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Ethics of Research with Human Subjects


ONLINEACPECMECNEMOCCommunicationEthics/ProfessionalismCollaborative and Team-Based CME/CEComplimentary - No FeeMEHP Courses

  • Overview
  • Register
  • Faculty
  • Online Content & Tests


Date & Location
Sunday, October 1, 2023, 12:00 AM - Wednesday, April 30, 2025, 11:59 PM

Course Overview
This course provides an overview of key ethical principles and regulatory frameworks for the conduct of research with human subjects. It is intended for researchers and those involved in research oversight.

Course topics include:

  • Historical evolution of the present system of research oversight in the United States.
  • Foundational documents, including the Nuremberg Code and Belmont Report.
  • The 8 core principles of ethical human research.
  • Relevant regulations in the United States, including the revised Common Rule, FDA research requirements, and HIPAA.
  • Challenging ethical concepts relevant to research consent, including the therapeutic misconception, coercion, undue influence, and exploitation.
  • International research ethics guidelines including the Declaration of Helsinki, CIOMS, and ICH.
The course provides specific and practical information needed to understand the role of Institutional Review Boards in overseeing research, as well as the requirements for adequate informed consent.

There was no commercial support used in the development of this educational activity.

Content last reviewed: March 8, 2024
Learning Objectives

After completing this activity, participants should be able to:


  1. Outline the historical context for current approaches to research ethics and regulation.
  2. Outline the 8-principle framework for evaluating the ethics of research studies.
  3. Identify key U.S. regulatory requirements for research with human subjects.
  4. Identify important international guidelines for research with human subjects, including their key provisions.
  5. Assess the ethical and regulatory compliance of research protocols.

Registration
There is no registration fee but you are still required to register. 
 
In this activity, learners will engage with the content by moving through a series of brief video lectures with links to related readings, downloadable resources, and quizzes. This course has 3 sections. Each section has a post-test with between 5 and 10 questions. You will have 5 attempts to earn at least 90% on all post-tests individually in order to complete the course and earn your certificate.
 
The Structure of the Course
  • History and Rationale of Research Ethics
    • A History of Ethics in Medical Research (9:12)
    • The Rationale of Research Ethics and the Nuremberg Code (9:46)
    • The Belmont Report (8:33)
  • Eight Principles of Ethical Research
    • Eight Principles of Ethical Research (13:32)
    • The US Public Health Service Syphilis Study at Tuskegee (6:48)
    • The Ethics of the USPHS Syphilis Study at Tuskegee, Part I (6:32)
    • The The Ethics of the USPHS Syphilis Study at Tuskegee, Part II (6:35)
  • The Common Rule and Related Ethical Considerations
    • The Common Rule (12:43)
    • IRB Oversight of Research (7:25)
    • Assessing Research Risks and Benefits (11:42)
    • Informed Consent Under the Common Rule (7:33)
    • Ethics of Informed Consent, Part I (6:17)
    • Ethics of Informed Consent, Part II (5:51)
    • Therapeutic Misconception (8:45)
    • Coercion and Undue Inducement (11:30)
    • Exploitation (5:22)
    • The Ethics of Payment (8:52)
    • Research with Data and Specimens (11:46)
  • Additional Regulations and Guidance
    • FDA Regulated Research, Part I (7:27)
    • FDA Regulated Research, Part II (8:06)
    • Privacy and HIPAA Compliance (7:34)
    • Navigating Conflicts of Interest (9:47)
    • International Ethics Guidelines, Part I: The Declaration of Helsinki (8:42)
    • International Ethics Guidelines, Part II: CIOMS (10:28)
    • International Ethics Guidelines, Part III: ICH Guidance (E6, E8) (8:27)

Note that closed captions are available for all video segments.


Accreditation
In support of improving patient care, Penn Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.  
 
Designation of Credit
Physicians: Penn Medicine designates this live activity for a maximum of 4.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
ABIM MOC: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 4.5 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
 
Nurses: This program provides 4.5 NCPD hours.
 
Pharmacists: This knowledge-based activity is approved for 4.5 ACPE contact hours of continuing pharmacy education credit. 
UAN: JA0000324-0000-21-034-H04-P 

Credits
AMA PRA Category 1 Credits™ (4.50 hours), ABIM MOC Part 2 (4.50 hours), ACPE (4.50 hours), NCPD Hours (ANCC) (4.50 hours), Non-Physician Attendance / Participation (4.50 hours)

About the Instructors:

Ezekiel J. Emanuel, MD, PhD, is the Vice Provost for Global Initiatives and the Diane v.S. Levy and Robert M. Levy University Professor at the University of Pennsylvania.

Dr. Emanuel is an oncologist and world leader in health policy and bioethics. He is a special advisor to the Director General of the World Health Organization, Senior Fellow at the Center for American Progress, and member of the Council on Foreign Relations. He was the founding chair of the Department of Bioethics at the National Institutes of Health and held that position until August of 2011. From 2009 to 2011, he served as a special advisor on health policy to the director of the Office of Management and Budget and National Economic Council. In this role, he was instrumental in drafting the Affordable Care Act (ACA). Emanuel also served on the Biden-Harris Transition Covid Advisory Board.

Dr. Emanuel is the most widely cited bioethicist in history. He has over 350 publications and has authored or edited 15 books. His recent books include the books Which Country Has the World’s Best Health Care (2020), Prescription for the Future (2017), Reinventing American Health Care: How the Affordable Care Act Will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System (2014) and Brothers Emanuel (2013).

Dr. Emanuel regularly contributes to The New York Times, The Washington Post, The Wall Street Journal, The Atlantic, and often appears on BBC, NPR, CNN, MSNBC and other media outlets.  

He has received numerous awards including election to the Institute of Medicine (IOM) of the National Academy of Science, the American Academy of Arts and Sciences, the Association of American Physicians, and the Royal College of Medicine (UK). He received—but refused—a Fulbright Scholarship. 

He has been named a Dan David Prize Laureate in Bioethics and is a recipient of the AMA-Burroughs Wellcome Leadership Award, the Public Service Award from the American Society of Clinical Oncology, Lifetime Achievement Award from the American Society of Bioethics and Humanities, the Robert Wood Johnson Foundation David E. Rogers Award, President's Medal for Social Justice Roosevelt University, and the John Mendelsohn Award from the MD Anderson Cancer Center. 

Dr. Emanuel has received honorary degrees from Icahn School of Medicine at Mount Sinai, Union Graduate College, the Medical College of Wisconsin, and Macalester College. Dr. Emanuel is a graduate of Amherst College. He holds a MSc from Oxford University in Biochemistry and received his MD from Harvard Medical School and his PhD in political philosophy from Harvard University.

Steven Joffe, MD, MPH, is the Art and Ilene Penn Professor of Medical Ethics and Health Policy at the University of Pennsylvania Perelman School of Medicine. He serves as chair of the Department of Medical Ethics and Health Policy and chief of the Division of Medical Ethics, where he directs a National Human Genome Research Institute- (NHGRI-) funded postdoctoral training program in the ethical, legal, and social implications of genomics. In addition, he is professor of pediatrics at the Perelman School of Medicine and Children’s Hospital of Philadelphia (CHOP). He attended Harvard College, received his medical degree from the University of California at San Francisco (UCSF), and received his public health degree from UC Berkeley. He trained in pediatrics at UCSF and undertook fellowship training in pediatric hematology/oncology at the Dana-Farber Cancer Institute and Boston Children’s Hospital. Prior to coming to Penn, he served on the faculty of Harvard Medical School, and was an attending pediatric oncologist at the Dana-Farber Cancer Institute and Boston Children’s Hospital, for 13 years. 

Dr. Joffe’s research addresses the many ethical challenges that arise in the conduct of clinical and translational investigation and in genomic medicine. He has been the principal investigator (PI) of NIH, Patient-Centered Outcomes Research Institute (PCORI), and foundation-funded studies that examine the roles and responsibilities of PIs in multicenter randomized trials, accountability in the clinical research enterprise, governance of learning activities within learning health care systems, return of individual genetic results to participants in epidemiologic cohort studies, and the integration of genomic sequencing technologies into cancer care. He has also lectured widely on research ethics and on the ethical, legal, and social implications of genomic technologies. He was previously a member of the Department of Health and Human Services Secretary’s Advisory Committee for Human Research Protections, of the National Academy of Sciences Committee on Federal Research Regulations and Reporting Requirements, and of the U.S. Food and Drug Administration’s (FDA) Pediatrics Ethics Subcommittee, and of the Data and Safety Monitoring Board overseeing the federally funded phase III trials of COVID19 vaccines. In addition, he previously chaired the Children's Oncology Group Bioethics Committee and the NHGRI's Genomics and Society Working Group. He is an elected member of the National Academy of Medicine.

In his teaching within the department's online educational initiatives, Dr. Joffe aims to convey a deep understanding of the ethical principles underlying research, while guiding students in how to apply those principles to real-world problems. He hopes students will take one core lesson from his teaching: it is possible to conduct studies on questions relevant to policy and practice that are simultaneously experimentally rigorous and ethically respectful of the rights and interests of the individuals who take part.

Emily Largent, JD, PhD, RN, is the Emanuel and Robert Hart Assistant Professor of Medical Ethics and Health Policy. She holds a secondary appointment at Penn Law, is a senior fellow at the Leonard Davis Institute of Health Economics, and is part of the Center for Health Incentives and Behavioral Economics (CHIBE).

Prof. Largent’s work explores ethical and regulatory aspects of human subjects research with a particular focus on Alzheimer’s disease research and the translation of research findings into care. Her work is supported by the National Institute on Aging and the Greenwall Foundation. Prof. Largent’s work has been published in leading journals, including The Hastings Center Report, American Journal of Bioethics, New England Journal of Medicine, and JAMA. She co-authored Clinical Research Ethics Consultation: A Casebook (Oxford University Press).  

Prof. Largent studied science, technology, and international affairs as an undergraduate at Georgetown University and earned a second degree in nursing from Penn Nursing. She received her PhD in health policy, with a concentration in ethics, from Harvard University and her JD from Harvard Law School. Prof. Largent was previously a fellow in the Department of Bioethics at the National Institutes of Health (2008–2010) and clerked for Chief Judge Jeffrey Howard of the United States Court of Appeals for the First Circuit (2016–2017) before coming to Penn. 

Holly Fernandez Lynch, JD, MBE, chairs the Master of Health Care Innovation (MHCI) admissions committee and supports the academic progress of MHCI students within the Department of Medical Ethics and Health Policy’s Online Educational Initiatives. She is also the curriculum director of online clinical and research ethics education for Penn medical students.

Prof. Fernandez Lynch pursues conceptual and empirical research and scholarship with the goal of influencing institutional and governmental policy. Her work focuses on clinical research ethics and regulation, priority setting in research, access to investigational medicines outside clinical trials, FDA pharmaceutical policy, and the ethics of gatekeeping in health care. She is founder and co-chair of the Consortium to Advance Effective Research Ethics Oversight (www.AEREO.org), an organization working to evaluate and improve IRB quality and effectiveness, and an active member of the NYU Working Group on Compassionate Use and Preapproval Access (CUPA). She serves as a member of the boards of Public Responsibility in Medicine and Research (PRIM&R) and the American Society for Law, Medicine, and Ethics, and as "ethicist in residence" at the Robert Wood Johnson Foundation. She was previously a member of the U.S. Department of Health and Human Services Secretary’s Advisory Committee on Human Research Protections (SACHRP).  

Professor Fernandez Lynch has worked as an attorney in private practice, as a bioethicist serving NIH’s Division of AIDS, as an analyst with President Obama's Commission for the Study of Bioethical Issues, and as executive director of Harvard Law School's bioethics and health law research program. She was named a Greenwall Faculty Scholar in 2019 and elected a fellow of the Hastings Center in 2021.

Disclosures
The following planning committee member has reported the following relevant financial relationships with commercial interests related to the content of this educational activity:
Ezekiel J. Emanuel, MD, PhD: Leigh Bureau, Speaker Honorarium; Oak HC/FT, Salary; Nuna, Stock Shareholder

The faculty and planning committee members listed below have disclosed that they have no relevant financial relationships with any commercial interests related to the content of this educational activity:
Steven Joffe, MD, MPH
Autumn Fiester, PhD
Dominic A. Sisti, PhD
Connie Ulrich, PhD, MSN
Amy Ashbridge, MBA
Adam Zolkover, MA
Laura C. Hart, MFA
Mila Kostic, CHCP, FACEHP
Michael Schoen, PhD
Rodman Campbell, CHCP
Patricia Smith, DNP, RN, BC

The faculty reported that there will be no mention of investigational and/or off-label use of products in this presentation.

Ezekiel J. Emanuel, MD, PhD, Vice Provost for Global Initiatives
Co-Director of the Healthcare Transformation Institute at the University of Pennsylvania
University of Pennsylvania
Philadelphia, PA
Holly Fernandez Lynch, JD, MBE
University of Pennsylvania
Philadelphia, PA
Steven Joffe, MD, MPH, Chief, Division of Medical Ethics
Chair, Department of Medical Ethics and Health Policy
Perelman School of Medicine
Philadelphia, PA
Emily Largent, JD, PhD, RN, Senior Fellow, Leonard Davis Institute of Health Economics
Emanuel and Robert Hart Assistant Professor of Medical Ethics and Health Policy, Perelman School of Medicine
University of Pennsylvania, Carey Law School
Philadelphia, PA

Instructions to Claim Credit
To receive your Certificate of Credit for participating in this CME/CE-certified educational curriculum, please follow these steps: 

Read all the introductory material including faculty and disclosure information

  • Review the video lectures, references and resources 
  • This course has 3 sections. Each section has a post-test with between 5 and 10 questions. You will have 5 attempts to earn at least 90% on all post-tests individually in order to complete the course and earn your certificate. 
  • Evaluate the activity using the brief survey.
  • You must complete the post activity evaluation to receive credit. 
  • You will be able to download your certificate after completing the post-activity evaluation.
Purchase
A History of Ethics in Medical Research (9:12)
Register to Access
The Rationale of Research Ethics and the Nuremberg Code (9:46)
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The Belmont Report (8:33)
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Eight Principles of Ethical Research (13:32)
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US Public Health Service Syphilis Study at Tuskegee (6:48)
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The Ethics of the USPHS Syphilis Study, Part I (6:32)
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The Ethics of the USPHS Syphilis Study, Part II (6:35)
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The History of Research Ethics, and the Eight Principles of Ethical Research - Post Test
History and Rationale of Research Ethics
  • A History of Ethics in Medical Research
  • The Rationale of Research Ethics and the Nuremberg Code
  • The Belmont Report
Eight Principles of Ethical Research
  • Eight Principles of Ethical Research
  • US Public Health Service Syphilis Study
  • Ethics of USPHS, Part I
  • Ethics of USPHS, Part II

Participants must have a score of 90% to pass. 

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The Common Rule (12:43)
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IRB Oversight of Research (7:25)

Note: To harmonize with the Common Rule and NIH requirements, FDA issued a proposed rule in September 2022 that, if finalized, would adopt a single IRB review requirement for research under its jurisdiction.

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Assessing Research Risks and Benefits (11:42)
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Informed Consent Under the Common Rule (7:33)
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Ethics of Informed Consent, Part I (6:17)
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Ethics of Informed Consent, Part II (5:51)
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Therapeutic Misconception (8:45)
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Coercion and Undue Inducement (11:30)
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Exploitation (5:22)
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The Ethics of Payment (8:52)
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Research with Data and Specimens (11:46)

Note: As of 2023, regulators have not offered additional guidance about which data and specimens will be deemed identifiable, as was contemplated by the revised Common Rule.

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The Common Rule and Related Ethical Considerations - Post-Test
  • The Common Rule
  • IRB Oversight of Research
  • Assessing Research Risks and Benefits
  • Informed Consent Under the Common Rule
  • Ethics of Informed Consent, Part I
  • Ethics of Informed Consent, Part II
  • Therapeutic Misconception
  • Coercion and Undue Inducement
  • Exploitation
  • The Ethics of Payment
  • Research with Data and Specimens

Participants must have a score of 80% to pass. 

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FDA Regulated Research, Part I (7:27)
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FDA Regulated Research, Part II (8:06)

Note: In December 2023, the FDA finalized regulations to allow consent waiver for certain minimal risk investigations under the same conditions set forth in the Common Rule.

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Privacy and HIPAA Compliance (7:34)
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Navigating Conflicts of Interest (9:47)
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International Ethics Guidelines, Part I: The Declaration of Helsinki (8:42)
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International Ethics Guidelines, Part II: CIOMS (10:28)
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International Ethics Guidelines, Part III: ICH Guidance E6, E8 (8:27)

Note: The ICH E6 guideline on Good Clinical Practice is currently undergoing a revision process, as of 2023. More information is available here.

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Additional Regulations and Guidance Post-Test
Additional Regulations and Guidance
  • FDA Regulated Research, Part I
  • FDA Regulated Research, Part II
  • Privacy and HIPAA Compliance
  • Navigating Conflicts of Interest
  • International Ethics Guidelines, Part I: The Declaration of Helsinki
  • International Ethics Guidelines, Part II: CIOMS
  • International Ethics Guidelines, Part III: ICH Guidance (E6, E8) 

Participants must pass with a score of 80%.

Purchase
Ethics of Research with Human Subjects – Supplementary Materials
Once the reference list opens and the pdf is displayed, please right click on the links for them to open in a new window. 
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Ethics of Research with Human Subjects – Supplementary Materials - Eight Requirements for Ethical Research
Once the reference list opens and the pdf is displayed, please right click on the links for them to open in a new window. 
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Ethics of Research with Human Subjects – Supplementary Materials - Institutional Review Board Overview
Once the reference list opens and the pdf is displayed, please right click on the links for them to open in a new window. 
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Ethics of Research with Human Subjects – Supplementary Materials - Checklist of Elements for Informed Consent
Once the reference list opens and the pdf is displayed, please right click on the links for them to open in a new window. 
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Ethics of Research with Human Subjects – Supplementary Materials - Evaluating Risk in Research Studies
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Contact us:  [email protected] | 215-898-8005 © 2019 The Trustees of the University of Pennsylvania. Privacy Policy
 
UPenn is Joint Accredited for Interprofessional Continuing Education
In support of improving patient care, Penn Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
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