1What is the primary purpose of an Institutional Review Board (IRB)?
Institutional Review Board (IRB) and its functions
Easy
A.To secure funding for research projects
B.To protect the rights and welfare of human research subjects
C.To publish research findings in journals
D.To recruit scientists for a study
Correct Answer: To protect the rights and welfare of human research subjects
Explanation:
An IRB reviews and monitors research involving human subjects to ensure their rights, safety, and welfare are protected.
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2Which document must researchers typically submit to an IRB before beginning a study with human participants?
Institutional Review Board (IRB) and its functions
Easy
A.A tax return
B.A research protocol
C.A patent application
D.A marketing plan
Correct Answer: A research protocol
Explanation:
Researchers submit a detailed protocol describing the study so the IRB can evaluate its ethical and scientific soundness.
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3What is the term for a participant's voluntary agreement to take part in research after being fully informed?
Ethical issues in clinical research
Easy
A.Peer review
B.Randomization
C.Informed consent
D.Data anonymization
Correct Answer: Informed consent
Explanation:
Informed consent means participants understand the study's risks, benefits, and procedures and agree voluntarily to take part.
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4In a clinical trial, a placebo is best described as:
Ethical issues in clinical research
Easy
A.An inactive substance with no therapeutic effect
B.A genetic test
C.A surgical procedure
D.A high dose of the study drug
Correct Answer: An inactive substance with no therapeutic effect
Explanation:
A placebo is an inactive treatment used as a comparison to measure the true effect of the active intervention.
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5Which of the following is considered a vulnerable population in research?
Vulnerable populations
Easy
A.Salaried professionals
B.Government officials
C.University professors
D.Children
Correct Answer: Children
Explanation:
Children are vulnerable because they cannot fully give informed consent and require extra protections in research.
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6Why do vulnerable populations require special protection in research?
Vulnerable populations
Easy
A.They complete studies faster
B.They may have limited ability to protect their own interests
C.They always produce better data
D.They are cheaper to recruit
Correct Answer: They may have limited ability to protect their own interests
Explanation:
Vulnerable groups may face barriers to giving free, informed consent, so ethical rules provide added safeguards.
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7Which group is typically NOT classified as a vulnerable population?
Vulnerable populations
Easy
A.Cognitively impaired individuals
B.Prisoners
C.Healthy independent adults
D.Pregnant women
Correct Answer: Healthy independent adults
Explanation:
Healthy, competent adults can make free and informed decisions, so they are not considered a vulnerable group.
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8In research ethics, a favorable risk-benefit ratio means that:
Risks and benefits
Easy
A.Risks are completely eliminated
B.Costs are lower than expected
C.Potential benefits justify the potential risks
D.Benefits are guaranteed to every subject
Correct Answer: Potential benefits justify the potential risks
Explanation:
Ethical research requires that the anticipated benefits reasonably outweigh the risks to participants.
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9Who is responsible for assessing whether the risks of a study are reasonable in relation to its benefits?
Risks and benefits
Easy
A.The journal editor
B.The funding agency's accountant
C.The study participants alone
D.The Institutional Review Board
Correct Answer: The Institutional Review Board
Explanation:
The IRB evaluates the balance of risks and benefits before approving research involving human subjects.
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10Who should generally be listed as an author on a research paper?
Authorship
Easy
A.The head of funding only
B.Someone who made a significant intellectual contribution
C.Anyone who works in the department
D.The journal reviewer
Correct Answer: Someone who made a significant intellectual contribution
Explanation:
Authorship requires substantial contribution to the design, execution, or interpretation of the research.
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11The unethical practice of listing someone as an author who did not contribute is called:
Authorship
Easy
A.Acknowledgment
B.Gift (honorary) authorship
C.Corresponding authorship
D.Peer review
Correct Answer: Gift (honorary) authorship
Explanation:
Gift or honorary authorship credits a person who did not make a genuine contribution, which is considered unethical.
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12Failing to credit a person who made a major contribution to a study is known as:
Authorship
Easy
A.Ghost authorship
B.Plagiarism of ideas
C.Fabrication
D.Falsification
Correct Answer: Ghost authorship
Explanation:
Ghost authorship omits someone who deserves credit for their substantial contribution, violating authorship ethics.
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13The ethical principle emphasizing that human subjects must be safeguarded during research is broadly known as:
Human protectionism
Easy
A.Cost optimization
B.Market analysis
C.Human protection
D.Data mining
Correct Answer: Human protection
Explanation:
Human protection focuses on ensuring the safety, dignity, and rights of people who participate in research.
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14Which historical document helped establish principles for protecting human research subjects?
Human protectionism
Easy
A.The Paris Agreement
B.The Kyoto Protocol
C.The Geneva Convention on trade
D.The Nuremberg Code
Correct Answer: The Nuremberg Code
Explanation:
The Nuremberg Code set foundational ethical standards, including voluntary consent, for research on humans.
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15Making up data that was never actually collected is known as:
Issues in research ethics
Easy
A.Peer review
B.Fabrication
C.Replication
D.Citation
Correct Answer: Fabrication
Explanation:
Fabrication is the invention of data or results, one of the most serious forms of research misconduct.
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16Using another person's words or ideas without proper credit is called:
Issues in research ethics
Easy
A.Anonymization
B.Randomization
C.Plagiarism
D.Falsification
Correct Answer: Plagiarism
Explanation:
Plagiarism is presenting someone else's work or ideas as one's own without acknowledgment.
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17Which type of cloning is aimed at producing a genetically identical individual?
Ethical issues in human cloning reproduction and stem cells research
Easy
A.Protein folding
B.Therapeutic cloning
C.Reproductive cloning
D.Gene sequencing
Correct Answer: Reproductive cloning
Explanation:
Reproductive cloning seeks to create a full organism genetically identical to another, raising major ethical concerns.
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18A major ethical concern in embryonic stem cell research is:
Ethical issues in human cloning reproduction and stem cells research
Easy
A.The destruction of human embryos
B.The high cost of microscopes
C.The speed of computers
D.The lack of laboratories
Correct Answer: The destruction of human embryos
Explanation:
Obtaining embryonic stem cells typically involves destroying an embryo, which raises debates about the moral status of the embryo.
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19Biological weapons are best defined as agents that use which of the following to cause harm?
Social and ethical implications of biological weapons
Easy
A.Electromagnetic pulses
B.Chemical explosives only
C.Nuclear fission reactions
D.Living organisms or their toxins
Correct Answer: Living organisms or their toxins
Explanation:
Biological weapons deliberately use pathogens or toxins to cause disease or death in humans, animals, or plants.
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20Euthanasia is best described as:
Euthanasia
Easy
A.A form of medical imaging
B.Intentionally ending a life to relieve suffering
C.A method of vaccine production
D.A type of genetic sequencing
Correct Answer: Intentionally ending a life to relieve suffering
Explanation:
Euthanasia refers to deliberately ending a person's life to relieve incurable suffering, raising significant ethical debate.
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21A researcher submits a protocol to enroll healthy adult volunteers in a low-risk survey study. Under standard regulations, the IRB may assign this study to which review category?
Institutional Review Board (IRB) and its functions
Medium
A.Full board review with quarterly reporting
B.Mandatory data safety monitoring board oversight
C.Automatic exemption without any submission
D.Expedited review
Correct Answer: Expedited review
Explanation:
Minimal-risk research such as low-risk surveys often qualifies for expedited review by a designated IRB member rather than the full board. It still requires submission, so it is not automatically exempt without any process.
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22An IRB reviews a study and finds the consent form adequate but the risk-mitigation plan incomplete. What is the most appropriate IRB action?
Institutional Review Board (IRB) and its functions
Medium
A.Permanently ban the investigator
B.Require modifications before approval
C.Approve as submitted
D.Refer directly to law enforcement
Correct Answer: Require modifications before approval
Explanation:
An IRB can approve, require modifications to secure approval, or disapprove research. When a plan is incomplete, requiring modifications is the standard action rather than outright approval or punitive measures.
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23A placebo-controlled trial is proposed for a condition that already has an effective standard treatment. Why is this design ethically problematic?
Ethical issues in clinical research
Medium
A.It reduces the sample size needed
B.It always increases the cost of the trial
C.It automatically violates copyright law
D.It may deny participants a proven effective therapy
Correct Answer: It may deny participants a proven effective therapy
Explanation:
Using a placebo when an effective treatment exists can expose participants to avoidable harm by withholding known benefit. Ethical guidelines generally require active comparators in such cases.
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24In a clinical trial, which practice best upholds the principle of informed consent?
Ethical issues in clinical research
Medium
A.Disclosing only the benefits to encourage participation
B.Explaining risks, benefits, and the right to withdraw before enrollment
C.Obtaining a signature only after the study ends
D.Enrolling participants first and informing them later
Correct Answer: Explaining risks, benefits, and the right to withdraw before enrollment
Explanation:
Valid informed consent requires disclosing risks, benefits, and the voluntary right to withdraw before participation begins, ensuring the decision is informed and free.
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25Which group is generally considered a vulnerable population requiring additional research safeguards?
Vulnerable populations
Medium
A.Prisoners
B.University faculty
C.Retired engineers
D.Salaried office employees
Correct Answer: Prisoners
Explanation:
Prisoners are classified as vulnerable because incarceration can compromise their ability to give truly voluntary consent, so extra protections are mandated.
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26A study seeks to enroll children. What additional consent requirement typically applies compared to studies with competent adults?
Vulnerable populations
Medium
A.Parental permission plus the child's assent where appropriate
B.Only the researcher's approval is required
C.Written consent from the school principal alone
D.No consent is needed for minors
Correct Answer: Parental permission plus the child's assent where appropriate
Explanation:
Because children cannot give full legal consent, research usually requires parental or guardian permission along with the child's assent when they are capable of understanding.
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27An IRB evaluates a study where potential harms clearly outweigh anticipated benefits to participants and society. According to the risk-benefit principle, the study should be:
Risks and benefits
Medium
A.Approved only if it is inexpensive
B.Not approved unless the balance is favorable
C.Approved with a shortened consent form
D.Approved to allow scientific progress
Correct Answer: Not approved unless the balance is favorable
Explanation:
Ethical research requires that anticipated benefits justify the risks. When risks outweigh benefits, the study should not proceed until the balance is acceptable.
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28Which of the following is the best example of minimizing risk in a research design?
Risks and benefits
Medium
A.Increasing the drug dose to speed up results
B.Using the least invasive procedure that answers the question
C.Recruiting only vulnerable individuals for convenience
D.Removing the option to withdraw to keep data complete
Correct Answer: Using the least invasive procedure that answers the question
Explanation:
Minimizing risk means selecting procedures that reduce potential harm while still achieving the scientific aim, such as choosing the least invasive method available.
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29A technician ran all the experiments but contributed no intellectual input to the study design, analysis, or writing. Under standard authorship criteria, this person should typically be:
Authorship
Medium
A.Excluded from any mention entirely
B.Listed as corresponding author
C.Listed as first author
D.Acknowledged rather than listed as an author
Correct Answer: Acknowledged rather than listed as an author
Explanation:
Authorship requires substantial intellectual contribution to conception, analysis, or writing. Purely technical help is properly recognized in the acknowledgments section.
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30Listing a senior scientist as an author solely because of their position, despite no real contribution, is an example of:
Authorship
Medium
A.Corresponding authorship
B.Gift (honorary) authorship
C.Co-first authorship
D.Ghost authorship
Correct Answer: Gift (honorary) authorship
Explanation:
Adding someone as an author based on status rather than contribution is gift or honorary authorship, an ethical violation. Ghost authorship is the opposite—omitting a genuine contributor.
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31The concept of human protectionism in research is primarily grounded in which foundational document that emerged after unethical wartime experimentation?
Human protectionism
Medium
A.The Nuremberg Code
B.The Human Genome Declaration
C.The Geneva Convention on trade
D.The Kyoto Protocol
Correct Answer: The Nuremberg Code
Explanation:
The Nuremberg Code, developed after abuses in World War II, established voluntary consent and human protection as core principles of ethical research on humans.
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32Which ethical principle most directly requires researchers to protect participants from harm and maximize their well-being?
Human protectionism
Medium
A.Beneficence
B.Publication priority
C.Data ownership
D.Confidentiality of funding
Correct Answer: Beneficence
Explanation:
Beneficence, a core Belmont Report principle, obligates researchers to do no harm and to maximize possible benefits while minimizing risks to participants.
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33A researcher reuses large portions of their own previously published text in a new paper without citation. This practice is best described as:
Issues in research ethics
Medium
A.Peer review
B.Fabrication
C.Falsification
D.Self-plagiarism
Correct Answer: Self-plagiarism
Explanation:
Reusing one's own published work without acknowledgment is self-plagiarism. Fabrication is inventing data and falsification is manipulating data, which are different offenses.
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34Which scenario is the clearest example of data falsification?
Issues in research ethics
Medium
A.Altering recorded measurements to fit a hypothesis
B.Citing another author correctly
C.Sharing raw data with reviewers
D.Reporting an unexpected negative result honestly
Correct Answer: Altering recorded measurements to fit a hypothesis
Explanation:
Falsification involves manipulating or changing real data or results, such as altering recorded measurements. Honest reporting and correct citation are ethical practices.
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35What is a central ethical objection to reproductive human cloning as opposed to therapeutic cloning?
Ethical issues in human cloning reproduction and stem cells research
Medium
A.It produces no ethical debate at all
B.It aims to create a genetically identical whole human being with safety and dignity concerns
C.It uses adult stem cells only
D.It is universally approved by all regulatory bodies
Correct Answer: It aims to create a genetically identical whole human being with safety and dignity concerns
Explanation:
Reproductive cloning intends to produce a full human being, raising serious concerns about safety, identity, and human dignity, whereas therapeutic cloning targets tissue or cell generation for treatment.
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36Much of the ethical controversy surrounding embryonic stem cell research centers on which issue?
Ethical issues in human cloning reproduction and stem cells research
Medium
A.The high cost of laboratory equipment
B.The naming of cell lines
C.The difficulty of writing grant proposals
D.Destruction of the embryo to obtain the cells
Correct Answer: Destruction of the embryo to obtain the cells
Explanation:
Obtaining embryonic stem cells typically requires destroying an embryo, which raises debate about the moral status of the embryo—the core ethical issue.
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37The dual-use dilemma in biological research refers to which situation?
Social and ethical implications of biological weapons
Medium
A.Two laboratories share the same equipment
B.A drug can treat two different diseases
C.Research can be published in two languages
D.Legitimate research findings can be misused to create harmful weapons
Correct Answer: Legitimate research findings can be misused to create harmful weapons
Explanation:
Dual-use research produces knowledge intended for beneficial purposes that could also be exploited to develop biological weapons, creating an ethical and security tension.
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38Which international agreement specifically prohibits the development and stockpiling of biological weapons?
Social and ethical implications of biological weapons
Medium
The Biological Weapons Convention (1972) bans the development, production, and stockpiling of biological weapons. The other documents address research ethics, not weapons.
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39A physician withholds a life-sustaining treatment at a terminally ill, competent patient's explicit request, allowing the natural course of disease. This is best classified as:
Euthanasia
Medium
A.Active involuntary euthanasia
B.Physician-assisted homicide
C.Non-voluntary active euthanasia
D.Passive voluntary euthanasia
Correct Answer: Passive voluntary euthanasia
Explanation:
Withholding treatment at a competent patient's request is passive (allowing death rather than causing it directly) and voluntary (patient consents), distinguishing it from active or involuntary forms.
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40What key ethical distinction separates active euthanasia from passive euthanasia?
Euthanasia
Medium
A.Active involves a deliberate act to cause death, passive involves withholding or withdrawing treatment
B.Active applies only to animals and passive only to humans
C.Active is always legal while passive is always illegal
D.Active requires no consent while passive requires a court order
Correct Answer: Active involves a deliberate act to cause death, passive involves withholding or withdrawing treatment
Explanation:
Active euthanasia is a positive action intended to end life, whereas passive euthanasia involves letting a patient die by withholding or withdrawing life-sustaining treatment.
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41A study proposes minimal-risk retrospective analysis of de-identified hospital records. The investigator argues it should be exempt from IRB review. Under the Common Rule, which factor most critically determines whether continuing IRB oversight (expedited vs. exempt) is warranted?
Institutional Review Board (IRB) and its functions
Hard
A.Whether the results will be published in a peer-reviewed journal
B.Whether the sample size exceeds 1000 records
C.Whether the study is funded by a federal agency
D.Whether identifiable private information could be readily traced back to individuals
Correct Answer: Whether identifiable private information could be readily traced back to individuals
Explanation:
Exemption hinges on whether human subjects are identifiable. If data are truly de-identified and cannot be linked back, exemption may apply; if re-identification is feasible, IRB oversight (at least expedited) is required. Funding, sample size, and publication venue do not determine exemption status.
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42In a Phase I oncology trial, participants have advanced disease with no standard options. The therapeutic dose is unknown and toxicity is expected. Which principle best justifies enrollment despite an unfavorable individual risk-benefit ratio?
Risks and benefits
Hard
A.The certainty that participants will directly benefit clinically
B.The obligation to maximize enrollment to accelerate approval
C.The requirement that risks be entirely eliminated before enrollment
D.The prospect of generalizable knowledge combined with informed, autonomous consent
Correct Answer: The prospect of generalizable knowledge combined with informed, autonomous consent
Explanation:
Phase I trials rarely offer direct benefit; ethical justification rests on societal value (generalizable knowledge) and genuinely informed, voluntary consent that acknowledges the low probability of personal benefit. Risks cannot be fully eliminated, direct benefit is not guaranteed, and maximizing enrollment is not an ethical justification.
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43A trial seeks to enroll incarcerated individuals for a study on a chronic disease unrelated to imprisonment. Which condition would most clearly render this ethically permissible under regulations governing prisoner research?
Vulnerable populations
Hard
A.The study requires no external IRB because prisons are self-regulating
B.The prison administration approves for operational convenience
C.The prisoners receive substantial payment improving their prison standing
D.The research concerns conditions affecting prisoners as a class and offers no undue inducement
Correct Answer: The research concerns conditions affecting prisoners as a class and offers no undue inducement
Explanation:
Special protections require that research involving prisoners fall into permitted categories (e.g., conditions affecting them as a class) and that incentives not be so large as to coerce given the constrained environment. Administrative convenience, standing-enhancing payments, and self-regulation are not valid justifications.
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44A senior lab head provided funding and lab space but did not contribute intellectually to a manuscript's design, analysis, or writing. Per ICMJE criteria, the appropriate action is to:
Authorship
Hard
A.List them as corresponding author regardless of contribution
B.List them as first author due to seniority
C.Acknowledge the contribution but not list them as an author
D.Omit any mention to avoid conflicts of interest
Correct Answer: Acknowledge the contribution but not list them as an author
Explanation:
ICMJE requires all four criteria including substantial intellectual contribution, drafting/revising, final approval, and accountability. Providing resources alone does not qualify for authorship; such contributions belong in the acknowledgments. Listing them as author would constitute gift/honorary authorship.
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45The '14-day rule' historically limits in vitro culture of human embryos. What is the primary developmental rationale underlying this specific threshold?
Ethical issues in human cloning reproduction and stem cells research
Hard
A.The first heartbeat detectable by ultrasound
B.The onset of the primitive streak, marking individuation and the end of possible twinning
C.The point of implantation in the uterine wall
D.The completion of neural tube closure
Correct Answer: The onset of the primitive streak, marking individuation and the end of possible twinning
Explanation:
Around day 14 the primitive streak appears, signaling the beginning of individuation (a single individual can no longer split into twins) and gastrulation. This developmental milestone, not heartbeat, neural closure, or implantation, underpins the moral significance of the 14-day boundary.
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46A competent terminally ill patient requests that a physician withdraw a life-sustaining ventilator, knowing death will follow. Ethically and legally, this is most accurately classified as:
Euthanasia
Hard
A.Passive euthanasia / withdrawal of treatment respecting autonomy
B.Involuntary euthanasia
C.Physician-assisted suicide
D.Active voluntary euthanasia
Correct Answer: Passive euthanasia / withdrawal of treatment respecting autonomy
Explanation:
Withdrawing unwanted life-sustaining treatment at a competent patient's request is withholding/withdrawal (often termed passive euthanasia) grounded in the right to refuse treatment. It differs from active euthanasia (administering a lethal agent) and assisted suicide (providing the means for the patient to end their own life).
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47A placebo-controlled trial is proposed for a new antihypertensive where effective standard treatment already exists. Under the Declaration of Helsinki, using a placebo arm is most defensible only when:
Ethical issues in clinical research
Hard
A.The sponsor requires it for faster regulatory approval
B.No proven intervention exists, or compelling methodological reasons justify it without serious harm risk
C.The placebo arm reduces trial costs significantly
D.Participants are unaware they might receive placebo
Correct Answer: No proven intervention exists, or compelling methodological reasons justify it without serious harm risk
Explanation:
Helsinki permits placebo only when no proven intervention exists, or where compelling scientific reasons exist and patients receiving placebo will not be subject to serious or irreversible harm. Cost, concealment, and regulatory speed do not ethically justify withholding effective treatment.
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48A researcher publishes gain-of-function methods that enhance pathogen transmissibility, citing scientific openness. This scenario best illustrates which ethical tension central to 'dual-use research of concern' (DURC)?
Social and ethical implications of biological weapons
Hard
A.Confidentiality versus the duty to warn identifiable third parties
B.Individual autonomy versus informed consent
C.Freedom of scientific inquiry versus prevention of misuse and public safety
D.Distributive justice versus beneficence in resource allocation
Correct Answer: Freedom of scientific inquiry versus prevention of misuse and public safety
Explanation:
DURC captures the tension between open dissemination of beneficial knowledge and the risk that the same information enables bioweapon development. The core conflict is scientific freedom/openness versus biosecurity and public safety, not consent, allocation, or confidentiality issues.
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49The Belmont principle of 'respect for persons' has two distinct components. When enrolling a patient with early-stage dementia who has fluctuating capacity, which action best honors both components?
Human protectionism
Hard
A.Proceeding based on the patient's original consent regardless of later capacity loss
B.Obtaining consent during lucid periods while providing additional protections such as a legal representative
C.Relying solely on a family member's decision without assessing the patient's wishes
D.Excluding all cognitively impaired individuals from any research
Correct Answer: Obtaining consent during lucid periods while providing additional protections such as a legal representative
Explanation:
Respect for persons requires honoring autonomy (seeking the individual's own consent when able) and protecting those with diminished autonomy (added safeguards). Combining lucid-period consent with a legal representative satisfies both. Blanket exclusion, ignoring the patient, or relying only on stale consent fails one component.
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50An investigator discovers that a co-author fabricated part of a dataset after publication. Which sequence of actions best conforms to responsible conduct of research?
Issues in research ethics
Hard
A.Notify the institution's research integrity officer and initiate correction or retraction of the publication
B.Publicly accuse the co-author on social media immediately
C.Quietly remove the co-author's name from future work
D.Ignore it since the paper is already published
Correct Answer: Notify the institution's research integrity officer and initiate correction or retraction of the publication
Explanation:
Suspected fabrication must be reported through proper institutional channels (research integrity officer), triggering investigation and, if confirmed, correction or retraction to preserve the scientific record. Silent removal, inaction, or public accusation bypass due process and fail the duty to maintain integrity.
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51During continuing review, an IRB learns of an unanticipated serious adverse event that shifts the risk-benefit balance unfavorably. The IRB's most appropriate immediate authority is to:
Institutional Review Board (IRB) and its functions
Hard
A.Delegate the decision entirely to the sponsor
B.Suspend or terminate approval and require re-consent or protocol modification
C.Refer the matter solely to the funding agency for a decision
D.Wait until the scheduled annual review to act
Correct Answer: Suspend or terminate approval and require re-consent or protocol modification
Explanation:
IRBs have authority to suspend or terminate approval of research not conducted in accordance with requirements or that has caused unexpected serious harm, and to require modifications or re-consent. Deferring to funders or sponsors, or waiting for annual review, abdicates the IRB's protective role.
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52In international research conducted in a low-income country, offering free healthcare that participants could never otherwise access raises concern about:
When benefits like otherwise-inaccessible care are so attractive that they distort judgment about risks, they constitute undue inducement, undermining truly voluntary consent especially among economically vulnerable populations. The issue concerns consent voluntariness, not placebos, authorship, or registration.
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53Induced pluripotent stem cells (iPSCs) are often cited as sidestepping a key ethical objection to embryonic stem cells. Which objection do they primarily circumvent?
Ethical issues in human cloning reproduction and stem cells research
Hard
A.The risk of teratoma formation in transplants
B.The destruction of human embryos to derive stem cells
C.The need for informed consent from donors
D.The problem of immune rejection after transplantation
Correct Answer: The destruction of human embryos to derive stem cells
Explanation:
iPSCs are reprogrammed from adult somatic cells, so their derivation does not require destroying embryos, the central moral objection to embryonic stem cells. Consent is still needed, and teratoma risk and (in allogeneic cases) rejection remain scientific concerns rather than the objection iPSCs resolve.
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54The doctrine of double effect is invoked to justify palliative sedation that may hasten death. For the doctrine to apply, which condition is essential?
Euthanasia
Hard
A.The lethal outcome is the direct means of achieving relief
B.The patient explicitly requests a lethal dose
C.The physician intends the patient's death to relieve suffering
D.The intended effect is symptom relief and death is a foreseen but unintended consequence
Correct Answer: The intended effect is symptom relief and death is a foreseen but unintended consequence
Explanation:
Double effect permits an action with a good intended effect (relieving suffering) even if a harmful effect (death) is foreseen, provided death is not intended and not the means to the good effect. If death is intended or used as the means, the doctrine no longer applies.
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55An IRB is evaluating a pediatric study with no prospect of direct benefit to child participants. Under the 'minor increase over minimal risk' standard, approval additionally requires that:
Risks and benefits
Hard
A.The research is likely to yield vital knowledge about the subjects' disorder or condition
B.The intervention offers a guaranteed therapeutic benefit
C.Parents waive all liability on behalf of the child
D.The children provide fully informed adult-level consent
Correct Answer: The research is likely to yield vital knowledge about the subjects' disorder or condition
Explanation:
For a minor increase over minimal risk with no direct benefit, regulations require that the intervention be commensurate with the child's situation and likely to yield generalizable knowledge of vital importance about the disorder/condition. Liability waivers, adult consent, and guaranteed benefit are not the operative criteria.
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56Two researchers dispute the order of authorship on a collaborative paper where contributions were roughly equal. Which mechanism most appropriately resolves this within accepted publishing norms?
Authorship
Hard
A.Excluding one author to avoid the dispute
B.Designating co-first authorship with an equal-contribution footnote
C.Assigning first authorship to the more senior researcher automatically
D.Alphabetical ordering imposed by the journal editor
Correct Answer: Designating co-first authorship with an equal-contribution footnote
Explanation:
When contributions are genuinely equal, journals accept co-first authorship denoted by an equal-contribution statement. Defaulting to seniority ignores actual contribution, editors do not impose ordering, and excluding a legitimate contributor would be misconduct.
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57The Biological Weapons Convention (BWC) is often criticized for a structural weakness compared to the Chemical Weapons Convention. This weakness is:
Social and ethical implications of biological weapons
Hard
A.The lack of any signatory states
B.The absence of a formal verification and inspection mechanism
C.The permission to stockpile pathogens for defense
D.The failure to ban offensive research entirely
Correct Answer: The absence of a formal verification and inspection mechanism
Explanation:
Unlike the CWC, the BWC lacks a legally binding verification/inspection regime, making compliance difficult to confirm. It does prohibit development and stockpiling for offensive purposes and has many signatories, so the acknowledged gap is verification, not scope or membership.
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58A trial's data safety monitoring board (DSMB) observes at interim analysis that the experimental arm shows overwhelming benefit exceeding a pre-specified stopping boundary. The ethically indicated action is to:
Ethical issues in clinical research
Hard
A.Unblind only the sponsor and continue enrollment
B.Recommend early termination so all participants can access the effective treatment
C.Continue to the planned end for maximal statistical power
D.Switch the control arm to a placebo
Correct Answer: Recommend early termination so all participants can access the effective treatment
Explanation:
When a pre-specified efficacy stopping boundary is crossed, continuing to randomize participants to the inferior arm becomes unethical (equipoise is lost). The DSMB should recommend stopping so participants gain access to the beneficial treatment. Pursuing power at participants' expense violates beneficence.
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59The Tuskegee Syphilis Study is a foundational case in research ethics. Its most egregious violation, which directly shaped later protections, was:
Human protectionism
Hard
A.Failing to publish the study results
B.Withholding available effective treatment (penicillin) from participants without disclosure
C.Enrolling participants from multiple countries without harmonized rules
D.Paying participants excessive incentives
Correct Answer: Withholding available effective treatment (penicillin) from participants without disclosure
Explanation:
In Tuskegee, effective penicillin therapy was deliberately withheld and the study's true nature concealed, causing preventable harm. This deception and denial of treatment drove reforms including the Belmont Report and informed consent requirements, not issues of publication, payment, or multinational rules.
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60A researcher holds equity in the company sponsoring the drug trial they lead. Beyond disclosure, which management strategy most robustly addresses this conflict of interest?
Issues in research ethics
Hard
A.Increasing the sample size to dilute bias
B.Selecting only participants likely to respond favorably
C.Divesting the financial interest or delegating trial oversight to an independent party
D.Simply noting the interest in the methods section
Correct Answer: Divesting the financial interest or delegating trial oversight to an independent party
Explanation:
Disclosure alone does not eliminate a financial conflict of interest. Robust management requires reducing or removing the conflict itself, through divestiture or independent oversight of the trial. Mentioning it, enlarging samples, or biasing participant selection do not neutralize the bias risk.
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