Bryn Williams-Jones

University research ethics boards, although well established in North American since the 1980s, sometimes still have a poor reputation among researchers. They may be seen by members of the academic community as a bureaucratic system designed to prevent or slow down research, and one that does not understand the reality of researchers. This negative view is often the result of misunderstanding by 1) researchers and 2) some REBs about what an REB’s mandate is and how it should work. Based on the experience of an REB President and a bioethicist, this series of Frequently Asked Questions aims to demystify research ethics so that researchers and REBs can collaborate in the advancement of knowledge, while ensuring the ethical and responsible conduct of research.

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or psychological disequilibrium” (Nilsson, Sjöberg, Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009).