Читать книгу Practitioner's Guide to Using Research for Evidence-Informed Practice - Allen Rubin - Страница 30

Some practitioners might find the idea of having research inform their practice distasteful due to their belief that research on human subjects is often unethical. Concern about research ethics is understandable in light of the times when research on human subjects could be carried out without scrutiny of their ethics. Such studies were not limited to the notoriously inhumane medical experiments conducted by Nazis during the Holocaust. For example, the Tuskegee syphilis study began in Alabama in 1932 and lasted several decades. In that study hundreds of poor Black male sharecroppers diagnosed with syphilis were not informed of the diagnosis. Instead, the researchers studied the progression of the disease without treating it, even after the discovery of penicillin as a cure (Jones, 1981).

Later in the twentieth century additional research studies in America involving human subjects were criticized as unethical. The most notorious was Milgram's (1963, 1965) study of human obedience that examined people's willingness to harm others when following orders. Forty unwitting men were ordered to administer severe and potentially fatal electric shocks to unseen learners whenever the learner gave a wrong answer to a question. Although the shocks were not real, a danger sign and fake screams made the unwitting men think they were really hurting people. The men who followed the orders became extremely upset about what they had done, and some had seizures. Another, less notorious, study had its ethics criticized by the Dallas Morning News (1990). It was a federal welfare experiment that involved a control group of 800 employed poor people who were eligible to receive welfare. The study denied their benefits just to see how well they could live without the benefits.

In light of decades-old studies that have been criticized as unethical, is it reasonable for practitioners to want to avoid having unethical research studies inform their practice? You bet it is! Fortunately, these days it is very unlikely that the relevant studies that they would find would be unethical. That is due to the abundance of Institutional Review Boards (IRBs) that emerged in recent decades to approve or disapprove the ethics of proposed research studies involving human subjects. It is virtually impossible nowadays for a study involving human subjects to begin without first being approved by an IRB. The IRBs are virtually ubiquitous, and are affiliated with human service agencies, funding sources, and other organizations. IRB panelists can be zealous in meticulously scrutinizing the details of research proposals looking for ethically questionable procedures. Sometimes they might even be overzealous (Tufford et al., 2012). So, if you are vigilant in your concern about ethics, we applaud you. But we hope your vigilance will not prevent you from seeking research evidence to inform your practice.

Having research evidence inform your practice decisions is a lot easier said than done. In Chapter 2, we examine various feasibility constraints practitioners face in trying to engage in the EIP process. We also examine the steps in the EIP process, and you will continue to see the importance of practice expertise and idiosyncratic client circumstances and preferences in that process. Nevertheless, you might be wondering whether engaging in the EIP process will have been a waste of time if your search finds no pertinent evidence. If so, consider the peace of mind you can feel knowing that at least you searched. Had you not searched, you would not know whether there is a better way to intervene with the people who need your help. Moreover, had you not searched, you would not know whether evidence exists implying that your intervention approach might be contraindicated, and perhaps even harmful, for those folks. Consider the pride you can feel as a compassionate professional who has left no stone unturned in trying to maximize your practice effectiveness.