Research in nursing homes. Ethical issues.

The growing need for care of elderly persons demands research in biomedical and clinical areas, as well as health services, social science, psychology, and ethics. There is a special urgency for research into the problems that affect persons needing long-term care, and for research into the structures and patterns of the delivery of long-term care. There are ethical issues in all aspects of human subjects experimentation, but the long-term care setting raises specific ethical issues related to the dependency of the subjects and to the fact of institutionalization. Special considerations about equity, informed consent, the meaning of special protections, and confidentiality are among those needing attention. Research into these ethical issues can serve to enable better research, not simply to act as a barrier to research. Understanding the conceptual and historical bases of the special problems in long-term care research will serve to further the understanding of how to improve long-term care.