The origins of research ethics can be traced back to horrifying incidents during the Third Reich, where Nazi doctors conducted inhumane experiments on concentration camp prisoners, including killing twins to study eye color differences and forcing prisoners of war to drink seawater (Bahrami & Langeroudi, 2023). Similar unethical experiments occurred globally, such as a South African oncologist administering excessive chemotherapy without consent, New Zealand women with cervical cancer denied standard treatment, and US prisoners subjected to dangerous studies (Tootee et al., 2023). These incidents underline the necessity of ethical guidelines in research. In a recent South African trial, researchers even used a placebo control instead of the best-proven therapeutic method, highlighting ongoing ethical challenges in research. The foundation of research ethics, therefore, can be traced back to troubling historical incidents, such as the experiments conducted by the Nazis and unethical trials that took place globally. These cases highlight the vital significance of ethical guidelines in safeguarding the well-being of research participants and maintaining ethical standards in research procedures (Sabermahani et al., 2023).

The ethical and professional standards within epidemiology and public health have been delineated through guidelines developed by various organizations. These guidelines encompass responsibilities to research participants, society, employers, and colleagues, shedding light on obligations concerning environmental hazards and impacted communities (Sabermahani et al., 2023). For instance, ethics guidelines by the Industrial Epidemiology Forum, the International Society for Environmental Epidemiology, and the American College of Epidemiology outline essential duties, values, and virtues in epidemiology (Paiva et al., 2024). They emphasize the need for risk minimization, participant welfare protection, equitable distribution of benefits and risks, confidentiality, informed consent, ethical review, conflict resolution, and community obligations.

The genesis of international ethical standards in medical research traces back to pivotal historical events. Following the atrocities committed during World War II, the Nuremberg Code (1947) established ten principles emphasizing voluntary consent for research involving human subjects. The Universal Declaration of Human Rights (1948) reiterated the prohibition of cruel treatment and explicitly outlined the need for consent in medical experimentation (Noroozi et al., 2022). Subsequent human rights instruments, including protections for women and children, reinforced the ethical principles underpinning international research guidelines. Notably, the World Medical Association's Declaration of Helsinki (1964), evolving over time and most recently revised in 2008, is a fundamental international document shaping research ethics (Ghotbi, 2020). Furthermore, various international organizations have issued ethical guidance on clinical trials, including directives from the World Health Organization (WHO), the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH), the Joint United Nations Programme on HIV/AIDS, the Council of Ministers of the European Union, and the Council of Europe. These regulations and protocols aim to ensure ethical standards in biomedical research and clinical trials, echoing the evolving landscape of ethical practices in research involving human participants (Asar & Aziman, 2023).

Mohamed, Shitindo, & Gasch contend that the Nuremberg Code emphasized the importance of informed voluntary consent, the freedom to withdraw from research, protection from physical and mental harm, and a careful consideration of the risk - benefit balance (Mezzich et al., 2023). The Helsinki Declaration of 1964 underscored the necessity of non- therapeutic research and prioritized the protection of subjects by emphasizing that individual well-being takes precedence over scientific or societal needs. While more declarations on research ethics emerged, these guidelines primarily targeted physicians and did not directly address research in developing countries (Zia et al., 2024).

The Council for International Organization of Medical Sciences (CIOMS) eventually tackled these issues in collaboration with the World Health Organization (WHO) and proposed guidelines for international research (Baharuddin, 2023). These guidelines were later amended in 1993 and are currently undergoing further revisions. While these guidelines are not legally binding on nation-states, they hold moral authority and significantly influence research policy, particularly in the developing world. Africa, in particular, has not been exempt from instances of unethical research, with numerous reports documenting such abuses, including unethical experimentation and clinical trials. For example, in the 1990s, studies were conducted on 500 patients in Zimbabwe, the majority of whom were indigenous Africans, using new drugs and anesthesia without approval from the National Drugs Authority and without the patients' knowledge, resulting in up to six deaths (Eltaybani et al., 2020). Another study testing the efficacy of breast cancer chemotherapy on South African women was conducted without research ethics approval or individual informed consent.

Hoeyer, Dahlager & Lynöe argue that there has been a significant shift in the medical ethos due to the increased emphasis on protection. Initially, the primary goal was to do good (beneficence), but the introduction of research introduced a need to balance the interests of various stakeholders, including current and future patients, researchers, and research subjects (Sona, 2021). The Tuskegee syphilis study in 1972 and the subsequent Belmont report highlighted the importance of non-maleficence, emphasizing the principle of doing no harm. This shift has sometimes been seen as a hindrance to research, leading to complex and occasionally questionable rules regarding informed consent and approval procedures. However, most medical researchers are committed to safeguarding the rights of research participants, with informed consent being a central aspect of these efforts, even in cases where the initial concern may not directly relate to assessing risks to an individual's body, such a s in biobank based research (Hamdani, 2024).

Throughout history, human interaction, including research involving people, inherently carries ethical considerations. Yet, ethical conduct encompasses more than mere adherence to rules; it involves a deeper respect and care for others. This National Statement on ethical conduct in human research emphasizes a fundamental ethos guiding how research is approached, extending beyond ethical guidelines to shape researchers' overall approach to their work. While much human research contributes positively and safely to society, there are instances where risks and ethical issues arise, whether due to oversight, technical errors, or, in extreme cases, deliberate ethical violations, notably exemplified by World War II experiments (Wahab, 2024). The involvement of individuals in research raises crucial ethical questions, particularly regarding trust between participants and researchers and the altruistic contribution of participants for the greater good. Ethical reflections on medical research trace back to ancient times, gaining momentum after World War II, highlighted by the Nuremberg Code and subsequent international human rights instruments. This period also saw the development of comprehensive ethical guidelines, such as the Helsinki Declaration, acknowledging the need for ethical conduct in research practices across diverse fields (Noohi et al., 2022).

The expanded scope and authority of the National Statement on research ethics underscore the critical need for comprehensive guidelines that balance flexibility with participant protection (Ed-dafali et al., 2024). Rooted in the lessons from tragic instances like the Tuskegee syphilis study, these guidelines prioritize the principles of non-maleficence and "do no harm." While they might pose challenges to research endeavors, these principles serve as crucial safeguards, ensuring the rights and safety of individuals involved in studies. The National Statement stands as a testament to the imperative of ethical considerations in evolving research landscapes, striving to prevent past injustices and mitigate potential harm in future investigations.

The concept of Institutional Review Boards (IRBs) as we know them today originated in the 1970s. It is now mandatory for all proposals involving human participants in biomedical research to undergo review and approval by an appropriately constituted institutional ethical review board, which may also be referred to as an institutional ethics committee (IEC), ethics review board (ERB), or Research Ethics Board (REB) in different countries (Al-Delaimy, 2022). Two fundamental characteristics of these boards are competence and independence. The responsibilities of an IRB include safeguarding the dignity, rights, and well-being of potential research participants, ensuring that universal ethical principles and international scientific standards are adapted to local values and customs, and assisting in the development and education of a research community that is responsive to local healthcare needs (Yazdi-Feyzabadi & Bashzar, 2023). These boards are responsible for reviewing research proposals before the projects commence and also for monitoring approved research projects to ensure ongoing compliance with ethical standards. The actions taken by an IRB can include approval without conditions, approval with conditions, rejection of a proposal, or the termination of an ongoing investigation in cases of noncompliance (Soleimani et al., 2024).

The purpose of Institutional Review Boards (IRBs) or Research Ethics Committees (RECs) is to ensure that research involving human participants upholds ethical standards and safeguards participants' rights and well-being. They assess the balance of risks and benefits, equitable participant selection, and the adequacy of informed consent procedures. These committees aim to prevent unethical research, primarily by conducting ethical reviews and providing opinions on research proposals (Fanara, 2021). The historical context, such as the Tuskegee study, led to the development of bio-ethical principles and the establishment of IRBs to oversee research ethics. Approaches to research ethics include emphasizing valid consent (autonomy), ensuring participant safety (duty of care), and weighing foreseeable consequences (consequentialism) (Khan et al., 2022).

For research proposals involving human participants, a scientific evaluation by an appropriate Scientific Review Committee typically precedes the ethical review process. The IRB secretariat reviews the research proposal for completeness and based on the level of risk involved, categorizes it into three types: exemption from review, expedited review, and full review (Obeidat & Komesaroff, 2021). Proposals with less than minimal risk may qualify for exemption from review and can be administratively reviewed without the need for full board review. Proposals presenting no more than minimal risk to participants may undergo expedited review, usually by a sub-committee. Research involving more than minimal risk, those that don't qualify for exemption or expedited review, and studies involving vulnerable populations or special groups are subject to full review by all members of the IRB. Research intended for publication is typically reviewed by the institutional review board (Ngatindriatun et al., 2024).

It is crucial to recognize that the ethical guidelines and principles discussed are not just historical relics but continue to shape contemporary research practices. The efforts to protect the rights of research participants and uphold the values of informed voluntary consent, freedom to withdraw from research, and the careful consideration of risk-benefit balances remain central in the ethical conduct of research.

Bioethics is an area of ethical inquiry that examines ethical dilemmas and issues arising from healthcare, health- related practices, and research involving humans. In a broader historical context, scholars have recently made significant progress in connecting the emergence of the bioethics movement to the secularization of society in liberal democracies during the late 20th century (Radzi et al., 2020). Bioethics provided an attractive alternative for governments in increasingly pluralistic societies as traditional sources of authority, such as religious traditions, waned. Bioethics offered a set of 'thin' moral principles (autonomy, beneficence, justice) that could easily be translated into liberal policies and regulations focused on patient rights (Kazemi et al., 2021). Thus, bioethics thrived because it met the needs of the bureaucratic state in a secularizing political climate, providing a way to reason about complex moral and technical questions. Research Ethics Committees (RECs) can be seen as a method for "reasoning together" about medicine and science, placing democratic constraints on medical research while legitimizing its conduct.

The bioethics movement has emerged as a crucial framework for navigating the intricate terrain of healthcare, medical practices, and research involving humans (Özdalga & P.U.L.P.I.T., 2022). Its historical roots, intertwined with the changing dynamics of society, reflect the need for a secular and adaptable ethical foundation in our increasingly diverse and complex world. By prioritizing values such as autonomy, beneficence, and justice, bioethics has not only influenced policies and regulations but also served as a means for democratic deliberation on matters of medicine and science (Yusuf & Oreagba, 2021).

The ethical principles established in various instruments and guidelines governing biomedical research are designed to safeguard the dignity, rights, safety, and wellbeing of research participants. The independent evaluation of the scientific merit of a research project and an ethical review are central to upholding these principles (Ellethy & Ajouaou, 2022). The enduring relevance of bioethics lies in its unwavering commitment to safeguarding the dignity, rights, safety, and well-being of those who participate in biomedical research. The ethical principles embedded in institutional guidelines ensure that the pursuit of knowledge and advancements in healthcare remain grounded in respect and responsibility.

Understanding what constitutes ethical research is crucial for all researchers and individuals who engage with research outcomes. Researchers should possess a solid grasp of fundamental ethical principles and stay updated on policies and procedures aimed at safeguarding research participants and ensuring the integrity of research (Rubbab et al., 2024). Ignorance of these policies cannot excuse ethically questionable projects. Thus, it is the responsibility of researchers to proactively seek and comprehend the policies and theories that promote ethical research practices. Research is a public trust that demands ethical conduct, trustworthiness, and social responsibility for its findings to be valuable (Walusimbi & Abdulrahman, 2024). Every aspect of a research project, from its design to the submission of results for peer review, must adhere to ethical standards. When even one aspect of a research project is dubious or unethical, it can cast doubt on the entire project's integrity. Ethical research is the cornerstone of trust in the scientific community. Researchers must be well-versed in ethical principles, stay updated on relevant policies, and actively seek to promote ethical research practices. Any lapse in ethical standards, even in one aspect of a research project, can jeopardize its entire credibility (Mollaei et al., 2021).

Given the crucial role of ethics in research, it is not surprising that numerous professional associations, government agencies, and universities have established specific codes, regulations, and policies related to research ethics. Many government agencies, including the National Institutes of Health (NIH), the National Science Foundation (NSF), the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA), and the US Department of Agriculture (USDA), have ethics rules governing funded research (Ramli, 2022). Other influential research ethics policies include the Singapore Statement on Research Integrity, the American Chemical Society's Code of Ethics, the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct, and the Nuremberg Code and the World Medical Association's Declaration of Helsinki, among others (Ayed & Hassen, 2024).

Certainly, a global harmonization of ethical standards in research is imperative. Researchers bear the responsibility of upholding ethical principles, staying informed about policies, and ensuring the integrity of their work. With numerous organizations and international guidelines in place, the commitment to ethical research practices remains vital for the credibility and trustworthiness of the entire research community (Smolo et al., 2023).

The Islamic-based research methodology emphasizes the Islamic tradition of seeking knowledge, pondering, and conducting research (Fitriyana & Merida, 2023). Rooted in Islamic law and principles, this methodology aims to uncover essential truths and propose solutions to contemporary issues, particularly in the social sciences. Despite the prevalence of Western research methods, some Islamic scholars advocate for the Islamization of research to align with Islamic epistemology and philosophy (Prabamurti & Widjanarko, 2019).

Defined as a research method integrating theology, reasoning, narration, and observed knowledge, Islamic-based research places Islamic principles at its core (Adib-Hajbaghery et al., 2017). This approach has gained prominence, exploring various aspects of life from an Islamic perspective, including economy, social issues, and management. The surge in Islamic- based research is attributed to historical events like the Iranian revolution, the 2001 World Trade Centre bombing, and the Arab Spring. While Islam historically encouraged research during the golden ages, the decline in research culture occurred after the fall of Muslim leadership in Baghdad and Spain (Yadegary et al., 2017). However, the Qur'an contains explicit instructions urging Muslims to engage in research, encouraging the study of historical facts and the use of common sense and experimentation (Hassan et al., 2021).

The Islamic research methodology challenges the positivist paradigm's emphasis on empirical evidence, highlighting the Qur'an's focus on the spiritual faculty known as al-fu͛ ad (Ghotbi, 2020). The Qur'an motivates the study of both physical and social phenomena, guiding believers to recognize the truth in various regions of the earth and within themselves. This encouragement is evident in verses emphasizing signs on earth and within souls. In contemporary times, research in Islam extends beyond traditional subjects to explore Islam's influence on education, religion, politics, and economics. Many universities in Muslim-majority areas include the study of Islam as part of modern scholarship, promoting a comprehensive understanding of Islamic knowledge.

Al-Qur’an inspires human beings to study both physical and social phenomena. Allah said in the Qur’an, “We will show them Our signs In the universe, and in their own selves, until it becomes manifest to them that This (the Qur'an) is the truth. is it not Sufficient In regard to Your Lord that He is a witness over All things”.

The Qur'an motivates the study of both physical and social phenomena, urging humanity to recognize the truth in various regions of the earth and within themselves. "Afaq" pertains to physical sciences, while "anfus/nafs" relates to social sciences. This encouragement is reiterated in verses emphasizing signs on earth and within souls. Same encouragement can equally be found in many Qur’anic verses, where Almighty Allah Says: On the earth are signs for those of assured faith. As also in your own souls/selves, will you not then see?.

Islamic ethics serve as a guiding light for researchers, emphasizing sincerity, integrity, and adherence to Islamic principles throughout the research process. With a foundation rooted in Qur’anic teachings, Islamic research ethics stress the importance of transparency, honesty, and respect for human dignity (Zia et al., 2024). As Islamic bioethics and research methodologies continue to evolve in order to uphold the sanctity of human life and prioritize ethical conduct in all endeavors.

Ethics in Islam are rooted in good principles and values derived from Islamic sources, guiding human behavior across all aspects of life. In Islam, ethical conduct is closely tied to faith (Iman), wherein strong faith correlates with virtuous character. The Prophet Muhammad (peace be upon him) emphasized the connection between faith and ethics, highlighting the importance of treating others with kindness and avoiding harm through words and actions (Khan et al., 2022).

Islamic ethics extend to various domains, including research, where researchers are encouraged to conduct their work with sincerity and integrity, aligning their intentions with the teachings of Islam. Upholding ethical standards in research involves respecting respondents, ensuring confidentiality, and maintaining honesty throughout the research process. Islamic researchers are advised to prioritize the purpose of research for the sake of Allah (SWT) and adhere to transparent and unbiased practices (Yusuf & Oreagba, 2021).

While Islam provides general ethical guidelines, specific codes of ethics for Islamic research are still developing. Some Western research ethics codes may be adopted as long as they align with Islamic principles. The teaching of Islam encompasses all areas of human activity, with Shari’ah serving as the guiding legal framework (Smolo et al., 2023). Shari’ah sources, including the Qur’an, Sunnah, consensus, analogy, and secondary sources, provide flexibility to adapt to different contexts while upholding core principles such as protecting religion, life, lineage, health, and property.

In dealing with ethical dilemmas, Islam emphasizes prioritizing benefits while minimizing harm, ensuring that actions align with overarching ethical goals. This comprehensive ethical framework reveals Islam's relevance in navigating contemporary challenges, including those encountered in research and medical practice.

Islam offers a comprehensive framework of overarching principles applicable to address life's challenges. The initial principle assesses if an action aligns with fundamental laws' underlying principles. These encompass safeguarding religion, preserving life, honoring ancestry, maintaining mental and physical well-being, and protecting property (Mihelič et al., 2022). The subsequent principle ensures that potential drawbacks don't compromise the fulfillment of benefits or interests.

In Islam, the sanctity of human life is paramount, and ethical principles derived from Qur’anic teachings shape health research practices. Qur’anic verses provide guidance on confidentiality, justice, and the preservation of life, informing ethical decision-making in healthcare and research. Islamic law offers a comprehensive moral framework, ensuring that ethical considerations are integral to medical practices and research endeavors.

In Islam, human life is regarded as a precious gift from God, and its sanctity is emphasized through Qur’anic verses. The Qur’an promotes the preservation of life and condemns the unjustified taking of it. This perspective has driven interest in Islamic bioethics, focusing on the imperative to save lives and adhere to Islamic law and ethics (Ghaly & al-Khatib, 2023). Islamic bioethics states that decisions and behaviors in health and research must align with Shari’ah (Islamic law) and ethical principles. Allah says in the Glorious Qur’an:

Because of that we ordained for the Children of Israel that if anyone killed a person not in retaliation of murder, or (and) to spread mischief in the land - it would be as if He killed All mankind, and if anyone saved a life, it would be as if He saved the life of All mankind, and indeed, there came to them Our Messengers with clear proofs, evidences, and signs, even Then after that many of them continued to exceed the limits (e.g. by doing oppression unjustly and exceeding beyond the limits set by Allah by committing the major sins) In the land!.

Research ethics in Islam is guided by Qur’anic verses that emphasize broad principles such as confidentiality, non-maleficence, and justice (Fitriyana & Merida, 2023). Verses highlight the importance of avoiding harm, maintaining justice, and standing firmly for fair dealing. Islam encourages believers to act justly in all aspects of life, including research, and to uphold moral and ethical principles as part of their faith (Hamdani, 2024). There are many verses on the broad guidelines for research ethics as relate to confidentiality, non-maleficence, justice, and others. The following are among them;

He (the father) said: "O My son! relate not Your vision to Your brothers, lest they arrange a plot against you. Verily! Shaitan (Satan) is to man an open enemy!.

Verily! Allah commands that You should render back the trusts to those, to whom they are due; and that when You judge between men, You judge with justice. Verily, how excellent is the teaching which He (Allah) gives You! Truly, Allah is ever All-Hearer, All-Seer.

O You who believe! stand out firmly for justice, as witnesses to Allah, even though it be against yourselves, or Your parents, or Your kin, be He rich or poor, Allah is a better protector to both (than you). so follow not the lusts (of Your hearts), lest You may avoid justice, and if You distort Your witness or refuse to give it, Verily, Allah is ever Well-Acquainted with what You do.

O You who believe! stand out firmly for Allah and be just witnesses and let not the enmity and Hatred of others make You avoid justice. be just: that is nearer to piety, and fear Allah. Verily, Allah is Well-Acquainted with what You do.

Say (O Muhammad): My Lord has commanded justice and (said) that You should face Him Only (i.e. Worship none but Allah and face the Qiblah, i.e. the Ka'bah at Makkah during prayers) In each and Every place of worship, in prayers (and not to face other false deities and idols), and invoke Him Only making Your Religion sincere to Him by not joining in Worship any partner to Him and with the intention that You are doing Your deeds for Allah's sake only. as He brought You (into being) In the beginning, so shall You be brought into being (on the Day of Resurrection) [in two groups, one as a blessed one (believers), and the other as a wretched one (disbelievers)].

Verily, Allah enjoins Al-Adl (i.e. justice and worshipping none but Allah alone - Islamic Monotheism) and Al-Ihsan [i.e. to be patient In performing Your duties to Allah, totally for Allah's sake and In accordance with the Sunnah (legal ways) of the Prophet In a perfect manner], and giving (help) to kith and kin (i.e. All that Allah has ordered You to give them e.g., wealth, visiting, looking after them, or any other kind of help, etc.): and forbids Al-Fahsha' (i.e. All evil deeds, e.g. illegal sexual acts, disobedience of parents, polytheism, to tell lies, to give false witness, to kill a life without right, etc.), and Al-Munkar (i.e. All that is prohibited by Islamic law: polytheism of Every kind, disbelief and Every kind of evil deeds, etc.), and Al-Baghy (i.e. All kinds of oppression), He admonishes you, that You may take heed.

Islamic law, encompassing a comprehensive system of morality, inherently provides a moral context in medicine. The flexibility of Muslim teachings allows adaptation to new situations, and ethical guidelines are seen as integral to Islamic law (Ghotbi, 2020). In Islam, ethical teachings are not a separate discipline but are integrated into the legal framework, with morality and ethics considered absolute and of divine origin. The fixed moral and legal principles within Islam are deemed broad enough to address the ethical needs of all times and places.

Moreover, the "Islamic code of medical and health ethics" established by the Regional Committee for the Eastern Mediterranean further emphasizes core principles rooted in Islamic values. These include the recognition of human dignity, the sanctity of life, equity in healthcare, excellence in care, and the obligation to avoid harm (Zia et al., 2024). The code reinforces the ethical obligation to provide high-quality healthcare, respecting individual rights and ensuring equal access to healthcare for all, without discrimination based on gender, race, or belief. This code reflects the enduring traditions within Islamic culture and serves as a guide for ethical medical practices.

The Islamic code of medical and health ethics, endorsed by the Regional Committee for the Eastern Mediterranean, reflects the core values of Islamic principles. It underscores the importance of human dignity, equity in healthcare, and the obligation to provide compassionate and high-quality care. Rooted in Islamic culture and tradition, this code serves as a beacon for ethical medical practices, promoting equal access to healthcare and prioritizing patient well-being.