Abstract
The principles of autonomy, beneficence, non-maleficence, and justice are well established ethical principles in health research. Of these principles, justice has received less attention by health researchers. The purpose of this article is to broaden the discussion of health research ethics, particularly the ethical principle of justice, to include societal considerations — who and what are studied and why? — and to critique current applications of ethical principles within this broader view. We will use a feminist intersectional approach in the context of health disparities research to firmly establish inseparable links between health research ethics, social action, and social justice. The aim is to provide an ethical approach to health disparities research that simultaneously describes and seeks to eliminate health disparities.
| Beauchamp T. and Childress J. Principles of biomedical ethics. New York: Oxford University Press, 1979. Google Scholar | |
| National Institutes of Health: Regulations and ethical guidelines. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research. http://ohsr.od.nih.gov/guidelines/belmont.html (1979, accessed January 2011). Google Scholar | |
| Kirch D. and Vernon D. The ethical foundation of American medicine: In search of social justice. JAMA 2009; 30: 1482-4. Google Scholar, Crossref, ISI | |
| Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press, 2003. Google Scholar | |
| United Nations. The universal declaration of human rights. http://www.un.org/en/documents/udhr/index.shtml#ap (1948, accessed January 2011). Google Scholar | |
| Kreiger N. A glossary for social epidemiology. J Epidemiol Community Health 2001; 55: 693-700. Google Scholar, Crossref, Medline, ISI | |
| Daniels N. Equity and population health: toward a broader bioethics agenda. Hastings Cent Rep 2006; 36(4): 22-35. Google Scholar, Crossref, Medline, ISI | |
| Mwaria C. From conspiracy theories to clinical trials: questioning the role of race and culture versus racism and poverty in medical decision making. In: Schultz A and Mullings L (eds). Gender, race, class and health: intersectional approaches. San Francisco, CA: Jossey-Bass, 2006, p.289-312. Google Scholar | |
| Rawls J. A theory of justice. Cambridge, MA: Harvard University Press, 1971. Google Scholar | |
| Venkatapuram S. and Marmot M. Epidemiology and social justice in light of social determinants of health research. Bioethics 2009; 25(2): 79-89. Google Scholar, Crossref, ISI | |
| World Health Organization. WHO Constitution . Home page. http://www.who.int/governance/eb/constitution/en/index.html (2011, accessed February 2011). Google Scholar | |
| Kelly U. Integrating intersectionality and biomedicine in health disparities research . Adv Nurs Sci 2009; 32: E42- E56. Google Scholar, Crossref, Medline | |
| Weber L. Reconstructing the landscape of health disparities research: promoting dialogue and collaboration between feminist intersectional and biomedical paradigms . In: Schultz A and Mullings L (eds). Gender, race, class and health: intersectional approaches. San Francisco, CA: Jossey-Bass, 2006, p.21-59. Google Scholar | |
| Berger MT and Guidroz K. Introduction. In: Berger MT and Guidroz K (eds). The intersectional approach: transforming the academy through race, class and gender. Durham, NC: University of North Carolina Press, 2009, p.1-22. Google Scholar, Crossref | |
| Berger MT Workable sisterhood: the political journey of stigmatized women with HIV/AIDS . Princeton, NJ: Princeton University Press, 2004. Google Scholar | |
| Collins PH Black feminist thought: knowledge, consciousness, and the politics of empowerment . Boston, MA: Urwin Hyman, 1990. Google Scholar | |
| Collins PH Toward a new vision: race, class and gender as categories of analysis and connection. Race Sex Class 1993; 1: 25-45. Google Scholar | |
| Crenshaw K. Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanford Law Rev 1991; 43: 1241-99. Google Scholar, Crossref | |
| Dill BT and Zambrana E. Critical thinking about inequality. In: Dill BT and Zambrana E (eds). Emerging intersections: race, class and gender in theory, policy and practice . New Brunswick, NJ: Rutgers University Press, 2009, p.1-22. Google Scholar | |
| Volbrecht RM Nursing ethics: communities in dialogue. Upper Saddle River, NJ: Prentice Hall, 2002. Google Scholar | |
| Daniels J. and Shulz A. Constructing whiteness in health disparities research. In Schultz A and Mullings L (eds). Gender, race, class and health: intersectional approaches . San Francisco, CA: Jossey-Bass , 2006, p.89-127. Google Scholar | |
| US Department of Health and Human Services. NIH [National Institutes of Health] policy and guidelines on the inclusion of women and minority subjects in clinical research. http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm (2001, accessed January 2011). Google Scholar | |
| Shields AF The use of race variables in genetic studies of complex traits and the goal of reducing health disparities. Am Psychol 2005; 60: 77-103. Google Scholar, Crossref, Medline, ISI | |
| Geiger J. Health disparities: What do we know? What do we need to know? What should we do? In: Schultz A and Mullings L (eds). Gender, race, class and health: intersectional approaches. San Francisco, CA: Jossey-Bass, 2006, p.261-89. Google Scholar | |
| Shilts R. And the band played on: politics, people and the AIDS epidemic. New York: St Martin’s Press, 1987. Google Scholar | |
| The crack baby myth. Harvard Ment Health Lett 2001; 18(3): 4. Google Scholar | |
| Logan E. The wrong race, committing crime, doing drugs, and maladjusted for motherhood: the fury over ‘crack babies’. Social Justice 1999; 26: 115-37. Google Scholar | |
| Zuckerman B. Selected methodologic issues in investigations of prenatal effects of cocaine: lessons from the past. (National Institute on Drug Abuse research monograph series: 114 - Methodological issues in controlled studies on effects of prenatal exposure to drug abuse.) 1991, 45-54. Google Scholar | |
| Appell A. Protecting children or punishing mothers: gender, race, and class in the child protective system. SC Law Rev 1996; 48: 578-613. Google Scholar | |
| Beattie R. Putting the crack baby myth to bed: researchers fail to link cocaine use and neonatal outcomes. Nat Rev Med 2005; 2(13). http://www.nationalreviewofmedicine.com/issue/2005/07_30/2_feature04_13.html (2005, accessed December 2009). Google Scholar | |
| Center for Disease Control. Office of Minority Health and Health Disparities (OMHD). Home page. http://www.cdc.gov/omhd/About/about.htm (n.d., accessed December 2009). Google Scholar | |
| Antai-Otong D. Women and alcoholism: gender-related medical complications: treatment considerations. J Addict Nurs 2006; 17: 33-45. Google Scholar, Crossref, ISI | |
| McCall L. The complexity of intersectionality. Signs J Wom Cult Soc 2005; 20: 1771-800. Google Scholar, Crossref | |
| Abrums ME and Leppa C. Beyond cultural competence: teaching about race, gender, class and sexual orientation. J Nurs Educ 2001; 40: 270-5. Google Scholar, Medline, ISI | |
| Ovadia S. Race, class, and gender differences in high school seniors’ values: applying intersectionality theory in empirical analysis. Soc Sci Q 2001; 82: 340-56. Google Scholar, Crossref, ISI | |
| Harnois C. Imagining a ‘feminist revolution’: can multiracial feminism revolutionize quantitative social science research? In: Berger MT and Guidroz K (eds). The intersectional approach: transforming the academy through race, class and gender. Chapel Hill, NC: University of North Carolina Press; 2009, p.157-72. Google Scholar | |
| Sandelowski M. Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed method studies. Res Nurs Health 2000; 23: 246-55. Google Scholar, Crossref, Medline, ISI | |
| Israel B. , Schulz A. , Parker E. , Becker A. , Allen A. and Guzman R. Critical issues in developing and following CBPR principles. In: Minkler M and Wallerstein M (eds). Community-based participatory research for health: from process to outcomes. San Francisco, CA: Wiley, 2008, p.47-66. Google Scholar |

