The search for knowledge about ourselves and the world around us is a fundamental human endeavour. Research is a natural extension of this desire to understand and to improve the world in which we live.
The scope of research is vast. On the purely physical side, it ranges from seeking to understand the origins of the universe down to the fundamental nature of matter. At the analytic level, it covers mathematics, logic and metaphysics. Research involving humans ranges widely, including attempts to understand the broad sweep of history, the workings of the human body and the body politic, the nature of human interactions and the impact of nature on humans – the list is as boundless as the human imagination. For the purposes of this Policy, research is defined as an undertaking intended to extend knowledge through a disciplined inquiry or systematic investigation.
There can be no doubt that research has greatly enriched and improved our lives. Significant advances in human understanding in the social sciences, humanities, natural sciences, engineering and health sciences have been made as a result of research involving humans. A fundamental premise of this Policy is that research can benefit human society. In order to maximize the benefits of research, researchers must have academic freedom. Academic freedom includes freedom of inquiry, the right to disseminate the results of that inquiry, freedom to challenge conventional thought, freedom to express one’s opinion about the institution, its administration or the system in which one works, and freedom from institutional censorship. With academic freedom comes responsibility, including the responsibility to ensure that research involving humans meets high scientific and ethical standards that respect and protect the participants. Thus, researchers’ commitment to the advancement of knowledge also implies duties of honest and thoughtful inquiry, rigorous analysis, commitment to the dissemination of research results, and adherence to the use of professional standards. There is a corresponding responsibility on the part of institutions to defend researchers in their efforts to uphold academic freedom and high ethical, scientific and professional standards.
Research is a step into the unknown. Because it seeks to understand something not yet revealed, research often entails risks to participants and others. These risks can be trivial or profound, physical or psychological, individual or social. History offers unfortunate examples where research participants have been needlessly, and at times profoundly, harmed by research, sometimes even dying as a result. Ethical principles and guidelines play an important role in advancing the pursuit of knowledge while protecting and respecting research participants in order to try to prevent such occurrences.
People have also been gratified and have had their lives enriched by their participation in research, either because they may have benefited directly or because their participation has contributed to the expansion of knowledge. Given the fundamental importance of research and of human participation in research, we must do all that we can as a society to ensure that research is conducted in an ethical manner so as to build public confidence and trust. By promoting and guiding the ethical conduct of research involving humans, this Policy seeks to contribute tangibly to these goals.
No single document can provide definitive answers to all ethical issues that may arise in an undertaking as complex as research involving humans. This Policy aims to assist those who use it – researchers, sponsors, members of research ethics boards (REBs), participants, and the public – to identify ethical issues in the design, conduct and oversight of research and to point the way to arriving at reasoned and ethical responses to these issues.
Respect for human dignity has been an underlying value of the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS or the Policy) since its inception. Despite clear recognition of its centrality in research ethics, the term lends itself to a variety of definitions and interpretations that make it challenging to apply.
Respect for human dignity requires that research involving humans be conducted in a manner that is sensitive to the inherent worth of all human beings and the respect and consideration that they are due. In this Policy, respect for human dignity is expressed through three core principles – Respect for Persons, Concern for Welfare, and Justice. These core principles transcend disciplinary boundaries and, therefore, are relevant to the full range of research covered by this Policy.1
Article 1.1 The guidelines in this Policy are based on the following three core principles:
These principles are complementary and interdependent. How they apply and the weight accorded to each will depend on the nature and context of the research being undertaken. Specific applications are addressed in the following chapters.
Respect for Persons
Respect for Persons recognizes the intrinsic value of human beings and the respect and consideration that they are due. It encompasses the treatment of persons involved in research directly as participants and those who are participants because their data or human biological materials, which for the purposes of this Policy include materials related to human reproduction, are used in research. Respect for Persons incorporates the dual moral obligations to respect autonomy and to protect those with developing, impaired or diminished autonomy.
Autonomy includes the ability to deliberate about a decision and to act based on that deliberation. Respecting autonomy means giving due deference to a person’s judgment and ensuring that the person is free to choose without interference. Autonomy is not exercised in isolation but is influenced by a person’s various connections to family, to community, and to cultural, social, linguistic, religious and other groups. Likewise, a person’s decisions can have an impact on any of these connections.
An important mechanism for respecting participants’ autonomy in research is the requirement to seek their free, informed and ongoing consent. This requirement reflects the commitment that participation in research, including participation through the use of one’s data or biological materials, should be a matter of choice and that, to be meaningful, the choice must be informed. An informed choice is one that is based on as complete an understanding as is reasonably possible of the purpose of the research, what it entails, and its foreseeable risks and potential benefits, both to the participant and to others. Respect for Persons also includes a commitment to accountability and transparency in the ethical conduct of research.
Certain factors may diminish a person’s ability to exercise their autonomy, such as inadequate information or understanding for deliberation, or a lack of freedom to act due to controlling influences or coercion. Such constraints may include the fear of alienating those in positions of authority, such as professional or personal caregivers, researchers, leaders, larger groups, or a community to which one belongs. Other constraints may consist of barriers to accessing resources or knowledge outside the research context. These factors and constraints should be addressed prior to any research being carried out, so as to ensure participants are sufficiently protected.
Some people may be incapable of exercising autonomy because of youth, cognitive impairment, other mental health issues or illness. While autonomy may be considered a necessary condition for participation in research, involving those who lack capacity to make their own decisions to participate can be valuable, just and even necessary. For those prospective participants, additional measures are needed to protect their interests and to ensure that their wishes (to the extent that these are known) are respected. These measures will generally include seeking consent from an authorized third party who is entrusted to make decisions on behalf of the prospective participant, based on knowledge of that person and that person’s wishes or, if such wishes are unknown, on consideration of that person’s welfare. Even when the requirements of free, informed and ongoing consent cannot be met, Respect for Persons requires involving individuals in circumstances of vulnerability in decision making where possible. This may include asking about their feelings regarding participation and/or for their assent.
Where it is foreseeable that a participant may lose capacity during a research project, for example in studies of cognitive impairment, it may be appropriate to ask participants to express their preferences and ensure that they have authorized a trusted person to make decisions on their behalf should they lose the capacity to provide ongoing consent (see Article 3.11 for guidance on research directives for individuals who lack capacity).
Concern for Welfare
The welfare of a person is the quality of that person’s experience of life in all its aspects. Welfare consists of the impact on individuals of factors such as their physical, mental and spiritual health, as well as their physical, economic and social circumstances. Thus, determinants of welfare can include housing, employment, security, family life, community membership, and social participation, among other aspects of life. Other contributing factors to welfare are privacy and the control of information about the person, and the treatment of human biological materials according to the free, informed and ongoing consent of the person who was the source of the information or materials. A person’s or group’s welfare is also affected by the welfare of those who are important to them. Harm includes any negative effects on welfare, broadly construed (for the relationship between risk and harm, see Chapter 2, Section B). Note that, for the purposes of this Policy, “group” and “community” are used in their ordinary sense. More detailed types of community as defined in Chapter 9 are specific to Aboriginal contexts.
Concern for Welfare means that researchers and REBs should aim to protect the welfare of participants, and, in some circumstances, to promote that welfare in view of any foreseeable risks associated with the research. They are to provide participants with enough information to be able to adequately assess risks and potential benefits associated with their participation in the research. To do so, researchers and REBs must ensure that participants are not exposed to unnecessary risks. Researchers and REBs must attempt to minimize the risks associated with answering any given research question. They should attempt to achieve the most favourable balance of risks and potential benefits in a research proposal. Then, in keeping with the principle of Respect for Persons, participants or authorized third parties, make the final judgment about the acceptability of this balance to them.
The welfare of groups can also be affected by research. Groups may benefit from the knowledge gained from the research, but they may also suffer from stigmatization, discrimination or damage to reputation. Engagement during the design process with groups whose welfare may be affected by the research can help to clarify the potential impact of the research and indicate where any negative impact on welfare can be minimized. Researchers must also consider the risks and potential benefits of their research and the knowledge it might generate for the welfare of society as a whole. Where research on individuals may affect the welfare of a group(s), the weight given to the group’s welfare will depend on the nature of the research being undertaken, and the individuals or group in question. This consideration does not imply, however, that the welfare of a group should be given priority over the welfare of individuals.
Justice refers to the obligation to treat people fairly and equitably. Fairness entails treating all people with equal respect and concern. Equity requires distributing the benefits and burdens of research participation in such a way that no segment of the population is unduly burdened by the harms of research or denied the benefits of the knowledge generated from it.
Treating people fairly and equitably does not always mean treating people in the same way. Differences in treatment or distribution are justified when failures to take differences into account may result in the creation or reinforcement of inequities. One important difference that must be considered for fairness and equity is vulnerability. Vulnerability is often caused by limited capacity, or limited access to social goods, such as rights, opportunities and power. Individuals or groups in vulnerable circumstances have historically included children, the elderly, women, prisoners, those with mental health issues and those with diminished capacity for self-determination. Ethnocultural minorities and those who are institutionalized are other examples of groups who have, at times, been treated unfairly and inequitably in research, or have been excluded from research opportunities. People or groups whose circumstances cause them to be vulnerable or marginalized may need to be afforded special attention in order to be treated justly in research.
The recruitment process, both of participants who may become directly involved in research and those who participate as the source of information or biological materials to be used in research, is an important component of the fair and equitable conduct of research. Participation should be based on inclusion criteria that are justified by the research question. Inequity is created when particular groups fail to receive fair benefits of research or when groups, or their data or their biological materials, are excluded from research arbitrarily or for reasons unrelated to the research question.
An important threat to Justice is the imbalance of power that may exist in the relationship between researcher and participant. Participants will generally not understand the research in the same way and in the same depth as does the researcher. Historically, there have been instances in which this power imbalance has been abused, with resulting harm to participants.
The Core Principles – Conclusion
The importance of research and the need to ensure the ethical conduct of research requires both researchers and REB members to navigate a sometimes difficult course between the two main goals of providing the necessary protection of participants and serving the legitimate requirements of research. The three core principles that express the value of human dignity provide the compass for that journey. Their application will help ensure that a balance between these two goals is maintained. Applying the core principles will also maintain free, informed and ongoing consent throughout the research process and lead to sharing the benefits of the research. These results will help to build and maintain the trust of participants and the public in the research process.
Proportionate Approach to REB Review
This Policy aims to strike an appropriate balance between recognition of the potential benefits of research, and protection of participants from research-related harms, including injustices and breaches of Respect for Persons. Given that research involving humans spans the full spectrum of risk, from minimal to significant, a crucial element of REB review is to ensure that the level of scrutiny of a research project is determined by the level of risk it poses to participants (see Article 6.12). A reduced level of scrutiny applied to a research project assessed as minimal risk does not imply a lower level of adherence to the core principles. Rather, the intention is to ensure adequate protection of participants is maintained while reducing unnecessary impediments to, and facilitating the progress of, ethical research. This approach is in keeping with the need to respect academic freedom and not to place unwarranted constraints upon it.
In the context of both initial and continuing research ethics review, the REB assesses the ethical acceptability of a research project through consideration of the foreseeable risks, the potential benefits and the ethical implications of the project (see Article 2.9). These two steps constitute the proportionate approach to REB review that is recommended throughout the Policy.
Research Ethics and Law
In addition to the principles and guidelines in this Policy, researchers are responsible for ascertaining and complying with all applicable legal and regulatory requirements with respect to consent and the protection of privacy of participants (see Chapter 5). These legal and regulatory requirements may vary depending on the jurisdiction in Canada in which the research is being conducted, and who is funding and/or conducting the research, and they may comprise constitutional, statutory, regulatory, common law, and/or international or legal requirements of jurisdictions outside of Canada. Where the research is considered to be a governmental activity, for example, standards for protecting privacy flowing from the Canadian Charter of Rights and Freedoms, federal privacy legislation and regulatory requirements would apply.
The law affects and regulates the standards and conduct of research involving humans in a variety of areas, including, but not limited to privacy, confidentiality, intellectual property and the capacity of participants. In addition, human rights legislation and most documents on research ethics prohibit discrimination on a variety of grounds and recognize equal treatment as fundamental. REBs and researchers should also respect the spirit of the Canadian Charter of Rights and Freedoms, particularly the sections dealing with life, liberty and security of the person, as well as those involving equality and discrimination.
Researchers may face situations where they experience a tension between the requirements of the law and the guidance of the ethical principles in this Policy. In such situations, researchers should strive to comply with the law in the application of ethical principles. Researchers should consult with colleagues, the REB or any relevant professional body, and if necessary, seek independent legal advice to help resolve any conflicts between law and ethics, and guide an appropriate course of action.
This legal context for research involving humans is constantly evolving and varies from jurisdiction to jurisdiction. For this reason, REBs and researchers should be aware of applicable laws so they can identify legal issues that may occur in the conduct of research. REBs may satisfy this obligation through expertise among their members or through wider consultation. The researcher may seek independent legal advice when necessary.
The Perspective of the Participant
In designing and conducting research or reviewing the ethics of research, researchers and REBs must be mindful of the perspective of the participant. It may be necessary to consider the various contexts (e.g., social, economic, cultural) that shape the participant’s life, to properly evaluate the implications of the research in terms of the core principles.
Appropriate Expertise for Review
It is also important that research ethics review be appropriate to the disciplines, fields of research, and methods of the research being reviewed. This means that REBs must understand the discipline and method under review and be able to assess the research on its own terms. This Policy provides more direction concerning appropriate expertise in Articles 6.4 and 6.5.
Interpreting This Policy
This Policy contains both guidance for the interpretation of the principles of research ethics, as well as a number of mandatory requirements for researchers, institutions and members of REBs. Mandatory provisions are signaled by the use of the term “shall.” Guidance for the interpretation of the core principles is generally indicated by use of the term “should.”
Evaluating the ethics of research involving humans is not, and cannot be, an exact science. The interpretation and application of the articles and principles to particular circumstances will always be a part of the exercise. The articles in this Policy are intended to provide guidance, and in some cases, to set out certain requirements. The application sections are intended to supplement the articles with further explanation and examples. Although they cannot guarantee identical decisions across REBs, they can ensure that researchers and REBs employing this Policy are operating within the same parameters and taking into account the same considerations as they design and evaluate research involving humans.
At the end of some chapters, a section entitled “References” provides links to documents that contain further guidance on specific topics addressed in the chapter. These references are not meant to be exhaustive, but are offered to assist the reader who wishes to explore certain topics in greater detail.
The definitions provided in this Policy are intended specifically and solely for the purposes of this Policy.
 The three core principles incorporate within them the eight guiding ethical principles set out in the 1998 TCPS. Respect for Human Dignity is expressed through the three core principles. Respect for Free and Informed Consent and Respect for Vulnerable Persons are both reflected in the principle of Respect for Persons, while Respect for Vulnerable Persons is also reflected in the principle of Justice. Respect for Privacy and Confidentiality is an element of Concern for Welfare. Respect for Justice and Inclusiveness is covered in the core principle of Justice. Balancing Harms and Benefits, Minimizing Harm and Maximizing Benefit are, in fact, not principles, but are the means by which the principle of Concern for Welfare is put into effect. Each of these elements is addressed in greater detail in a chapter or section of this Policy. By using these broader and more encompassing core principles, this Policy seeks to provide a more focused framework for the ethical guidance that follows. It is also a framework that harmonizes with other national and international ethics policies.[Back]