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Ethical preparedness in health research and care: the role of behavioural approaches

Ethical preparedness in health research and care: the role of behavioural approaches
Ethical preparedness in health research and care: the role of behavioural approaches
Background: Public health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising ethical preparedness
as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability (ability), opportunity, and motivation (willingness) to work in an ethically prepared way.
Methods: We use two case examples from our empirical research—one pandemic and one non-pandemic related— to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the
COM-B model categories to analyse the transcripbed data from each case study.
Results: Our analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge (or principles and frameworks), a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.
Conclusions: To understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using
examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared.
Behavioural science, COM-B model, COVID-app, Ethical preparedness, Genomics, Health psychology, Implementation science
1472-6939
1-13
Samuel, Gabrielle N
66af6213-08de-4c0e-92c1-12083ec456e3
Ballard, Lisa
48a7b1af-4d2b-4ec7-8927-84361a3c62a9
Carley, Helena
7c44b85c-0136-473f-b158-14ff191a699c
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Samuel, Gabrielle N
66af6213-08de-4c0e-92c1-12083ec456e3
Ballard, Lisa
48a7b1af-4d2b-4ec7-8927-84361a3c62a9
Carley, Helena
7c44b85c-0136-473f-b158-14ff191a699c
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5

Samuel, Gabrielle N, Ballard, Lisa, Carley, Helena and Lucassen, Anneke (2022) Ethical preparedness in health research and care: the role of behavioural approaches. BMC Medical Ethics, 23 (115), 1-13, [115]. (doi:10.1186/s12910-022-00853-1).

Record type: Article

Abstract

Background: Public health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising ethical preparedness
as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability (ability), opportunity, and motivation (willingness) to work in an ethically prepared way.
Methods: We use two case examples from our empirical research—one pandemic and one non-pandemic related— to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the
COM-B model categories to analyse the transcripbed data from each case study.
Results: Our analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge (or principles and frameworks), a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.
Conclusions: To understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using
examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared.

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More information

Accepted/In Press date: 29 October 2022
Published date: 17 November 2022
Additional Information: © 2022. The Author(s).
Related URLs:
Keywords: Behavioural science, COM-B model, COVID-app, Ethical preparedness, Genomics, Health psychology, Implementation science

Identifiers

Local EPrints ID: 472951
URI: http://eprints.soton.ac.uk/id/eprint/472951
ISSN: 1472-6939
PURE UUID: f1e83bcb-eec6-43e6-9356-cbad61da6396
ORCID for Lisa Ballard: ORCID iD orcid.org/0000-0003-1017-4322
ORCID for Anneke Lucassen: ORCID iD orcid.org/0000-0003-3324-4338

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Date deposited: 06 Jan 2023 12:59
Last modified: 17 Mar 2024 03:37

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