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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
JUSTICE IN RESEARCH ON ELDER ABUSE AND NEGLECT
The Belmont Report’s final ethical principle is justice. Justice in research involves the fair distribution of risks and benefits associated with research. The principle advises against relying too heavily on disadvantaged individuals or groups to bear the burdens of acting as research participants. On the other hand, the justice principle holds that individuals and groups should receive a fair share of the benefits available through study participation and the improved health and social interventions research makes possible.
The justice principle has several applications to research on elder abuse and neglect. One is that investigators observing the principle will not seek study participants solely from economically and socially disadvantaged populations simply because of “their easy availability, their compromised positions, or their manipulability” (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1979:5). Similarly, vulnerable populations such as decisionally incapable adults should not be involved in research if adequate data can be obtained by studying adults able to make their own choices about participation. Instead, there must be sound scientific and policy justifications for targeting disadvantaged or vulnerable populations in research.
Three additional applications of the justice principle pertain to the distribution of benefits available through research on elder abuse and neglect. One such application is to give individuals and groups fair access to studies that offer potential direct benefit to participants. Thus, investigators ought not exclude certain people from studies simply because it is more inconvenient or costly to recruit them (Institute of Medicine, 1994:82).
Another application of the justice principle involves ensuring that the improved interventions publicly funded research makes possible are reasonably available to research participants and to those in the general population who would benefit from them (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1979:5). Thus, when elder abuse and neglect studies yield health and social benefits, those benefits should be available to groups that participated in the studies and to others based on need rather than ability to pay.
Finally, the failure to implement a robust research program to study elder abuse and neglect can be seen as unjust, because it denies vulnerable older persons and their families the benefits that could flow from such a program. A fair system of research funding will allocate funds to studies of serious public health needs, including elder abuse and neglect (Dresser, 2001b).