What is the primary ethical error in an e‑research study of a gastritis patient receiving two different non‑steroidal anti‑inflammatory drugs (NSAIDs) with participation via an online interview?

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Primary Ethical Error in Online NSAID Research

The primary ethical error in this e-research study is the inability to properly monitor and verify the informed consent process (Option C), which represents a fundamental breach of research ethics principles in online health research. 1, 2

Why Informed Consent Monitoring is the Critical Issue

The online interview format creates insurmountable barriers to ensuring valid informed consent:

  • Only 0.8% (1 out of 119) of online health studies actually sought informed consent from participants, demonstrating widespread failure in this fundamental ethical requirement 3, 1

  • The online format makes it impossible to verify participant identity, comprehension of risks, or voluntary participation - all essential elements of valid informed consent 1

  • 73.9% of online health studies made no mention of ethical considerations, and only 12.6% sought IRB review, highlighting systematic neglect of consent processes in e-research 3, 2

Why Other Options Are Secondary Concerns

Privacy (Option A) - Important but Manageable

  • While 27.7% of online health studies contained identifying information, privacy can be technically protected through anonymization and data security measures 3, 1
  • Privacy concerns exist but are secondary to the fundamental consent violation 1

Information Accuracy (Option B) - Methodological, Not Ethical

  • Data collection accuracy is a methodological consideration rather than a primary ethical violation 2
  • While online interviews may have limitations, this doesn't constitute an ethical error per se 2

Participant Withdrawal (Option D) - Technically Feasible

  • Participants can exit online interviews at any time by closing their browser or disconnecting 3
  • This is actually easier in online formats than in-person settings 3

The Consent Crisis in E-Research

Researchers often incorrectly assume online platforms constitute "public space" and therefore don't require traditional consent processes - this is ethically problematic, especially when studying vulnerable populations like gastritis patients 3, 1, 2

Specific Consent Failures in Online Research:

  • Cannot verify participant comprehension of study risks, particularly relevant for gastritis patients being exposed to different NSAIDs 1, 4
  • Cannot ensure voluntary participation without coercion or undue influence 1
  • Cannot confirm participant capacity to provide informed consent 1, 4
  • Cannot monitor for concerning symptoms during data collection, critical when studying NSAID effects in gastritis patients 2

Critical Pitfall for This Study

For gastritis patients comparing two NSAIDs, the inability to monitor informed consent is particularly dangerous because:

  • Patients may not fully understand the risks of NSAID-induced gastric damage 5, 6
  • There's no way to verify they comprehend potential complications like erosions, ulcers, or hemorrhagic events 2, 6
  • No mechanism exists to ensure patients know they can withdraw if symptoms worsen 2

The correct answer is C: Informed consent cannot be monitored.

References

Guideline

Ethical Considerations in Online Health Research

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Ethical Considerations in E-Research on NSAID Gastric Symptoms

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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