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Discussion 5

Ethical Considerations in Pain Research There are some concerns with the setup of this study that may or may not have already been considered by theprimary researcher. A first group of concerns focus on the division of subjects into the two groups. Will those patients in the control group who request relaxation be allowed such a therapy? Will the choice of therapies be made available to the patients, or will they be “ assigned” to treatments without discrimination? This issue also has implications for the contamination of research results through the placebo effect that should also be considered. Pain medication usage should be carefully monitored to prevent overuse, abuse, and the possibility of addiction in both groups. The control group patients especially should be watched for the necessity of a referral to other pain management methods. Pain research studies also have the possibility of issues with informed consent due to a confounding of clinical treatment with research, which may be an issue with this study. Patients may join a pain study with the intent of accessing treatment or having their pain taken seriously. This reduces their ability to truly consent to the research (Wasan et al., 2009). A separate ethical issue that is not as relevant to the study at hand but is related to the ethics of pain research is the availability of pain management medications to all study participants regardless of the group they have been placed in for the research purposes (Drummond, 2009). Research considerations specific to the community involved also exist. The researcher must be aware of the culture of the people they are studying and the effects this has on etiquette in that culture, to avoid offending the research subjects or contaminating their results. Cross-cultural researchers must also be careful to understand the heterogenity of a foreign culture, and to interpret their findings appropriately. Another ethical consideration for research that involves tribal participants is an awareness of the often tight-knit nature and small size of such groups; researchers must be extremely careful not to provide an extraneous amount of information which could be used to identify research participants to other members of their group (Trimble et al., 2010). Considering the lack of existing health studies for the Torres Strait Islander populations, it is especially important to be aware of the cultural surroundings (Grove et al., 2003). This lack reduces the ability of the researcher to do background research and understand the population they are working with and increases the possibility of clashes and ethical problems. DRUMMOND, G. B. 2009. Reporting ethical matters in The Journal of Physiology: standards and advice. The Journal of Physiology, 587, 713-719. GROVE, N., BROUGH, M., CANUTO, C. & DOBSON, A. 2003. Aboriginal and Torres Strait Islander health research and the conduct of longitudinal studies: issues for debate. Aust N Z J Public Health, 27, 637-41. TRIMBLE, J. E., SCHARRON-DEL RIO, M. R. & BERNAL, G. 2010. The Itinerant Researcher: Ethical and Methodological Issues in Conducting Cross-Cultural Mental Health Research. In: JACK, D. C. & ALI, A. (eds.) Silencing the self across cultures: depression and gender in the social world. Oxford University Press. WASAN, A. D., TAUBENBERGER, S. P. & ROBINSON, W. M. 2009. Reasons for Participation in Pain Research: Can They Indicate a Lack of Informed Consent? Pain Medicine, 10, 111-119.

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