Connect
MJA
MJA

Double standards in clinical practice ethics

Ian A Harris and Justine M Naylor
Med J Aust 2014; 200 (2): . || doi: 10.5694/mja13.10452
Published online: 3 February 2014

Is the researcher held to a higher standard than the clinician?

Human research ethics committees (HRECs) are now firmly entrenched in the research environment. Clinical research, including quality improvement activities, can only be performed and published with HREC approval. Clinical practice, however, is not subject to such approval, yet the risk of harm (to the individual and to society) from clinical practice may be considerable.1 Are researchers being held to a higher standard than clinicians? Has our concentration on ethical standards for clinical research led to an ethical blind spot for clinical practice?


  • Orthopaedic Department, South Western Sydney Clinical School, Liverpool, NSW.


Correspondence: ianharris@unsw.edu.au

Competing interests:

No relevant disclosures.

  • 1. Kilo CM, Larson EB. Exploring the harmful effects of health care. JAMA 2009; 302: 89-91.
  • 2. Moon MR, Khin-Maung-Gyi F. The history and role of institutional review boards. Virtual Mentor 2009; 11: 311-321.
  • 3. Schenker Y, Wang F, Selig SJ, et al. The impact of language barriers on documentation of informed consent at a hospital with on-site interpreter services. J Gen Intern Med 2007; 22 Suppl 2: 294-299.
  • 4. Reitsma AM, Moreno JD. Ethical regulations for innovative surgery: the last frontier? J Am Coll Surg 2002; 194: 792-801.
  • 5. Spaans AJ, van Hout JA, Bolder SB. High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach. Acta Orthop 2012; 83: 342-346.
  • 6. Taylor R, Giles J. Cash interests taint drug advice. Nature 2005; 437: 1070-1071.
  • 7. Appelbaum PS. Clarifying the ethics of clinical research: a path toward avoiding the therapeutic misconception. Am J Bioeth 2002; 2: 22-23.
  • 8. Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical? JAMA 2000; 283: 2701-2711.
  • 9. Agich GJ. Ethics and innovation in medicine. J Med Ethics 2001; 27: 295-296.
  • 10. Wilson CB. Adoption of new surgical technology. BMJ 2006; 332: 112-114.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.