Sports Medicine

, Volume 32, Issue 3, pp 169–183 | Cite as

Ethics in Exercise Science Research

Leading Article


Ethical evaluation is a vital but sometimes neglected component of research policy in the exercise sciences. This article reviews some issues in human research, with particular reference to studies undertaken by the exercise scientist. The typical composition and functions of the research review committee are examined in the context of individual and institutional ethical norms. In multicentre trials, there are often problems in coordinating ethical approval between institutions. On-going monitoring of research may have value in the detection of fraud. A reduction in the secrecy of committee proceedings would allow a closer auditing of the research review process. Authors need to give more thought to developing appropriate research questions. Scarce resources may be wasted because of inappropriate study design or an inadequate statistical analysis of the results. The costs of any proposed investigation must be weighed carefully against possible benefits. Confidentiality is particularly important when collecting data at the worksite or over the internet. Informed consent should be based on a full disclosure of risks; the participant should be competent to understand the nature and magnitude of these risks, and undue pressure to participate in an experiment must be avoided. The opposition to placebo trials expressed in the Declaration of Helsinki requires careful consideration of the use of control groups, since regular exercise is known to benefit health. If research is conducted in under-developed societies, the standards of treatment of the participants should match those expected in developed societies. The publication of findings must be fair and well balanced; examples of fraud and misconduct continue to be reported. Some journals apparently still publish papers, even if they have not received an initial institutional review. Editors should restore meaning to the word ‘author’, avoid the bias to a publication of ‘positive’ results, limit the impact of commercial sponsorship on reporting and curtail the current trend to redundant presentations and publications. Development of academic courses in research ethics may help to avoid some of these abuses.


  1. 1.
    Onions CT, editor. Shorter Oxford dictionary. 3rd ed. Oxford: Clarendon Press, 1964Google Scholar
  2. 2.
    Kant I, Heath PL, Schneewind JB, editors. Lectures on ethics. Translated by Heath PL. New York (NY): Cambridge University Press, 1997Google Scholar
  3. 3.
    Mill JS. Utilitarianism. New York (NY): Longmans Green, 1907Google Scholar
  4. 4.
    Leaning J. War crimes and medical science. BMJ 1996; 313: 1413–5PubMedCrossRefGoogle Scholar
  5. 5.
    Lock S. Research ethics: a brief historical review to 1965. J Intern Med 1995; 238: 513–20PubMedCrossRefGoogle Scholar
  6. 6.
    Reich WT. Encyclopedia of bioethics. New York (NY): Simon and Schuster MacMillan, 1995Google Scholar
  7. 7.
    World Medical Association. Human experimentation: code of ethics of the World Medical Association. BMJ 1964; II: 177Google Scholar
  8. 8.
    Clegg H. Human experimentation. World Med J 1960; 7: 77–9PubMedGoogle Scholar
  9. 9.
    World Medical Association. Ethical principles for medical research involving human subjects. Geneva:World Medical Association, 2000Google Scholar
  10. 10.
    Cruess RL, Cruess SR. Professionalism, laws and kings. Clin Invest Med 1997; 20: 407–13PubMedGoogle Scholar
  11. 11.
    Medical Research Council. Guidelines on research involving human subjects. Ottawa (ON): Medical Research Council, 1987Google Scholar
  12. 12.
    Tricouncil Working Group. Code of conduct for research involving humans. Ottawa (ON): Department of Supply and Services, 1996Google Scholar
  13. 13.
    Canadian Medical Association. Code of ethics of the Canadian Medical Association. Ottawa (ON): Canadian Medical Association, 1996Google Scholar
  14. 14.
    Kenny NP. The CMA code of ethics: more room for reflection. Can Med Assoc J 1996; 155: 1063–5Google Scholar
  15. 15.
    Ruyter KW. Medical research ethics 50 years after Nuremberg. Tidsskr Nor Laegeforen 1997; 117: 4383–91PubMedGoogle Scholar
  16. 16.
    Baum M. Education and debate: Declaration of Helsinki should be strengthened. BMJ 2000; 321: 442–5CrossRefGoogle Scholar
  17. 17.
    Rothman KJ, Michels KB. Education and debate: Declaration of Helsinki should be strengthened. BMJ 2000; 321: 442–5PubMedCrossRefGoogle Scholar
  18. 18.
    Veatch R. Medical codes and oaths. In: Reich W, editor. Encyclopedia of bioethics. Vol. 3. New York (NY): Simon Schuster MacMillan, 1995: 1419–35Google Scholar
  19. 19.
    Dickens BM. Human research beyond the medical model: legal and ethical issues. Med Law 1997; 16: 687–703PubMedGoogle Scholar
  20. 20.
    American College of Sports Medicine. Policy statement regarding the use of human subjects and informed consent. Med Sci Sports Exerc 2000; 32: viGoogle Scholar
  21. 21.
    American Psychological Association. Ethical principles in the conduct of research with human participants. Washington, DC: American Psychological Association, 1982CrossRefGoogle Scholar
  22. 22.
    American College of Sports Medicine. Code of ethics. Indianapolis (IN): American College of Sports Medicine, 2001Google Scholar
  23. 23.
    American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 6th ed. Philadelphia (PA): Lippincott, Williams and Wilkins, 2000Google Scholar
  24. 24.
    Ethical standards. Journal of Physiology [online]. Available from URL: #ethstan [Accessed 2002 Jan 30]
  25. 25.
    Shephard RJ. Ethical considerations in human experimentation. Can Assoc Health Phys Exerc Recreation J 1967; 33: 13–6Google Scholar
  26. 26.
    Shephard RJ. Alive, man: the physiology of physical activity. Springfield (IL): CC Thomas, 1972Google Scholar
  27. 27.
    Kent G. The views of members of local research ethics committees, researchers, and members of the public towards the roles and functions of LRECs. J Med Ethics 1997; 23: 186–90PubMedCrossRefGoogle Scholar
  28. 28.
    Weijer C, Dickens B, Meslin EM. Bioethics for clinicians: 10. Research ethics. Can Med Assoc J 1997; 156: 1153–7Google Scholar
  29. 29.
    Coker R, McKee M. Ethical approval for health research in central and eastern Europe: an international survey. Clin Med 2001; 1: 197–9PubMedGoogle Scholar
  30. 30.
    Lynoe N, Sandlund M, Jacobsson L. Research ethics committees: a comparative study of assessment of ethical dilemmas. Scand J Public Health 1999; 27: 152–9PubMedCrossRefGoogle Scholar
  31. 31.
    DeRenzo EG. Power differentials, context, relationship, and emotions: feminist ethics considerations and human subjects research. J Womens Health 1998; 7: 971–7PubMedCrossRefGoogle Scholar
  32. 32.
    Berk RA, Korenman SG, Wenger NS. Measuring consensus about scientific research norms. Sci Eng Ethics 2000; 6: 315–40PubMedCrossRefGoogle Scholar
  33. 33.
    Wenger NS, Korenman SG, Berk R, et al. The ethics of scientific research: an analysis of focus groups of scientists and institutional representatives. J Investig Med 1997; 45: 371–80PubMedGoogle Scholar
  34. 34.
    Price JH, Dake JA, Islam R. Selected ethical issues in research and publication: perceptions of health education faculty. Health Educ Behav 2001; 28: 51–64PubMedCrossRefGoogle Scholar
  35. 35.
    Blunt J, Watson AJM. Meeting the challenges facing research ethics committees: some practical suggestions. BMJ 1998; 316: 58–61PubMedCrossRefGoogle Scholar
  36. 36.
    Lux AL, Edwards SW, Osborne JP. Responses of local research ethics committees to a study with approval froma multicentre research ethics committee. BMJ 2000; 320: 1182–3PubMedCrossRefGoogle Scholar
  37. 37.
    Alberti KGM. Multicentre research ethics committees: has the cure been worse than the disease? BMJ 2000; 320: 1157–8PubMedCrossRefGoogle Scholar
  38. 38.
    McCusker J, Kruszewski Z, Lacey B, et al. Monitoring clinical research: report of one hospital’s experience. Can Med Assoc J 2001; 164: 1321–5Google Scholar
  39. 39.
    Smith T, Moore EJH, Tunstall-Pedoe H. Review by a local medical research ethics committee of the conduct of approved research projects, by examination of patients’case notes, consent forms, and research records and by interview. BMJ 1997; 314: 1588–90PubMedCrossRefGoogle Scholar
  40. 40.
    Pickworth E. Should local research ethics committees monitor research they have approved? J Med Ethics 2000; 26: 330–3PubMedCrossRefGoogle Scholar
  41. 41.
    Ashcroft R, Pfeffer N. Ethics behind closed doors: do research ethics committees need secrecy? BMJ 2001; 322: 1294–6PubMedCrossRefGoogle Scholar
  42. 42.
    Hoffenberg R. A National Association LRECs? J R Coll Physicians Lond 1992; 26: 423–31Google Scholar
  43. 43.
    Foster C. Why do research ethics committees disagree with each other? J R Coll Physicians Lond 1995; 29: 315–8PubMedGoogle Scholar
  44. 44.
    Pearn J. Publication: an ethical imperative. BMJ 1995; 310: 1313–5PubMedCrossRefGoogle Scholar
  45. 45.
    Lee PN, Fry JS, Forey BA. Trends in lung cancer, chronic obstructive lung disease, and emphysema death rates for England and Wales 1941–85 and their relation to trends in cigarette smoking. Thorax 1990; 45: 657–65PubMedCrossRefGoogle Scholar
  46. 46.
    Harris TC. Re: OOH – near school and bulletins. BATES Numbers 511999051–9052, 1991. RJ Reynolds Tobacco Company Online Litigation Document Archive [online]. Available from URL: [Accessed 2002 Jan 21]
  47. 47.
    Phair JJ, Carey GCR, Shephard RJ. Measuring human reactions to air pollution. J Franklin Inst 1958; monograph 4: 37–51Google Scholar
  48. 48.
    Carey GC, Harley WJ, Melvin WW, et al. A clinical study of a respiratory disease in Kingsport, Tennessee. Cincinnati (OH): Kettering Laboratory, 1957Google Scholar
  49. 49.
    National Cancer Institute. Smoking and Tobacco Control Monograph 11: state and local legislative action to reduce tobacco use. Bethesda (MD): Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 2000. Report No.: NIH Publication 00–4804Google Scholar
  50. 50.
    National Cancer Institute. Population based smoking cessation: proceedings of a conference on what works to influence cessation in the general population. Bethesda (MD): Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 2000. Report No.: NIH Publication 00–4892,Google Scholar
  51. 51.
    de Gruchy J, Lewin S. Ethics that exclude: the role of ethics committees in lesbian and gay health research in SouthAfrica. Am J Public Health 2001; 91: 865–8PubMedCrossRefGoogle Scholar
  52. 52.
    Soderstrom M. Why researchers excluded women from their trial populations. Lakartidningen 2001; 98: 1524–8PubMedGoogle Scholar
  53. 53.
    Marrococco A, Stewart DE. We’ve come a long way, maybe: recruitment of women and analysis of results by sex in clinical research. J Womens Health 2001; 10: 175–9Google Scholar
  54. 54.
    Shephard RJ. Human rights and worker selection [editorial]. Can J Sport Sci 1989; 14: 132–3PubMedGoogle Scholar
  55. 55.
    Shephard RJ, Bonneau J. Avoiding gender discrimination in recruitment standards for police officers. Can J Appl Physiol. In pressGoogle Scholar
  56. 56.
    Savulescu J, Chalmers I, Blunt J. Are ethics research committees behaving unethically?. Some suggestions for improving accountability. BMJ 1996; 313: 1390–3PubMedCrossRefGoogle Scholar
  57. 57.
    Kleinman I, Baylis F, Rodgers S, et al. Bioethics for clinicians: 8. Confidentiality. Can Med Assoc J 1997; 156: 521–4Google Scholar
  58. 58.
    Singer PA. Recent advances. medical ethics. BMJ 2000; 321: 282–5PubMedCrossRefGoogle Scholar
  59. 59.
    Doyal L. Informed consent inmedical research: journals should not publish research to which patients have not given fully informed consent -with three exceptions. BMJ 1997; 314: 1107–11PubMedCrossRefGoogle Scholar
  60. 60.
    Hébert PC, Hoffmaster B, Glass KC, et al. Bioethics for clinicians: 7. Truth telling. Can Med Assoc J 1997; 156: 225–8Google Scholar
  61. 61.
    Deaths in Bristol have changed the face of British medicine [news]. Can Med Assoc J 2001; 165: 628Google Scholar
  62. 62.
    Shephard RJ. Exercise and sudden death: an overview. Sport Sci Rev 1995; 4 (2): 1–13Google Scholar
  63. 63.
    Macklin R. Understanding informed consent. Acta Oncol 1999; 38: 83–7PubMedCrossRefGoogle Scholar
  64. 64.
    Kopelman LM. Children as research subjects: a dilemma. J Med Philos 2000; 25: 745–64PubMedCrossRefGoogle Scholar
  65. 65.
    Ruyter KW, Nyquist I. Children as medical research subjects. Tidsskr Nor Laegeforen 1999; 119: 2833–7PubMedGoogle Scholar
  66. 66.
    Harrison C, Kenny N, Sidarous M, et al. Bioethics for clinicians: 9. Involving children in medical decisions. Can Med Assoc J 1997; 156: 825–8Google Scholar
  67. 67.
    Coimbra CE, Santos RV. Ethics and biomedical research in Amerindian societies in Brazil. Cad Saude Publica 1996; 12: 417–22PubMedGoogle Scholar
  68. 68.
    Kaufert J, Commanda L, Elias B, et al. Evolving participation of aboriginal communities in health research ethics review: the impact of the Inuvik workshop. Int J Circumpolar Health 1999; 58: 134–44PubMedGoogle Scholar
  69. 69.
    Macaulay AC, Delormier T, McComber AM, et al. Participatory research with native community of Kahnawake creates innovative Code of Research Ethics. Can J Public Health 1998; 89: 105–8PubMedGoogle Scholar
  70. 70.
    Macaulay AC, Cross EJ, Delormier T, et al. Developing a Code of Research Ethics for research with a Native community in Canada; a report from the Kahnawake Schools Diabetes Prevention Project. Int J Circumpolar Health 1998; 57 Suppl. 1: 38–40PubMedGoogle Scholar
  71. 71.
    Karlawish JH, Hougham GW, Stocking CB, et al. What is the quality of the reporting of research ethics in publications of nursing home research? J Am Geriatr Soc 1999; 47: 76–81PubMedGoogle Scholar
  72. 72.
    Erlen JA, Sauder RJ,MellorsMP. Incentives in research: ethical issues. Orthop Nurs 1999; 18: 84–7PubMedGoogle Scholar
  73. 73.
    Guest S. Compensation for subjects of medical research: the moral rights of patients and the power of research ethics committees. J Med Ethics 1997; 23: 181–5PubMedCrossRefGoogle Scholar
  74. 74.
    Joseph KS. Ethics in clinical research: searching for absolutes. Can Med Assoc J 1998; 158: 1303–5Google Scholar
  75. 75.
    Singer PA, Benetar SR. Beyond Helsinki: a vision for global health ethics. Improved ethical behaviour depends on strengthening capacity. BMJ 2001; 322: 747–8PubMedCrossRefGoogle Scholar
  76. 76.
    Freedman B. Equipoise and the ethics of clinical research. N Engl J Med 1987; 317: 141–5PubMedCrossRefGoogle Scholar
  77. 77.
    Bouchard C, Shephard RJ, Stephens T. Physical activity, fitness and health. Champaign (IL): Human Kinetics Publishers, 1994Google Scholar
  78. 78.
    Rechnitzer P, Sangal S, Cunningham D, et al. Acontrolled prospective study of the effect of endurance training on the recurrence rate of myocardial infarction. Am J Epidemiol 1975; 102: 358–65PubMedGoogle Scholar
  79. 79.
    Shephard RJ, Rode A. The health consequences of ’modernization’. London: Cambridge University Press, 1996CrossRefGoogle Scholar
  80. 80.
    Benatar SR, Singer PA. A new look at international research ethics. BMJ 2000; 321: 824–6PubMedCrossRefGoogle Scholar
  81. 81.
    McKneally MF, Dickens BM, Meslin EM, et al. Bioethics for clinicians: 13. Resource allocation. Can Med Assoc J 1997; 157: 163–7Google Scholar
  82. 82.
    Williams JR. Ethics and human rights in South African medicine. Can Med Assoc J 2000; 162: 1167–70Google Scholar
  83. 83.
    Lansang MA, Crawley FP. The ethics of international biomedical research. BMJ 2000; 321: 777–8PubMedCrossRefGoogle Scholar
  84. 84.
    Lee K, Mills A. Strengthening governance for global health research. BMJ 2000; 321: 775–6PubMedCrossRefGoogle Scholar
  85. 85.
    Wise P, Drury M. Pharmaceutical trials in general practice: the first 100 protocols. An audit by the clinical research ethics committee of the Royal College of General Practitioners. BMJ 1996; 313: 1245–8PubMedCrossRefGoogle Scholar
  86. 86.
    Anonymous. Uniform requirements for manuscripts submitted to biomedical journals. International Committee of Medical Journal Editors. Med Educ 1999; 33: 66–78CrossRefGoogle Scholar
  87. 87.
    Amdur RJ, Biddle C. Institutional review board approval and publication of human research results. JAMA 1997; 277: 909–14PubMedCrossRefGoogle Scholar
  88. 88.
    Malone RE. Ethical issues in publication of research. J Emerg Nurs 1998; 24: 281–3PubMedCrossRefGoogle Scholar
  89. 89.
    Angell M. Fraud in science. Science 1983; 219: 418–9CrossRefGoogle Scholar
  90. 90.
    Association of American Universities. Framework for institutional policies and procedures to deal with fraud in research. Washington, DC: Association of American Universities, 1988Google Scholar
  91. 91.
    Broad W, Wade N. Betrayers of Truth. New York (NY): Simon and Schuster, 1982Google Scholar
  92. 92.
    Lock S. Misconduct in research: does it exist in Britain? BMJ 1988; 297: 531–5Google Scholar
  93. 93.
    Royal College of Physicians of London. Report of the working party on fraud and misconduct in medical research: causes, investigation and prevention. J R Coll Physicians Lond 1991; 25: 89–94Google Scholar
  94. 94.
    Korenman SG, Berk R, Wenger NS, et al. Evaluation of the research norms of scientists and administrators responsible for academic research. JAMA 1998; 279: 41–7PubMedCrossRefGoogle Scholar
  95. 95.
    Evans I. Dealing with research misconduct in the United Kingdom. Conduct unbecoming: the MRC’s approach. BMJ 1998; 316: 1726–33CrossRefGoogle Scholar
  96. 96.
    Marco CA, Larkin GL. Research ethics: ethical issues of data reporting and the quest for authenticity. Acad Emerg Med 2000; 7: 691–4PubMedCrossRefGoogle Scholar
  97. 97.
    International Committee of Medical Editors. Statement on project-specific industry support for research. Can Med Assoc J 1998; 158: 615–6Google Scholar
  98. 98.
    Carnall D. Doctor struck off for scientific fraud. BMJ 1996; 312: 400PubMedCrossRefGoogle Scholar
  99. 99.
    Lock S, Wells F. Fraud and misconduct in medical research. London: BMJ Publishing Group, 1996Google Scholar
  100. 100.
    Chantler C. Dealing with research misconduct in the United Kingdom. Deception: difficulties and initiatives. BMJ 1998; 316: 1726–33CrossRefGoogle Scholar
  101. 101.
    Merton RK. A note on science and democracy. J Leg Polit Sociol 1942; 1: 115–26Google Scholar
  102. 102.
    Cohen J. Share and share alike isn’t always the rule in science. Science 1995; 268: 1715–8PubMedCrossRefGoogle Scholar
  103. 103.
    Rennie D. Dealing with research misconduct in the United Kingdom: an American perspective on research integrity. BMJ 1998; 316: 1726–33PubMedCrossRefGoogle Scholar
  104. 104.
    Riis P. Dealing with research misconduct in the United Kingdom. BMJ 1998; 316: 1726–33CrossRefGoogle Scholar
  105. 105.
    Altman DG. Systematic reviews of evaluations of prognostic variables. BMJ 2001; 323: 224–8PubMedCrossRefGoogle Scholar
  106. 106.
    Deeks J. Systematic reviews of evaluations of diagnostic and screening tests. BMJ 2001; 323: 157–62PubMedCrossRefGoogle Scholar
  107. 107.
    Stern JM. Publication bias: evidence of delayed publication in a cohort study of clinical projects. BMJ 1997; 315: 640–5PubMedCrossRefGoogle Scholar
  108. 108.
    Van Camp SP, Bloor CM, Mueller FO, et al. Non-traumatic sports deaths in high-school and college athletes. Med Sci Sports Exerc 1995; 27: 641–7PubMedGoogle Scholar
  109. 109.
    Maron BJ. Hypertrophic cardiomyopathy in athletes: catching a killer. Physician Sportsmed 1993; 21 (9): 83–91Google Scholar
  110. 110.
    Sibbald B. All conflicts of interest are not created equal [letter]. Can Med Assoc J 1999; 160: 1866Google Scholar
  111. 111.
    Phillips RA, Hoey J. Constraints of interest: lessons at the Hospital for Sick Children. Can Med Assoc J 1998; 159: 955–7Google Scholar
  112. 112.
    Shuchman M. Independent review adds to controversy at Sick Kids. Can Med Assoc J 1999; 160: 386–8Google Scholar
  113. 113.
    Lexchin J. Secrecy and the Health Protection Branch. Can Med Assoc J 1998; 159: 481–3Google Scholar
  114. 114.
    Silversides A. Private sector becoming the key to research funding in Canada. Can Med Assoc J 1998; 159: 397–8Google Scholar
  115. 115.
    Hole OP, Winther FO, Straume B. Clinical research: the influence of the pharmaceutical industry. Eur J Clin Pharamacol 2001; 56: 851–3CrossRefGoogle Scholar
  116. 116.
    Smith R. Why journals should not publish articles funded by the tobacco industry. BMJ 2000; 321: 1075–6Google Scholar
  117. 117.
    King J. Why journals should not publish articles funded by the tobacco industry. BMJ 2000; 321: 1074–5PubMedCrossRefGoogle Scholar
  118. 118.
    Lemmens T, Singer PA. Bioethics for clinicians: 17. Conflict of interest in research, education and patient care. Can Med Assoc J 1998; 159: 960–5Google Scholar
  119. 119.
    Little M. Research, ethics, and conflict of interest. J Med Ethics 1999; 25: 259–62PubMedCrossRefGoogle Scholar
  120. 120.
    NEJM’s new editor cut ties with 20 drug companies before taking helm. Can Med Assoc J 2000; 163: 1182Google Scholar
  121. 121.
    Lynoe N. Medical ethics — an endeavour for social medicine? Scand J Soc Med 1997; 25: 225–8PubMedGoogle Scholar
  122. 122.
    Kopelman LM. Bioethics and humanities: what makes us one field? J Med Philos 1998; 23: 356–68PubMedCrossRefGoogle Scholar
  123. 123.
    Teaching medical ethics. BMJ 2000; 316: 1623Google Scholar
  124. 124.
    Royal College of Physicians and Surgeons of Canada. Bioethics curricula [online]. Available from URL: [Accessed 2002 Jan 21]

Copyright information

© Adis International Limited 2002

Authors and Affiliations

  1. 1.Faculty of Physical Education and Health, and Department of Public Health Sciences, Faculty of MedicineUniversity of TorontoBrackendaleCanada

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