Table 2.

Thematic categories and illustrative statements across cases.

	Illustrative Statements
Theme	Case 1	Case 2	Case 3
Beneficence Investigators should strive to do good and prevent harm. This principle can be achieved through (a) maximizing knowledge that will be useful to future vulnerable populations through scientifically valid methods or (b) maximizing the health and well-being of research participants and others, especially those that are vulnerable to harm.	“I don’t care if Dr. Jones is a researcher or not, but the thing is Terry could lose her kid and once ACS takes the kid it is gone. So she should try to help Terry.” “[Hiding the drug] would perpetuate a risky situation for the child without necessarily helping Terry.”	“Chris could die then [Dr. Alba] will never be able to live with that.” “Dr. Alba should tell Chris because that is only the right thing to do, He should make sure Chris doesn’t get sick too. That goes beyond the duties of a researcher’s promise to keep confidentiality in my opinion.”	“This would violate the integrity of the study and would not necessarily help the addicts since the medicine’s effects are yet unproven.” “Dr. Ross should make an exception every now and then because in this case [Mary] is not just breaking the rules, she is trying to help those people.”
Respect Investigators respect the rights of all individuals to self- determination by recognizing that participants (a) are responsible for the choices that they make, (b) have the right to knowledge that will affect their safety or health care decisions; or (c) have a right to privacy.	“If Terry was so concerned about her kid, she wouldn’t be doing drugs and hiding from the cops in the 1st place if you ask me.” “Terry needs to know better than to ask Dr. Jones. That is not Dr. Jones’s job.” “Because you’re grown and know what you’re doing. You know the consequences.”	“You gotta remember that John is a grown adult who can let Chris know if he wants. So no [Dr. Alba] should not tell Chris.” “If Chris had some sense, he would have done some homework of his own and found out for himself. It is not Dr. Alba’s job.” If your going to do something that will hurt people’s lives, confidentiality does not apply anymore.” “John has a right to his privacy.”
Justice Fairness requires that investigators (a) ensure that all persons have equal opportunity to share the benefits and burdens of research; (b) eliminate bias in subject selection or group assignment; or (c) use group assignment to make up for historic and current health disparities.			“Everyone should be treated the same which is why the guidelines were that way.” “By firing Mary Dr. Ross did the right thing because he is saying that he does not support preferential treatment.” “When you make exceptions like that you are not giving everyone an equal chance.”
Relationality As human beings, researchers and participants are in relationships that obligate investigators to: (a) obtain and maintain the trust of participants and (b) honor the reciprocity of relationships where both investigator and participant “get and give”.	“Just because she is a researcher doesn’t mean she stops being a friend” “How can you trust a researcher if the researcher is going around hiding drugs in their bags?” You gotta help the person that’s helping her get the data for her research.	“John trusted him with something personal, so he should not let him down I feel.” “Because when you agree to participate in a study, you trust the researcher with something very personal. So it is all about trust.”
Professional Obligations Researchers have responsibilities to participants and society defined by their training and membership in a profession. Investigators must (a) serve as a model of right conduct; (b) maintain professional- personal boundaries with participants; (c) preserve the good reputation of the profession; and (d) ensure the good conduct of other members of the profession.	“Dr. Jones should just do her job and not get involved in all of Terry’s stuff. That is just getting too personal with your subjects and to me that feels wrong somehow.” “[Dr. Jones] should set an example for Terry, not the other way around.” “If Dr. Jones gets busted then the research organization she works for ends up looking bad too.”	“All that is not Dr. Alba’s business if you ask me. He should just stay out of it and not get involved. Informing Chris is not his responsibility.”	“[Mary] should have checked with [Dr. Ross] first. How can she take the decision into her own hands like that? She deserves [to be fired].” “People need to know boundaries especially when it comes to work. Otherwise they do not learn. “This may not be that bad that she needed to be fired but if she gets away with it, next time another one of his staff will. So it is important to set examples.”
Rules Rules have intrinsic moral value and are important for preserving social order. Investigators’ are morally obligated to obey the law, adhere to informed consent agreements with participants, and follow research guidelines.	“You should obey the law…no matter what it is. It is what keeps society going”. “As a researcher [Dr. Jones] has a higher responsibility to obey the law at all times.” “As a human being [Dr. Jones] should help out Terry, but since she is at a job she should obey the law.”	“I don’t care, but if you promise me to keep my info safe, then you should not go back on it. It is a basic expectation you know” “As a professional researcher, Dr. Alba has a responsibility to both Chris and John. But still, because he promised John he should keep that end of his professional obligation.”	“Everybody should follow rules because otherwise there will be no order. So yes, [Mary] should be punished for that.” “Dr. Ross should have considered that Mary was trying to help, but since she did break the rules she should be fired I feel.”
Pragmatic Self-Interest The moral priority in a given situation is to maximize satisfaction of the researcher’s own needs and to minimize negative consequences to the self.	“I don’t think that [Dr. Jones] should break the law….that would end up with her in jail.” “Why am I [Dr. Jones] going to take something when I could go to jail? My family and everything I studied could do down the drain.”	“[Dr. Alba] has to follow the rules because he could lose his license”	“What if they, the people who gave him the money for the study come after Dr. Ross? So he is doing the right thing – he is protecting his job.” “If they find out, then it will look bad on Dr. Ross. He is the main researcher and he will be held accountable for Mary’s stupidity. So its good that he fired her.”