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Published on June 1, 2012 | http://doi.org/10.5867/medwave.2012.05.5424
Clinical ethics and biomedical research - is being attending physician and researcher compatible?
Ética clínica e investigación biomédica: compatibilidad entre ser médico tratante y ser investigador clínico
Research policies and strategies tend to encourage the participation of clinicians in biomedical research, either by referring their patients or directly recruiting them as research subjects. In order to analyze whether this simultaneous duplicity is ethical, the distinction between therapeutic and non-therapeutic studies must be upheld, also insisting that when patients become research subjects, they are entitled to full protection of both clinical and research ethical guidelines.
A number of authors suggest a universal obligation of participating in research that purportedly serves the common weal, medical progress and future patients. If voluntariness no longer exists, the distinction between attending physician and researcher is eroded.
Accepting that scientific knowledge is not valuable per se, since information gained serves corporate, individual and, possibly social ends, there is no ethical argument to impose research obligations on patients, unless expectations of direct medical benefits convince them to voluntarily consent. Physicians should not conduct research on their patients unless they are convinced that it is in their best medical interest, lest they neglect their primary duty of care, which is incompatible when wash-out periods, the use of placebos or sub-medication are required by the rigors of scientific method.