Guiding Values

In developing a set of guidelines for the field, the Committee focused on three underlying values. We began with a belief that health services research can lead to improved clinical and public policies, but only if such research and analyses are conducted to yield valid and reliable results and considered credible by the public. Therefore, the first and most crucial value is preserving and enhancing integrity in health services research by identifying and minimizing potential bias—and appearances of such bias—and by providing effective oversight for individual and institutional decisions. Such a commitment to integrity includes not only professional integrity as a health services researcher, but also personal integrity to act in an ethically responsible way, especially when faced with difficult or complicated decisions and situations. Integrity in research requires not knowingly making false, inaccurate or misleading statements. Furthermore, while researchers can have—and probably need—conjectures and passionate commitments, integrity requires fairness and openness to finding the truth. Integrity in research requires not pursuing a pre-determined conclusion, but pursuing a hypothesis and accepting whatever conclusions are revealed through the research, particularly if they contradict one’s initial preconceptions. Integrity requires thoroughness and transparency in regard to the multitude of decisions made, conclusions drawn, and the consequent limitations in the analysis. Fundamental to the notion of integrity, then, is the realization that perceptions of conflicts of interest, particularly those that are perceived as concealed, can be damaging not only to the organization or individual researchers, but to the entire discipline. In this sense, health services researchers must recognize that their actions are both individual and communal—they not only ensure personal integrity, but also the integrity of the field.

The second value is maintaining consistency with other ethical values of health-related research. Conflicts of interest are not the sole relevant ethical consideration in health services research; these guidelines must be consistent with other ethical principles—such as respect for research subjects and confidentiality of information—that guide health services researchers in their related fields. Basic ethical principles apply across all arenas, thus it is important for health services researchers to be clear and transparent about the role they have assumed and to maintain their ethical principles at all times.

A third guiding value is adhering to the ethical guidelines of other intersecting fields. As noted by the IOM, health services research is inherently a “multidisciplinary field of inquiry” and health services researchers frequently associate with other disciplines. For instance, health services researchers’ findings may be utilized to improve service delivery, shape policies in the political arena, or researchers may be called as expert witnesses in a court of law or regulatory hearing. In each of these cases, health services researchers must not only recognize the ethical expectations of these other fields, but also recognize how these expectations may conflict with the ethical imperatives related to their research role. For example, health services research should be open, transparent, and available to the public when possible. However, if health services research is introduced into a legal proceeding, such research may be required to adhere to the special norms of the law, such as having testimony sealed and therefore not available to the public. Health services researchers should adhere to the ethical guidelines related to health services research and, when ethical expectations and guidelines differ from those in health services research, there must be compelling reasons to deviate, such as the requirements of law or national defense. Lacking such compelling reasons, they should choose not to undertake activities because of the possibility of such conflicts.

GUIDING VALUES
OF HEALTH SERVICES RESEARCH

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Continue to:

• Introduction
• AcademyHealth Ethical Guidelines Committee and Its Objectives
• Conflicts of Interest
  • What is a Conflict of Interest?
  • Conducting Research versus Using Research
• Distinctive Characteristics of Health Services Research
• Guiding Values
• Ethical Guidelines
  • Initiation of Research
  • Conducting Research
  • Reporting Research
• Analyzing a Potential Conflict of Interest
• Implementation and Enactment of the Guidelines
• Conclusion
• Appendix A – AcademyHealth Ethical Guidelines Committee
• Appendix B – Committee Action
• Appendix C – Conflict of Interest Resources