Ancillary Care Obligations

Intro

Ancillary Care Obligations are moral duties binding a medical researcher to provide information, treatment, or other resources to study participants for reasons other than scientific soundness, roughly their responsibilities are conducting medical research to aid study participants for diseases or injuries that were not caused by the study.

In the “ Ancillary Care Obligations in the Light of an African Bioethics” by Thaddeus Metz, he explains the model called the partial-entrustment model presented by Henry Richardson which concerns what medical researchers are morally required to provide to participants beyond what safety requirements.

However, Metz disagrees with some main topics within the model and provides a new theory that should be a stronger argument for ancillary care obligations.

Richardson’s Models

Richardson’s theory “partial-entrustment model” is ultimately grounded on the value of autonomy, it is roughly the view, upon waiving privacy rights and providing information to the researcher, the latter becomes obligated to support participants’ health in light of the information acquired from them, even if their need for medical assistant has not been caused by the study. He explains that ancillary care obligations arise when patient autonomy is reduced or threatened by virtue of disclosing intimate information about themselves with the researcher. This central claim of the model is simply by providing researchers with special permissions and participants efficiently entrusting the researchers with the special responsibilities to look after their needs when they discover that acting on their permissions. As Richarson says “ The basis of the special ancillary care obligations, then lies in the special responsibility for protecting participants’ autonomy falls to researchers when they accept the participants waivers of their private rights”, which means researchers incurs an obligation to protect them from harm discovered by means of that information.

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Metz Model

In Metz approach to ancillary care obligations, he provides a new theory that is grounded on the ideals of communion salient in African philosophical tradition. According to this perspective ethic, act is right insofar as it honors communal relations,ones of identity and solidarity. Kenyan historian of African philosophy Dismas Malasolo, highlights what he calls the “communitarian values” of living a life of mutual concern for the welfare of others, such as in a cooperative creation and distribution of wealth…. feeling integrated with as well as willing to integrate others into a web of relations free of friction and conflict. This Afro- communal ethic includes everything that is a care ethic prize, as it prescribes acting to improve others and quality of life to a certain attitude of sympathy and altruism. He considers that informed consent is possible captured by the idea that conducting research on or treating someone without his consent would be essential to degrade his capacity to generally share a way of life and not so much a failure to care for him.

Metz Vs Richardson

Metz examined a lot of explanations to why Richardson’s model should be looked at again and see what things could be fixed. He explains that one of the weaknesses within the model is not so much the fact of reducing privacy or compromise autonomy that, by Richardsons full account generates, the duty to aid be on providing a warning of a discovery illness but rather the intensity of the relationship between the parties. Richerson’s appeal to the intensity of relationship in order to grow an obligation if it’s naturally in a communal ethic but not in autonomy-based one that makes no essential reference to other persons. Continuing to move against Richardson, he also notices that he appeals to the death or intensity of the relationship of how close the parties are and how long the relationship has lasted, in order to determine how much a researcher is obligated to aid participants. However this factor again has nothing inherently to do with the participants autonomy, and rather fits best within a fundamentally relational ethical framework.

The obligation to offer treatment to participants seems to him, existed before such threats to autonomy were obtained. His intuition is that if the researcher has a duty to warn participants of the disease they are revealed to have in the course of the study, then they also have a duty to offer more than that at the same time, prior to having actually warned them and thereby having negatively affected their autonomy. Finally he suggests that autonomy is a prima facie Poor explanation of a special, positive, and understanding obligation. He believes if a person makes a fully free in a French ways to give something to a party, then, in the light of autonomy, he is responsible for any foreseeable vulnerability that doing so may entail, and the one who now has the information is not liable to aid on that basis

Conclusion

When reviewing both models and applying Thaddeus Metz’s discussion of Western and African perspectives of ancillary care obligations, I think medical researcher do have a moral obligations to provide ancillary care because as long as they follow ethical codes human research and feel it benefit the society as a whole then it would be reasonable. If the subjects in the study are informed about the risk and benefits then it is acceptable. To me, if the researchers find a disease that could become contagious and spread from person to person, then treating it shouldn’t be a problem because it’s preventing another health issue for the community. According to “Declaration of Helsinki: Ethical Principles for Medical Research involving Human Subjects”, medical research is subject to ethical standards that promote respect for all human beings and protect their health and rights. Some research populations are Bonable and his special protection.

The particular needs of the economically disadvantaged must be recognized. Special attention is also required for those who cannot give or refuse consent for themselves, for those who may be subject to give consent under duress, for those who will not benefit personally from the research and from those whom the research is combined with care. Also research investigators should be aware of the ethical, legal and regulatory requirements for research on human subjects in their countries as well as applicable international requirements. No national ethical, legal or regulatory requirements should be allowed To reduce or eliminate any of the protections for human subjects set forth in declaration.

Reference

1. Vaughn, L. (2020). Bioethics: Principles, issues, and cases (4th ed.). New York, NY: Oxford University Press.
2. Handout: Thaddeus Metz, “Ancillary Care Obligations in the Light of an African Bioethic,” Excerpt from: Yaw A. Frimpong-Mansoh and Caesar Atuire (Eds.), Bioethics in Africa: Theories and Praxis. Vernon Press, 2019.