Case 9.1 “The Nuu chah nulth Nation and Arthritis Research

In 1981, researcher Dr. Richard Ward consulted the Nuu chah nulth nation, a group of Aboriginal people living on the west coast of North America, about conducting a study on the increased rate of rheumatoid arthritis experienced by these people. Not only was no such study ever conducted, but Ward used the 30mL of blood conducted from 883 Nuu chah nulth as the basis for his groundbreaking research on the genetic distinctiveness of the Nuu chah nulth. The obvious moral question is should Aboriginal communities have the right to dictate what type of research is performed on their data and materials?

As I read this case, not only was I alarmed by the lack of informed consent involved in Ward’s research, but the complete disregard for the Nuu chah nulth people. While genetic research is hot and flashy, studies show that such research can be damaging to the group, resulting in the questioning of group membership, and the abandonment of the value of culture and oral history (W & G 290). As a result of such controversial studies, researchers such as Dr. Judy Putt propose necessary ethical guidelines that must be followed when conducting research with Aboriginal groups. She writes, “safeguarding participant privacy, which may require special measures with the sharing of research with community organizations…should be negotiated with participants, partners, and/or collaborators” (Putt). She goes on to list values that should be considered when conducting research with Aboriginal peoples such as honesty and integrity, appropriate acknowledgements of the role of others, and responsible communication of results. Due to the fact that none of these values were honored in the present study, I would argue that Ward’s complete disregard of the Nuu chah nulth nation was unethical.

This case reminded me Dr. Peter Provonost’s work in evaluating the infection-control of ICUs in 67 Michigan hospitals. Provonost’s research was halted by the Office for Human Research Protections on the grounds that Provonost was conducting his research without the informed consent of the ICU’s patients. After much review, the OHRP permitted the continuation of the study based on the belief that the work was being used solely for clinical purposes and not medical research or experimentation (B. 157-158). Given that Ward’s work does qualify as medical research, the informed consent of the Nuu chah nulth people seems requisite.

When conducting research, especially research with a unique cultural group, not only is it important to uphold the value of informed consent but respect for the customs of the cultural group, neither of which occurred in the present case.

 

Beauchamp, Tom L., and James F. Childress. “Respect for Autonomy.” Principles of Biomedical Ethics. 7th ed. New York: Oxford UP, 1994. 125-31. Print.

Putt, Judy. Conducting Research with Indigenous People and Communities. Sydney: Indigenous

Justice Clearinghouse, 2013. Indigenousjustice.gov.au. Indigenous Justice Clearinghouse, 2013. Web. 25 Feb. 2017.

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. “Case 10.3 Should Patients Be Informed of Remote Risks of Procedures?” Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. Peterborough, Ontario: Broadview, 2014. 300-02. Print.

One thought on “Case 9.1 “The Nuu chah nulth Nation and Arthritis Research

  1. Hello!

    I absolutely agree with you, especially with your reference to the Provonost case. Informed consent is a necessity required to provide patients or subjects with their full right to autonomy. This right provides individuals with the ability to reject or accept treatment. “Basic or simple consent entails letting the patient know what you would like to do; giving basic information about the procedure; and ensuring that the patient assents or consents to the intervention.” (De Bord) Dr. Richard Ward did not ensure that the Nuu chah nulth nation provided full informed consent prior to the collection of the blood samples. In my opinion, this constituted a gross violation of ethical principles. The trust between a physician and a patient is sacred. Dr. Ward had a responsibility to disclose all pertinent information to the Nuu chah nulth nation regarding the usage of their blood. Due to his incompetence to disclose this information, the subjects did not have a chance to disallow the blood samples from being collected. Therefore, he denied the subjects from enacting their right to autonomy.

    References

    De Bord, Jessica. “Informed Consent.” Informed Consent: Ethical Topic in Medicine. University of Washington School of Medicine, 7 Mar. 2014. Web. 02 Mar. 2017.

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