According to the American Dental Association (n.d.) DPH is the field of dentistry that is particularly focused on the population-based dental health care provision, research, policy development, disease prevention and health promotion. Alongside the dental private practices, DPH representatives attempt to deliver accessible oral health services for the population daily. As a result, it is possible to notice that community-based research is one of the essential tasks and responsibilities of DPH. Dental research, just like any other type of research involving people and other living beings has ethics as one of its cornerstones alongside its primary principles such as confidentiality, justice, autonomy, and beneficence (Shashidhar, 2007). Nowadays, the issue of the protection of people and animals from the intrusive and potentially harmful investigators is driven by the civil rights organizations. As a result, under the pressure of the liberal governments and a multitude of civil rights organizations complicating the process of clinical research, many of the world’s leading countries began to outsource research practices to the developing countries where the research protocols are not as limiting (Shashidhar, 2007).
The moral judgments about the rightness or wrongness of this approach can be quite confusing because apart from breaching some of the ethical principles, they also aim at the utilitarian goals of bringing positive results to a larger number of communities in the end. In that way, from the point of view of DPH, the utilitarian analysis of the outsourcing research practices proves their use for the greater good.
The Role of Community in the Ethics of Community-Based Research
Using the example of the research outsourcing practices, it is possible to review the role communities play in the community-based dental research. Practically, from their perspective, the utilitarian analysis shows the result opposite to that of the researchers’ point of view. In particular, this analysis contains three major steps: 1) definition of the audience of the research in question (the individuals who will be affected by it); 2) the evaluation of positive and negative alternatives to the research; and 3) the final decision as to which option brings the greatest good (“Moral concepts and theories,” n.d.).
The three-step utilitarian analysis from the perspective of the community affected shows that the latter could be potentially exposed to a dangerous treatment or medication without even knowing it (because outsourced research often tests harmful substances on the populations unaware of the risks or the ones forced to participate in the trials) (Shashidhar, 2007). In that way, the overall results of such experiment may reveal some new information benefiting the future research projects on the topic at the cost of its participants. It is possible to argue that the overall greater good will still be achieved in this scenario. However, for the participating individuals and communities exposed to risks, the costs outweigh the benefits.
In that way, it seems that to help the research, the communities need to participate in different trials, including the ones that can be potentially dangerous. They could do it voluntarily and expose themselves to dangers, or they could be forced into a trial without knowing it. In both cases, the chances are high that benefits are a long-term outcome whereas the short-term outcome could be adverse.
American Dental Association. (n.d.) Oral health topics. Web.
Moral concepts and theories. (n.d.). Web.
Shashidhar, A. (2007). Ethical issues in research outsourcing. Journal of Dental Education, 71(4), 447-448.