship and only should be acknowledged. On top of that, they are his colleagues and maybe friends where personal and social embarrassments have a great influence on the researcher.

The researcher will find himself in a dilemma where either to quit any project within his expertise that involve patients, or to accept the situation as is. A third option will rely on causing embarrassment to the clinician by refusing the ghost authorship and making him to accept being not an author. This latter option mostly will not facilitate the project but creates more obstacles from the clinician side. A fourth option, the modest one, where the researcher has to accept the co-authorship of the clinician, however through imposing responsibilities the clinician should perform during the project. Although the fourth option looks like the modest solution, the solution is not as simple and what is encountered in real life that clinicians do not commit to the responsibilities imposed on them. Simply, they do not have time!

When they do not commit, the researcher will encounter the ethical dilemma again, should they be coauthors or not. Including them as coauthors will be considered as research misconduct, and disqualifying them from authorship will create huge dispute since they are already enrolled in the project. This dispute is not healthy, creates a bad environment in the work place and affects every worker in a negative way. Also, it may include legal actions from any side claiming their rights when dispute emerges.

I find an ethics committee within each institution is a good solution. This committee shall include professors with very high reputation, their decisions are independent of any higher authority within the institution, and one of its powers is to define how each researcher is participating in the project submitted. Also, to have each researcher signing off an affidavit expressing the detailed responsibilities he/she will perform during the project. This committee shall have the authority of inspecting any project while it is being done to make sure of each individual’s responsibility. A committee like this will not only solve authorship misconduct in basic-clinical research, but also authorship misconduct in all areas of research at the university.

 

 13) Ethical Issues About Authorship Of Scientific Manuscripts In Jordan.

By:Dr. Ayman Mustafa

Granting authorship among co-investigators and investigators and graduate students is by itself a challenging task to do. One of the reasons for that is the lack of a consensus on a set of guidelines regulating this issue not only at the national level but even at the level of small research teams. Sometimes even a single researcher fails to define clear authorship guidelines that he follows in his lab. For example, I myself as a researcher find myself torn between three opinions when it comes to authorship guidelines. First, the guidelines I learned in my PhD ethics course which focuses on the intellectual contribution. Second, what my mentor used to do, where authorship was granted for collaborators who provided an antibody or a single reagent which we are able to buy by ourselves. Third, what is being done at JUST where authorship decisions are clouded by many factors unrelated to science.

Speaking about Jordan, it is my belief that an unethical assignment of authorship rights is related to the immense competition on being principal author and on increasing the number of publications among University Professors. This competition is driven by the promotion regulations in Jordanian universities which focus on the number of publications rather than the quality. It is my view that the golden guidelines for authorship that can eradicate the unethical practices starts from changing the promotion regulations in Jordan. Such change should aim at decreasing the value of being first author and making the research team work as a norm practice in Jordanian institutions. At the same time, intellectual contribution and the continuous involvement in the project should be the only way you can get authorship. This intellectual contribution can be in the form of perceiving coherent ideas, grant writing, designing experiments, trouble shooting for any problems in conducting the experiments, manuscript writing and or critical revisions of the manuscript. Each research team should be responsible for the quality control of authorship guidelines and should report any changes in the proposed authorship assignment of research projects that evolve during the work to the deanship of research.

When such huge value is given to co-authorship under new regulations of promotion, meaning that you can get tenured without first author publications, it is my expectation that research teams will be more reserved on granting authorship unethically.

 

 14) Logistics of Ethics in an Educational Hospital

By:Dr. Belal Alhusein

I am trying to see if an idea of research is applicable, so I headed to King Abdullah II University Hospital, which is an educational hospital. The idea summarizes in collecting blood samples of newly admitted acute myeloblastic leukemia patients before receiving chemotherapy and after chemotherapy. Samples will then be analyzed for miRNA changes using an SA Biosciences Cancer Pathways Array. The adult ward doesn’t get many of those cases so I went to the Pediatric Oncology ward. I introduced myself to the coordinator of the pediatric oncology ward, she is a nurse, and proposed the idea of research and what is the possibility of acquiring the samples so that I could go ahead and write a grant proposal and get IRB approval. The nurse volunteered to do two things: start collecting blood samples before IRB approval just from a patient that is newly admitted with ALL diagnosis and to be scheduled for first dose of chemotherapy (Hyper-CVAD); and to collect those blood samples without an assent. I debated with here about how this is unethical but she told me that this is an OK procedure since we are in an educational hospital. She also said that parent sign a disclosure to address this issue, and I asked to see what they are signing off about and we couldn’t find such a detail in patients’ records. The ethical question here is, in an educational hospital:

Should samples be collected with a consent/assent?

Should samples be collected before an IRB, even if an IRB is on route?

If such violations are happening, how can IRB and research ethics personnel put hinders against people with such misconduct?

 

15) Consent or Assent

By:Dr. Abeer Qandil

Conducting research in any population requires taking their approval to participate, this would be in the form of a consent if participants reached the legal age of consent (most countries 18 years); or consent of the guardians in addition to an assent of the participant, when the participants are children or adults who are unable to give consent but have enough understanding of the research potential risks and benefits, and the participants expected roles. So what if one of the two, guardian or child, refused the participation in the study. Which one would over role the other? Reviewing several debates concerning this issue revealed that the assent can be waived by the IRB and the consent is considered enough if the outcome of the research has a promising benefit to the wellbeing of the population under research including the participant. However, if the guardian of the child or unable adult refused to give consent then these two will not participate in the study despite the availability of the assent.

Given these two situations it is clear that the consent of the guardian is stronger than the assent; but how do researchers feel when forcing a child or unable adult to participate against their will, does this impact the research process and the validity of the data.

I think the assent is as important as consent and the participant should not be passive at any situation. In some studies the participants might negatively impact the research as they act negative and this will affect the results of the study. In addition there is a human part in all researches that should not be neglected. The researchers are not dealing with machines; the human dignity should be above everything. Research would not be a research without willing participants.

 

16) Authorship and Promotion in Jordan

By:Dr. Mazhar Alzoubi

One of the most important issues in the research field in Jordan is the authorship and promotion criteria in each specific institute. For example there is a big problem in the order of authors in any publication because in all institutes there is a focus on the first author nevertheless who the PI is. I do believe it is a very unethical decision to consider the first author as the main author because as a PI I’ll put my name as a first author whatever the role of co-researchers in the group, especially the Master’s students’. And what makes things worse is just including two papers as a maximum in the promotion file from the Master Degree student’s work. Moreover, some institutes decided to have a single author paper as a major condition to get promoted, which is impossible in scientific research.

Risk of such criteria on the research:

Having single author papers will have very negative impact on many levels:

• Very limited research cooperation either locally or internationally.
• Publishing the work (if possible) in very low impact factor journals.
• Workers in the research team will be ignored and disappointed.
• Reduction of research advancement and productivity.
• Limitation of research collaboration.
• Reduction of the institutes ranking as well as citation index.

Proposed solutions:

• Stratification of research according to the specialization because it is obvious that applied sciences are different from economy or politics.
• Unifying promotion criteria nationally.
• Creation of index for local national use and institution indexing.
• Considering PIs according to the international standards as a main author to give young researchers a chance of being first authors.
• Promoting researchers with collaborated work by certain incentives or credits in a way that increases institutional collaboration.

  

17) Plagiarism from an Instructor

By:Dr. Wael Hananeh

HOW ETHICALLY WOULD YOU RESPOND TO PLAGIARISM FROM AN INSTRUCTOR

Instructor X submitted a proposal to the head of his department for evaluation to get funded. The head of department had software that detects plagiarism. The submitted proposal was checked by that software and found insignificant similarities with others. The head of department asked the department committee member to evaluate the proposal as required. When the head of department read the proposal, it came to his mind that he did see such a title during his career within the school. He returned back to his instructor file and he was astonished when he found exactly the same proposal that had been funded years ago. No single letter or word was changed.

Several questions came to my mind regarding ethics:

• Was the instructor aware (with intention) of what he was submitting?

Yes, he was since the proposal was going back and forth between the instructor and the department committee correcting it.

• Was the instructor familiar with plagiarism issues?

Yes, there was no doubt.

• Was he conducting what is called a prototypical plagiarism?

Yes, since he did not change any single letter or word

• Do you think he under estimated the humility of his colleagues by doing this?

Yes, I think so.

• Should the head of department forward this case to his dean?

Yes, because this kind of plagiarism is with intention. So he has to be responsible for his actions. So I forwarded the case to my dean.

• Do you think this instructor deserves a second chance?

Maybe, but with remarkable punishment.

 

 18) Case Analyses:

By:Dr. Saleem Banihani

This case is real and it is worthwhile to be discussed:

We used different names to respect the privacy of the people.

 Dr. Mohammad was an assistant professor at a university in Jordan and he wrote with his master student a master-oriented grant proposal (a master student project under Dr. Mohammad’s supervision) to investigate the effect of certain nutrients on diabetic patients.

After he applied the proposal, the dean of the faculty refused to process the proposal until Dr. Mohammad appoints a co-adviser for this work, even though the proposal passed the graduate committee of the department and the faculty committee.

“You are an assistant professor and you need a professor to help you.” the dean’s said! Dr. Mohammad said, “but I can run this work by myself and I do not need to appoint a co-adviser, I’ve published several articles before and I know how to handle that from A to Z, in addition, this proposal successfully passed the peer-review without any help!”, the dean said “you must do that!” Then Dr. Mohammad contacted the most relevant professor in the area of interest from the university and asked him to be a co-adviser and the professor welcomed that. When coming to the achievements in this work, the whole practical work was handled by Dr. Mohammad and his master student without the need of the Professor’s assistance. And, in terms of paper writing, Dr. Mohammad wrote the draft of the whole paper and sent it to the co-adviser asking him to review the paper. The answer by the co-adviser via e-mail was “Ok, good work”! Given that Dr. Mohammad sent it to another professor and he had a good addition to the paper. Now, the regulations of the university give the right for the co-adviser, just because he is a “co-adviser” to have an authorship in this work. Dr. Mohammad felt depressed as he should put the name of the co-adviser in the work to avoid any complaints by the co-adviser to the deanship, which will affect his promotion in the university.

 Based on this case:

1. Can the dean push the assistant professor to appoint a co-adviser in the master oriented project given that this is not mandatory in the university regulations?
2. Does the professor (co-adviser) have the authorship right in Dr. Mohammad’s and his master student’s publication?
3. What do you feel about the regulations of the university, which gives the right for the co-adviser to serve as a co-author in Dr. Mohammad’s publication?

Answer:

1. It is unethical that the dean pushes the assistant professor to appoint a professor as a co-author and this is at least not mentioned in the university regulations. The PI of the work has the right to choose who should be involved in his work.
2. Mohammad has the right to omit the name of the co-adviser because he did not have a major contribution, at least in the paper writing!
3. The regulations of the university are not fair until it determines that, in such cases, Dr. Mohammad can skip the name of the co-adviser from the publication if he did not add to the work.

  

19) Case Analyses:

By:Dr. Qais Alefan

Research on Alzheimer’s disease is normally designed to bring interventions that may improve dementia. Such research projects tend to include patients with Alzheimer’s disease. It is essential that participants in these research projects should be protected and signed informed consent. However, symptoms of Alzheimer’s disease may make it difficult for researchers to obtain a signed informed consent. In such cases, persons with Alzheimer’s disease must rely on surrogates. These maybe any trusted individuals.

In research, discussions on protecting participants should address all issues of risks that participants may encounter as a result of their participation in any research project. However, there is no consensus on what is a “minimal risk” research.

 

20) Case Analyses:

By:Dr. Sukaina Alzyoud

Institutional Review Boards [IRB] – in Jordanian Universities

The founding of Institutional Review Boards in Jordanian Universities is an ongoing issue; some universities still do not have any form of IRB or Ethical committee when approving research studies.

One of the major issues with the IRB committees in most Jordanian Universities is that they only adapt the name, with no structured guidelines, regulations, or even procedure manuals for structured application process.

Another issue is that most of the committee members do not get any type of training on ethics of research or their basic role in the committee. This is a vital issue that needs to be addressed, since members come from different backgrounds and not necessarily oriented about ethics of research among humans or animals. I would suggest a training program for internal committee members in each University. Forming an independent entity for Responsible Conduct of Research affiliated with the Ministry of Higher Education, to provide guidance, needed training and participation in regulation formulation.

 

21) Case Analyses:

By:Dr. Nour Abdo

Recent discoveries and advancements in genomics and genetic sciences broadened our knowledge about perinatal genetic diseases. It is a common practice nowadays in the United States to offer pregnant women the option to screen for many different genetic diseases. However, these screening tests are controversial, expensive, and not very well-understood among non-genetic specialists. There are several ethical issues that are often debated upon when the tests are brought up leading to esteemed discussions. While some people debate that those screening tests are pro-abortion, especially if they are offered late in pregnancy, others think they prepare new parents to cope with a child with special needs before the child is born. The other issue with these screening tests is that they have high false positives, high false negatives, and uncertainties associated with them with certain genetic conditions, making it harder to translate to the community and gain their trust. While genetic screening is meant to be a first step and not a diagnostic test, going through a false positive test, then a usually invasive test after, like amniocentesis, can negatively affect pregnant women with unnecessary stress. Whether to incorporate those tests in Jordan and weather their benefit will outweigh their risk is yet to be determined.  Genetic tests can be greatly beneficial in some cases and lifesaving in others.  However, current practicing doctors and common people in Jordan are way behind in genetic testing. We lack professional genetic counselors and they are greatly needed in Jordan for proper establishing of genetic tests, how they are done, what the results mean, and if the test need to be done or taken into consideration considering other factors (family history, age, …etc.).

 

22) Integral Bioethics:

By:Dr. Qosay Albabalas

Nowadays, ethics in research is considered a hot topic and becoming a more challenging issue due to the accelerated scientific advances all over the world. Bioethics is shrouded in mystery for many researchers causing many violations to people, cultures and values. It is highly recommended to have a “universal ethical core” for research that can evolve to suit any particular country or nation. This unfathomable core can be explored if we understand the new world model.

The new world model can be divided to four parts. Those parts extracted from the four cultures that dominate the world. The south; which is represented by “Humanism” in which culture lies in community, community building and human relations (Ubuntu: I’m because you are).

The east; which supports the “Holistic” view, and supports the fact the organisms are irreducible to the sums of their parts, rather they function in relationship to them (Kyosei; co-existence).

The north; based on “Rationalism” derives its strength from logical inferences and emphasizes that the reason is the source of power (Naringsliv; nourishment for life).

The west; which is supportive of “Pragmatism”. It stated that the cultural strength of the west is in its practical treatment of things (Individuation; actualization).

Based on these assumptions, we can imagine an integral bioethical model that is based on those four pillars. Once philosophers study and absorb these facts, this will absolutely reflected on ethics in research in order to achieve global standards that are able to satisfy the research needs and respect the ethics of all nations worldwide.

A strong core of ethical research will satisfy all nations as they feel that they have a contribution in it and are represented. Finally, any special requirement needed for certain race nations can be modified accordingly but based on a strong core of “Integral Bioethics”.

 

23) Biofuel Vs Food:

By:Dr. Alaa Aljabali

Availability of adequate and affordable energy is one of the basic requirements for sustaining human wellbeing and functionality of any society. Surging oil prices over the last 10 years, and record levels of oil consumption have encouraged biotechnological research to find an alternative, sustainable fuel source. The resulting emerging biofuels (plant-based fuel) market created significant demand for agricultural commodities such as sugar, corn, soybean, and palm oil. The belief that increased demand for these commodities may be a leading factor behind the increase in food prices worldwide. Food prices have increased by approximately 6% in the United States alone over the past 5 years, and significantly more throughout the world. Food supply and market situation differs from country to country but projections suggest that food prices will remain high in the next few years and some contribute this increase to the use of commodity crops for biofuels. This conflicting interest has created controversy in the area of biofuels production. This in turns created a significant conflict on using plants/crops as fuel sources.