Case 1: Testing Tribulations
Following the earthquake in Haiti, a number of refugees are brought into the Montréal clinic and are assessed. Amy is working at the clinic on a research project. The refugees arrive during a flu outbreak in the community, and many of its staff are sick.
Given Amy’s emergency medical training, she was asked to assist the clinic by assessing the refugees as they arrive for TB and other underlying diseases and to collect blood for a serological test (Hepatitis B).
Amy carefully explains the plans to the refugees as she assesses them. She collects, labels and brings the blood to the laboratory for analysis. She assures them that the information from the tests on each patient will be held in strict confidence and will be relayed back to them and documented in their records. She will also inform- the attending physician at the clinic of the results so that the refugees can get ongoing help and be vaccinated against diseases as normally done in Canada.
One day Amy drops by the laboratory to pick it up some notes she had forgotten. When she enters the lab, she notices that a research assistant, Steve, is removing blood samples from the ‘to be destroyed’ container in the lab. Amy asks what he is doing in the lab. Steve replies that his supervisor is testing the samples of blood that Amy collected for HIV. This is a part of the final stages of a study on HIV detection and spread. Amy assumes that Steve’s boss has gone through the proper channels of approval and thinks nothing more about it.
A few months pass, and the Haitians are getting actively integrated into the community. Amy is back in the research lab, and everything seems to be according to plan until Amy reads an article on the front page of the Montréal Gazette – “Haitian refugees bring new strain of HIV to Montréal”.
Amy quickly skims the article and notices that Steve’s supervisor is the lead researcher on the study. She wonders how he would have been able to gain consent from the refugees to test their blood for HIV and disclose this information. HIV tests are performed in strict confidence to avoid stigmatizing a person (or population), something this article has clearly done.
Suddenly, she remembers the day in the lab, and wonders if her samples are linked to this study. Amy quickly looks up the journal that is quoted in the Gazette, and is shocked to see that both Steve and Amy are listed as co-authors on the paper. In disbelief, she heads directly to the clinic to get to the bottom of this and tells her supervisor of her concerns.
Seminar Discussion Questions
- What situations are considered secondary use of data/samples and when is it appropriate to use samples in this way?
- What are the implications of this development? Should Amy take action? Why or why not?
- What are the research ethics requirements that would have to be met?
- How should the potential misconduct be reported and who should be involved?
- What are the implications for Amy and Steve as researchers?
- What are the requirements for authorship?
- As a researcher/physician, what could you do to protect yourself from a similar situation occurring?