Grimes Vs Kreiger Institute

Running Head: GRIMES VS KRIEGER INSTITUTE

Grimes vs. Krieger Institute

Name:

Institution:

GRIMES V. KRIEGER INSTITUTE 2

1. The Grimes v. Kennedy Krieger case reinvigorated the debate of important ethical issues which

resulted from conducting research with vulnerable children. However, the decision was criticized

and termed as inconsistent. Kennedy Krieger Institute of John Hopkins University engaged in this

case study comparing the efficiency of low-cost measures for controlling lead. The blood levels of

lead were keenly watched during the study. The trial court then issued a judgment which was in

summary and also in defendant’s favor. It was ruled that the complainants' cases could continue

due to the researchers owing no legal care duty to the participants of the research. These two cases

were joined into one by the Court of Appeal hence overruling the trial court. The court of appeal

further ruled out that the plaintiffs had sufficient evidence to support the findings.

2. The issues that were raised by the ruling of the court of appeals were the duty of care, research

risks to children, informed consent, institutional review process and exploitations of vulnerable

populations. The court proposed that the researchers had to produce enough information about

risks involved and that it would have been important to provide various sample tests in order to

satisfy the child’s duty subjects regarding the duty of care. However, there were inadequate facts

submitted to the judges to decide the exact information required to provide the plaintiffs in order

for the duty to be satisfied.

Another issue is the exploitation of vulnerable populations whereby the court ruling compared

studies towards different unethical research studies, the most recognizable one being the study on

syphilis whereby infected people were followed for some time unknowingly.

Another issue raised was that of an institutional review process. This issue was deeply criticized,

and further investigations are ongoing concerning the issue. The court ruling moreover stressed

that IRB’s are usually not designed to be adequately functional in such a way that they are

concerned with the ethicality of the reviewed testing.

GRIMES V. KRIEGER INSTITUTE 3

The issue of informed consent is also of utmost importance since it questions if the institute had

offered enough information to the parents concerning the designs of studying and risks associated

with joining the study.

3. An ethical dilemma is involved in that the children who were used in the study benefited from

their participation. Failing to conduct research such as these could result to greater harm as the

health conditions among the disadvantaged populations would not be improved. The research,

however, was vital as it was noted that it helped decrease the lead concentration in the blood

(POLLAK, 2002). However, on the other hand, this research exploited the economically and

educationally disadvantaged children which only perpetuates social injustice. A difficult ethical

dilemma is involved in order to think critically and come to a conclusion what was right and

wrong in this case and possible future solutions.

4. Most of the laws are based upon ethics and this is the reason legal and ethical issues overlaps

each other making it hard to distinguish between the two. Ethical and legal issues are however

two different things. There are no set of rules that governs ethical issues making it unpunishable

by the law. Conversely, there exist a set of rules that governs legal issues making them

punishable if these rules are not adhered to. What is legal can be unethical and what is ethical

can be illegal. In this case, it is ethical to put children in health risk for the greater good of the

society but it is illegal according to the court.

5. The purpose of this essay is to illustrate the conflicting part of ethical issues and legal issues.

While these terms may be used in the same context, it is clear that what can be ethical could be

illegal and what is legal could be unethical. The court ruled based on what is legal and not what

is ethical. Another purpose is to explain the principles in the Belmont report which include

Beneficence, Respect for persons, Justice, and autonomy that are crucial in research.

GRIMES V. KRIEGER INSTITUTE 4

6. Many commentaries on the case since the ruling by the judges in Maryland Court, have

appeared in Bioethics, medical and legal journals. The research’s social value has been called

into question by the critics where they have questioned further whether such studies enforces

social policies by undermining the efforts.

7. The key stakeholders in this case include the researchers, the court, and the children that were

involved in the study.

8. The case impacted the interdisciplinary team approach in several ways. One is that it made

clear that the children could not be involved in research and the parents could not consent their

involvement if these children were put at risk. The court hardly criticized the study’s design

inferring that Kennedy Krieger by allowing children not to live in entirely lead-free homes as an

unethical behavior (NationalAcademyPress, 2005). The court, in this case, came up with

Maryland law in order to ensure a balance between this ethical conflict. This law offers

protection to innocent children, for example, those in this case from harm that may result.A

vulnerable child according to the court should not be used in testing potentially dangerous

theories that should be left to an independent adult who is well informed.

9. Roe v. Wade is another case similar to Grimes v. Kennedy Krieger case study. The court here

that the state was forbidden from regulating or outlawing abortions that are performed during

pregnancy’s first trimester (Thomas, 2016). This resolution however conflicted with the existing

laws as most of the laws in the United States before this case only allowed women to get abort if

the mother’s life was put in danger. However, this is an issue for most of the people believing

that abortion is unethical and the Roe V. Wade court decision is still debated.

10. Application of ANA code of ethics helps in making the right decisions for the patient. The

ANA code of ethics applies in this case in that the benefit of the research is weighed against its

GRIMES V. KRIEGER INSTITUTE 5

outcomes. In Grimes v. Kennedy Krieger case, innocent children were put at risk where most of

them were seen to have high concentration of lead in their blood. However, in the long run, this

research could be used for the good of the society. ANA code of ethics could be used to make

rational decision.

11. Grimes v. Kennedy Krieger portrays some ethical issues that resulted from the research. The

children were included in this research were exposed to lead which is detrimental especially to

children’s health. Exposure to lead may heavily affect the physiological as well as mental

development of children younger than six years. Lead poisoning at very high levels can be fatal

and can lead to death. All this illustrate that children should not be exposed to lead.

12. In every research, there are things that should be considered. The Belmont report principles

are crucial and this are what guides and determines whether the research is ethical or not.

Beneficence, justice and respect for persons (Mandal, 2011). The benefit of the research must

outweigh the risks which is not true in this case. Children were exposed to poisonous lead. Also,

it is children who were used as subject in the research. According to reports, informed consent

was not offered and information was withheld which make it termed unethical.

13. According to the court, the research was unethical as children’s health was put at risk. This

case contributed to the change in healthcare especially in research. Children should not be used

in testing potentially hazardous theories and adults. Also, informed consent forms have to be

given out to the participants and information should not be withhold to them. Children cannot

make rational decisions regarding some matters and this is left to their parents (Morse, 2003).

However, care should be taken as children ‘s life should not be put at risk.

14. Some of the recommendations that could reduce moral distress include observing the

Belmont report principles. These include beneficence, justice and respect for persons. Before

GRIMES V. KRIEGER INSTITUTE 6

carrying out a research on humans, the benefits of the study and its risks should be weighed. The

benefits should outweigh the risks involved in the study. The vulnerable persons such as children

as in this case should never be used. Also, informed consent is of vital importance. No

information should be withheld to the participants. They should be made to know of every risks

involved in the process.

15. Grimes v. Kennedy Krieger case shows that the interest of the society in research may

conflict with the research subject’s interests. It is more complex when children are involved in

the study. In this case, the court came up with Maryland law that protects children from potential

harm. The court of appeals allowed the research subjects exposed to injuries to seek redress.

Vulnerable populations like children in this case according to the court should not be used in

testing potentially harmful theories. Belmont report principles that include justice, beneficence

and respect for persons should be highly valued and considered in research.

16. Based on this case, I believed there was something amiss and that there were various ethic

principles that were missed during this research. It is wrong to involve children who cannot make

a rational judgment for themselves in research. The benefits of the study should be weighed

against the risks that are involved. The children in this study were exposed to lead. Some

information according to the plaintiff was withheld which is unethical. There should be an

informed consent where the participants are made to know the entire process of the research and

the risks as well.

GRIMES V. KRIEGER INSTITUTE 7

References

Buchanan, D. R., & Miller, F. G. (2006). Justice and fairness in the Kennedy Krieger Institute

lead paint study: the ethics of public health research on less expensive, less effective

interventions. American Journal of Public Health, 96(5), 781-787.

Jharna Mandal, S. A. (2011). Ethics in human research. Tropical Parasitology, 2-3.

JOANNE POLLAK. (2002). THE LEAD-BASED PAINT ABATEMENT REPAIR & MAINTENANCE STUDY IN

BALTIMORE: HISTORIC FRAMEWORK AND STUDY DESIGN. JOURNAL OF HEALTH CARE LAW &

POLICY, 90-110.

Morse, R. (2003). Grimes v. Kennedy Krieger Institute--Nontherapeutic Research with Children. AMA

Journal of Ethics®, 5(11).

NationalAcademyPress. (2005, May 09). Grimes v. Kennedy Krieger Institute: Revisiting the Ethical Issues.

Retrieved from nap.edu: https://www.nap.edu/read/11450/chapter/5#43

Thomas, N. (2016, January 28). Five Historical Medical Ethic Cases. Retrieved from minoritynurse.com:

https://minoritynurse.com/five-historical-medical-ethic-cases/

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