Which of the following principles of the Belmont Report suggests that individuals are capable of making deliberate decisions about whether to participate in research?

The Belmont Report states that “respect for persons incorporates at least two ethical convictions: first, that individuals should be treated as autonomous agents, and second, that persons with diminished autonomy are entitled to protection. The principle of respect for persons thus divides into two separate moral requirements: the requirement to acknowledge autonomy and the requirement to protect those with diminished autonomy.” The Belmont Report goes on to describe an autonomous person as “an individual capable of deliberation about personal goals and of acting under the direction of such deliberation.” To respect an individual’s autonomy is to allow an individual to develop opinions, make choices, and act as they please, unless their actions are clearly detrimental to others. Investigators may not touch or examine subjects or interfere in their lives in any way unless they agree or consent to the examination or interference. Investigators’ actions must recognize and affirm subjects’ autonomy. Lack of respect is shown when individuals’ considered judgments are rejected, their ability to act on their judgments is denied, or information is withheld that is necessary to make a thoughtful, considered judgment when there is no compelling reason to do so.

Not all human beings are capable of acting autonomously. The ability to set personal goals, develop opinions, and make choices may be compromised at times in a person’s life and, in the case of children, only develops over time. In other instances, individuals (such as the severely or terminally ill, mentally handicapped, and imprisoned) may lose the capacity for acting autonomously partially or completely, or for a period of time. Respect for these persons, as defined by the Belmont Report, requires that these vulnerable individuals be offered special protections during that period when they cannot act autonomously. Offering special protections for vulnerable individuals is also a major emphasis of the principle of justice which is discussed later in this module. The principle of justice requires that the vulnerable be extended special protections with regard to the distribution of the benefits and burdens of research. The vulnerable should be assured of receiving their fair share of the benefits and protected from having imposed upon them more than their fair share of the burdens of research.

Respect for Persons – Philosophical Foundation

A philosophical basis for treating individuals as autonomous agents can be found in the writings of Immanuel Kant. Kant argued that respect for persons is required due to our inherent dignity, which in turn is due to our being rational creatures. Rational beings have the capacity to use reason in forming decisions, and act not only in accordance with reason, but also for the sake of reasons we believe are right (thus becoming a moral agent). According to Kant, it is the capacity to choose right from wrong, and the responsibility that follows from possession of such a capacity, that accords persons the Kantian sense of dignity that deserves respect. As free and autonomous beings, we become responsible for our actions in ways that nonrational creatures cannot be.

To treat persons with respect is to treat them as beings who are morally self-determining. People must never be used simply as a means to the ends of others, but always as ends in themselves. Respect for persons, in Kantian terms, implies that what is crucial is that a person be free to act for the sake of reasons they believe are right. Thus, a person’s moral agency or autonomy is violated if that decisional process is denied or subverted, even if the person would have acted in the same way had they been given the opportunity to decide. In such a case, a person who is denied decisional involvement is thus denied the status of moral agent. And this, in turn, denies something essential to having moral dignity. This philosophical basis for treating individuals as autonomous agents and always as ends in themselves is consistent with the Judeo-Christian doctrine, which asserts that each human has infinite value.

An investigator’s ethical obligation to treat persons with respect is primarily carried out in the informed consent process, which is discussed in Module 2. However, ethical norms derived from this principle are discussed in each of the modules. 

Research ethics for lab-based psychology experiments are relatively well-establish. Research ethics for online field experiments, on the other hand, are still a subject of great disagreement, as was illustrated by the recent debates over the Facebook emotional contagion experiment. Because the tools of digital experimentation will evolve more quickly than shared norms about research ethics, we are likely to continue to confront disagreements about research ethics for some time to come. When making decisions about the ethics of our own research — and having debates about research ethics in the digital age more broadly — researchers should make use of existing principles of ethical research that have already been developed. Although the specific ethical issues that we face are new, the general problems are very old.

One excellent source of existing wisdom about research ethics is the Belmont Report, which was published in 1979. Commissioned by the US Government in response to ethical failures in medical research, such as the Tuskegee Syphilis Study, the Belmont Report was written by a panel of experts and proposes three principles that should underlying the ethical conduct of research involving human subjects: 1) Respect for persons; 2) Beneficence; and 3) Justice. These three principles, which are somewhat abstract in the Report, were later operationalized into the the detailed rules and procedures that make up the Common Rule, which governs research at US universities. When facing a research ethics challenge, going back to these three principles can often be very helpful.

• Respect for Persons

The Belmont Report argues that respect for persons consists of two distinct principles: individuals should be treated as autonomous and individuals with diminished autonomy should be entitled to additional protections. The principle of respect for persons is interpreted to mean that researchers should, if possible, receive informed consent from participants, and the Belmont Report identifies three elements of informed consent: information, comprehension, and voluntariness. That is, respect for persons implies that participants should be presented with relevant information in a comprehensible format and then should voluntarily agree to participate.

• Beneficence

Beneficence can roughly be understood to mean having the interests of research participants in mind. The principle of beneficence is behind efforts by researchers to minimize risks to participants and maximize benefits to participants and society. For example, when considering a research design, the principle of beneficence should cause us to ask if there is another way that we could obtain the same knowledge but with lower risks to participants.

• Justice

The principle of justice addresses the distribution of the burdens and benefits of research. That is, it should not be the case that one group in society bears the costs of research while another group reaps its benefits. Issues of justice arise most strongly around questions about the selection of participants.

Applying these three principles to specific ethical situations can be difficult, and the principles sometimes come into conflict. However, even if they do not lead to clear decisions in all cases, keeping these three principles in mind helps clarify the issues.

Update: If you would like to read more about the ethics of social research, you can read Chapter 6 of my book Bit by Bit: Social Research in the Digital Age.