New report provides valuable insights into the ethical dilemmas in bringing prevention programs into community settings
The process of transitioning from a research study with promising results to community ownership and implementation of an effective prevention practice is fraught with ethical challenges that warrant discussion in order to ensure that we "do no harm" while simultaneously providing society with the best prevention programs available. To advance discussion of these ethical challenges, the Society for Prevention Research (SPR) commissioned an Ethics Task Force to foster a dialog around the ethical implementation of tested interventions for the benefit of children, youth, families and communities. The current issue of Prevention Science (available here through open access) reports on the findings from the Task Force's two-year effort to identify ethical challenges as researchers work to deliver to the public programs with demonstrated efficacy to prevent a wide range of mental health, substance use and behavioral health problems that threaten the health and well-being of society.
The ethical application of scientific advances is one of the great challenges of our day. As the lead author on the report Dr. Bonnie Leadbeater, (University of Victoria, BC, Canada) says "Ethical practice is not just rule following. It is about creating opportunities to discuss benefits and anticipate harms before choosing a course of action." A foundational premise of prevention science is that evidence-based programs and practices become available to those who would benefit from them, outside of the context of a specific research study.
The Society for Prevention Research commissioned this Task Force because the accumulated scientific evidence for the efficacy of prevention programs has led to an increased public interest in the implementation of these programs in their communities. Being aware of the ethical dilemmas that have arisen in the application of scientific findings in other fields, such as medicine, the Task Force identified a number of ethical dilemmas that often arise in the application of prevention science program in community settings. These dilemmas included topics such as how to deal with conflicts of interest in providing advice and consultation to public bodies, how to develop ethical partnerships with historically disadvantaged communities, how to ethically conduct evaluations of prevention programs in the community, issues of privacy in an era of big data access, and how to deal with ethical issues as programs become commercialized in the delivery to the public. In the resulting report, the Task Force did not seek to resolve these issues or to establish formal guidelines for ethical practice. Rather, the Task Force sought to identify the ethical issues and promote broad awareness and dialogue about them. The implicit faith of the Task Force is that the open and transparent discussion of ethical issues is a critical step towards the ethical application of the remarkable scientific advances in the field and ultimately, to advancing the health and well-being of society. "The resulting paper is not only a highly valuable resource for prevention researchers and practitioners alike, but also provides the grist for thought-provoking dialog with early career prevention scientists who are in graduate training programs and learning the foundational components of prevention science," says Dr. Leslie Leve, President of the Society for Prevention Research. Dr. Irwin Sandler (Arizona State University) one of several authors of the report, put the report in perspective as follows; "I'm pleased that the report is derived from the experience of prevention scientists and practitioners in the field. Proactive reflection on the ethical dilemmas is not a criticism of current practice. Rather it is the best mechanism we have to promote the ethical application of prevention science."
The Society for Prevention Research is an organization dedicated to advancing scientific investigation on the etiology and prevention of social, physical and mental health, and academic problems and on the translation of that information to promote health and well-being. The multi-disciplinary membership of SPR is international and includes scientists, practitioners, advocates, administrators, and policy makers who value the conduct and dissemination of prevention science worldwide.